Completing treatment can be both stressful and exciting. You will be relieved to finish treatment, yet it is hard not to worry about cancer coming back. (When cancer returns, it is called recurrence.) This is a very common concern among those who have had cancer. For more information on this please refer to the American Cancer Society document, "Living With Uncertainty: The Fear of Cancer Recurrence."
It may take a while before your confidence in your own recovery begins to feel real and your fears are somewhat relieved. Even with no recurrences, people who have had cancer learn to live with uncertainty.
Follow-up Care
After treatment is completed, it is very important to go to all scheduled follow-up appointments. During these appointments, your doctors will ask questions about any symptoms, do physical exams, and order laboratory or imaging tests as needed to look for recurrences or side effects. Almost any cancer treatment can have side effects. Some may last for a few weeks to several months, but others can be permanent. You should never hesitate to tell your doctor or other members of your cancer care team about any symptoms or side effects that concern you.
At first, your follow-up appointments will probably be scheduled for every 4 to 6 months. The longer you have been free of cancer, the less often the appointments are needed. After 5 years, they are done once a year. You will need to continue to have yearly mammograms.
If you are taking tamoxifen, you should have yearly pelvic exams because this drug can increase your risk of uterine cancer. Be sure to tell your doctor right away about any abnormal vaginal bleeding you are having. Although excessive or irregular vaginal bleeding is usually caused by a non-cancerous condition, it may also be the first sign of uterine cancer.
If you are taking an aromatase inhibitor, you should consider testing your bone density.
Other tests such as blood tumor marker studies, blood tests of liver function, bone scans, and chest x-rays are not usually needed unless symptoms or physical exam findings suggest it is likely the cancer has recurred. These and other tests may be done as part of evaluating new treatments by clinical trials.
If initial exams and tests suggest a recurrence, a chest x-ray, CT scan, PET scan, MRI scan, bone scan, and/or a biopsy may be done. Your doctor may also measure the tumor marker CA-15-3, CA 27-29, or CEA with a blood test. The blood level of this substance goes up in some women if their cancer has spread to bones or other organs such as the liver. Depending on the location of a recurrent cancer, treatment may involve surgery, radiation therapy, hormone therapy, and/or chemotherapy.
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