| Ch 14 | Page 8 / 21 | |
| Cancer follow-up |
Follow-up protocols | |
The various examinations required for the surveillance of treated cancer patients should be coordinated within a coherent strategy depending on the therapeutic possibilities offered following early relapse or discovery of metastases.
Even if early relapse detection does not influence therapy or its results, certain patients need, for personal reasons, (for instance: professional responsibilities, family situations, social situations, personal philosophy) to be informed as soon as possible of a pejorative development of their cancer.
Follow-up of cancer patients should therefore be adapted after discussion with the patient. Besides the few situations discussed previously, there are cases for which strict monitoring fundamentally changes the evolution of the disease.
In most cases, since no clear scientific studies have ever demonstrated the
efficiency of follow-up strategy and frequency, expert consensus has established
more and less ‘ideal’ protocols, which attempt to conciliate the
scientific desire to better understand the disease and the desire to avoid multiple,
pointless, costly and unpleasant examinations of ‘cured’ patients.
In this state of mind, simple follow-up calendars have been proposed :
Follow-up of a patient operated for breast carcinoma
Follow-up of a patient treated for invasive cervix carcinoma
Follow-up of a patient operated for colon cancer
Follow-up of a patient treated for localised prostate carcinoma
Follow-up of a patient treated for testicular cancer
- Follow-up of a patient treated for ovarian carcinoma
Many other follow-up diagrams for other locations could be described.
Even the best follow-up schedule cannot, however, avoid the occurrence of relapses with clinical manifestations between two consultations or series of examinations. Such events are known as interval relapses
These relapses are neither easier nor more difficult to treat than systematically discovered relapses.
However, the existence of such interval relapses should lead the physician to be particularly cautious in his conclusions of each follow-up examination. Although the physician should remain positive, he/she should never speak in terms of cure but rather of persisting remission.
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