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Most cancer survivors eventually return to the care of their primary physicians after treatment. Since your primary care doctor may know little of your cancer experience, it's crucial to develop an individualized, long-term follow-up plan with your cancer doctor before returning to a primary-care setting.

This plan should include:

  • The cancer diagnosis
  • The treatment (including, timing, dosage and duration)
  • Potential side effects of the cancer and treatment
  • Recommendations for frequency of follow-up visits
  • Types of tests to be performed during appointments
  • Tips for staying healthy and preventing recurrences or secondary cancers

Most official guidelines for follow-up care focus on the first five years of survival. The guidelines below for longer-term follow-up care are based on the educated opinions of cancer specialists. (As yet, there is no research formally proving that adhering to these guidelines will extend the lives of survivors.)

These guidelines suggest annual tests or procedures for long-term follow-up of specific cancers:

  • Medical history/physical exam
  • Complete blood count
  • Medical history/physical exam
  • Urine cytology (if cystectomy performed)
  • Cystoscopy (if no cystectomy)

For all breast cancer survivors:

  • Medical history/physical exam
  • Mammogram

For invasive breast cancer survivors on tamoxifen:

  • Pelvic exam
  • PAP smear

If treatment included chemotherapy:

  • Complete blood count
  • Liver function tests
  • Alkaline phosphatase test (for abnormal levels of the enzyme)
  • Bone health assessment
  • Medical history/physical exam
  • Pelvic exam
  • PAP test
  • Chest X-ray

Guidelines for long-term follow-up care are not available. Discuss your situation with your doctor.

  • Medical history/physical exam
  • Colonoscopy (if recommended by your physician)
  • Medical history/physical exam
  • Pelvic exam
  • CA-125 blood test (if levels are elevated)

Information on long-term follow-up care is not available. Discuss your situation with your doctor.

  • A head and neck medical history/physical exam

  • Chest X-ray

Optional annual tests:

  • Barium swallow

  • Liver function tests

  • Thyroid-stimulating hormone (TSH) and calcium tests (if treated with radiation)

Information on long-term follow-up care for survivors of Hodgkin's disease is not available at this time. Discuss your situation with your doctor.

For survivors of stages T1, T2, or T3 cancer:

  • Medical history/physical exam

For stage T4 survivors:

  • Medical history/physical exam
  • Chest X-ray
  • CT scan of the abdomen
  • Liver function tests
  • Alkaline phosphatase test

For survivors of small cell lung cancer (SCLC):

  • Medical history/physical exam
  • Chest X-ray
  • Lab tests

For survivors of non-small cell lung cancer (NSCLC) stages I and II:

  • Medical history/physical exam
  • Chest X-ray

For survivors of NSCLC stage III:

  • Medical history/physical exam
  • Chest X-ray
  • Lab tests
  • Medical history/physical exam
  • Chest X-ray
  • Urinalysis
  • Mammogram at 40, then annually (start at 30 if you've had radiation to the chest area)
  • Thyroid function tests (if radiation to upper body)
  • Adult vaccines as recommended by the Centers for Disease Control and Prevention, especially if the spleen was removed

For survivors of melanoma in situ:

  • Medical history/physical exam
  • Skin exam

For survivors of other skin cancers:

  • Medical history/physical exam
  • Thorough skin exam
  • Chest X-ray
  • Lab tests
  • Medical history/physical exam
  • Pelvic exam
  • CA-125 blood test (if levels are elevated)

For survivors of post-definitive therapy:

  • PSA test every six months

For survivors with a life expectancy more than 10 years:

  • PSA test every six months
  • Digital rectal exam (DRE) every six months
  • Consider annual transrectal ultrasound

For survivors of NxM1, TxN1, or post-androgen ablation:

  • Physical exam every three to six months
  • PSA test every three to six months
  • DRE every three to six months
  • Bone scan (if PSA levels elevated on two occasions)

For survivors of primary bone sarcoma (high grade):

  • Medical history/physical exam/
  • Chest X-ray
  • Lab work
  • Plain films of the primary site

For symptomatic patients with history of bone metastases:

  • Bone scan
  • CT scan of chest if X-ray results are unclear

For survivors of soft-tissue sarcomas:

  • Medical history/physical exam
  • Chest X-ray
  • CT scan of chest if the X-ray results are unclear
  • Lab tests
  • Medical history/physical exam
  • Serum T4
  • Thyroid stimulating hormone (TSH)
  • Chest X-ray
  • Additional imaging studies in selected cases