Hi, is there any research as to the optimum time people should be followed up by the hospital, after treatment for oesophageal cancer? There was an article in the newspaper this week that many cancers are not followed up in this country, for long enough. Thanks
Length of hospital follow up - Oesophageal & Gas...
Length of hospital follow up
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Hi, I had six monthly check ups until I was five years post op, but told if I had any problems or worries to call my clinician direct and not go thru my GP
REGARDS
Edwina
Today was my first follow up appointment with GI Surgeon after 2.5 months post hospital discharge (4 months post IL surgery).
Next will be in 4 months and thereafter 6 months.
Dr told me that they would not do any routine scans/tests etc and the follow up will mostly be just talk etc. Unless something is wrong.
On my personal note at this stage after Oesophagectomy I do not see any need of medical intervention from the GI team, but majorly getting back to "new normal" life. Unless offcourse something goes wrong.
I also popped in the ITU and spoke to couple of staffs in there, whom I don't remember from the ward (as I was in induced coma) and we all were delighted to catch up.
A common belief is that you're cured without a recurrence in 5 years of diagnosis of cancer- hence this being used as a general milestone for follow-up. I was followed for every three months for a year then 6 months up to 2 years - baseline CT scan at the start then bloods and physical exam at each appointment . After that I was told to come back if I had any problems and that 2-year follow-up was the current practice (though I'm not sure if that was a health board or national guideline at the time - probaly the former and I guess it would also depend on pathological results post-op). I've had reasons to visit the oncology outpatient clinic a couple of time after 2 years (now into 6th year post-op) and the process was quick and revealed no issues. In the clinical trial that was used as the model for surgery/chemo for patients with oesophageal (and gastric) adenocarcinoma in the UK, most recurrences occurred within 2 years following surgery , which is probably why the 2-year timeline may be used (at least for some).
If interested here's the original trial (ignore gastric as OC patients were also included)...
nejm.org/doi/full/10.1056/N...
David
Thanks for your replies
I saw my oncologist and consultant surgeon on a rotating basis every six months for two years, then called a halt, as I was making good progress and felt fine, with the proviso, like Edwina, that I could call them if I had any problems. To the best of my knowledge, it is no longer common practice to do regular scans, as the radiation itself is harmful. Unlike some other cancers, which have blood markers or other indicators, in the absence of any symptoms or scans, there is not much the doctors can do to monitor OG cancer.
There is a common trend now to tailor follow up checks according to the needs of the patient, so they tend to become less standardised, but for logical reasons. Some people get better value by going back to see a dietician, for instance, rather than a scan when there is no prospect of a recurrence of the cancer. It does all depend on how the patient regards these checks though.
I saw the surgeon about 6 weeks after my op and then meetings as and when I required them with a dietician and specialist nurse .These were about once a month for about 8 months .They were all at my instigation which didn't really suit me as I have a horror of "making a fuss " and wasting HP's time .
After that nothing, though obviously I can contact the Upper GI clinic if I have concerns .