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Follow-up Appointments Post Treatment

lemonade
Posts: 62
Joined: Feb 2010

What is the protocal for follow-up appointments after the completion of surgery, chemo and radiation? I was diagnosed in July 2009 and I finished everything in October 2009. I had a pet scan in August 2009 after surgery, but before chemo and radiation. I had another pet scan in December 2009. Everything looks good at this point.

I just went to the doctor for a 3 month follow-up. He took some blood for lab work. What tests are your doctors recommending during the first year after diagnosis? From what I understand - some people are getting cat scans every 3 months. My son did this with testicular cancer in 2002 and I have a friend with ovarian cancer this year who gets a cat scan every 3 months. Is the anal cancer follow-up different? I live in Houston and have a lot of confidence in my doctors.

Barbara

z's picture
z
Posts: 1251
Joined: May 2009

Barbra,

I was diag. 4-23-09, completed treatment 6-30-09. I had a pet-ct prior to treatment on 5-18. I had a pet-ct, on 11-18, and am scheduled for a pet-ct 5-10. I have had numerous blood tests due to chemo. I have had a dr appt. every 3 months since treatment started. I have dres, and presently had a biopsy taken last Thursday. I have had 2 biopsys taken thus far. I am waiting for the most recent results by this Thursday. They will check me about every 3 months for the next several years. I believe I will have a pet-ct for the next several years annually. I hope I answered your question. I wish you well Lori

JDuke's picture
JDuke
Posts: 443
Joined: Nov 2009

oncologist visit every month including blood work for the first three months after treatment. PET 3 months after treatment completion. Followed by PET, sigmoidoscopy and biopsy every six months.

lizdeli's picture
lizdeli
Posts: 521
Joined: Jul 2009

Hi Barbara,
I finished treatment in September, first follow up in Dec, CT, proctoscopy, blood work, etc. Follow up every 3 months for proctocopy and blood work, CT scan every 6 months. Was told this would be protocol for the first two years. Were you treated at MD Anderson? You mentioned you were in Houston so I'm thinking you might have been. I was treated there.
Liz

mp327's picture
mp327
Posts: 2852
Joined: Jan 2010

Hi Barbara--

I have communicated with many people with anal cancer in the last 18 months and have found that follow-up protocol varies quite a lot. My staging PET was done just prior to the start of my treatment. After treatment ended, I had a PET a month later, a CT a couple of months after that, then have been getting PETs every 3 to 4 months since. My med onc intends to have me get one more PET in May, then they will probably only be done yearly from then on. As for visits to the colorectal doc, I am still going every 3 months. I see the rad onc every 6 months and the med onc after I have a scan.

Some people are only getting CT's for follow-up, while others get PET. Some of that depends on what their doc orders, some of it depends on what insurance approves.

If you want to know what the recommended guidelines are as per the National Comprehensive Cancer Network, go to their website at www.NCCN.org and register. Then go to diseases and find anal cancer, which will take you to lots of good information, including pages outlining the most up-to-date recommendations on the treatment and follow-up of anal cancer. It's presented in easy to understand format. I would recommend printing two copies, one for you and one to take to your doctor to discuss with him. I hope this info can answer some of your questions.

lemonade
Posts: 62
Joined: Feb 2010

Thank you everyone for your responses. Everyone is just great on this discussion board. And, no, I was treated in the Medical Center area in Houston, not M.D. Anderson. I went to Methodist Hospital for radiation and surgery. I can't speak highly enough about that hospital. Dr. Foote is my oncologist at Texas Oncology.

Barbara

SueRelays
Posts: 489
Joined: Dec 2009

Hi Barbara

I had anal exams YUCK!!! every 6 months. WhenI first finished treatment, I had one with my radiologist, and with my surgeon, and one with my onc. Can't get enough people putting their hands you know where GEESH!!!! I had a biopsy 3 months after treatment. Since then it has been every 6 months, and just the exam, and one anal scope. I always felt my follow up was a little light. I thought "can they really FEEL cancer? I know they were seeing if the tissue changed, but I always felt there should be more. Then this year I had mets to my liver......so even though I love my onc, I think I should have had CT or PET scans.
Wish you all the best!!!!

pjjenkins's picture
pjjenkins
Posts: 173
Joined: Mar 2009

I don't think there is a standard from looking at this. I also wonder about our various medical insurance coverage and how much it influences the particular kinds of tools being used and their frequency. I had a PET for staging. A PET about 3 months after treatment and an annual one last year. I am hoping for another this year for a couple of reasons but my medical oncologist left and I have a new guy. (This switching docs is a subject for another line of discussion, I think.)

Just before my first "annual", my doctor told me he wanted to do a PET but wasn't sure the insurer would allow it. I did get it last year but am not sure what I will have this year (due in May). I have not had any more CT scans since the Dec. one prior to dx.

I had monthly medical and radiology oncology appts. for the first 3 months. Then, after 6 months I had one with each and the radiology oncologist appt then went to annual. My medical oncologist has since the 6 month mark been every six months so far. I have had sigmoidoscopy exams every 3 months that in June will have become every 6 months. And then??

I have asked for digital exams because I developed a large hemorrhoid during/after treatment and I was told for more than a year that what turned out to be a tumor, was a hemorrhoid so I want them to really look at this ding dong hemorrhoid.

Interesting to find out how different follow up is compared to treatment which does seem to be standard!

msannstar's picture
msannstar
Posts: 7
Joined: Sep 2009

what mets to the liver mean?

mp327's picture
mp327
Posts: 2852
Joined: Jan 2010

Mets to the liver means that cancer from the primary tumor has spread to the liver. Mets is a shortened terms for metastasize, which means spread.

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