Completion of cancer treatment feels like a long battle won. Whatever the treatment modality you might have undergone for ovarian cancer, it is relieving physically and emotionally to know that you are at last through it.
Yes, now you can relax and focus on living a healthy life! However, this is not the time to let your guard down completely. You now need post-treatment follow ups to make sure that the side effects to the treatment are managed well and the signs and symptoms of recurrent disease, if any can be identified early.
To ensure this, you might want to ask several questions to your healthcare team.
Post-treatment follow-up is an important part of cancer care. It helps you to set your fears aside and help you deal with challenges involved in getting back to normalcy.
Hence, accepting and adhering to follow-up care is crucial for every cancer patient.
Mark your Calendar: Follow-up care schedules
Follow-up care involves addressing the challenges of patients who have completed their cancer treatment. It includes development of an individualised follow-up care plan that consists of detailed summary of the treatment and information about the possible short and long-term side effects.
The treatment for ovarian cancer can often cause a variety of side effects, managing these is an important part of follow-care.
You may need to undergo laboratory tests as a part of your health assessment. Self-care and customised wellness activities are advised that empower you to live life to its fullest.
The frequency of the follow-up visits are partly influenced by the stage of the cancer at the time of diagnosis and the chance of cancer recurrence. For the first couple of years, you are likely to have check-ups every three months. Thereafter, you may have regular half-yearly appointments for up to five years.
Make the most of doctor appointments
The doctor visits are the best opportunities to communicate your health concerns. Seeking help and getting assurance from the doctor about your health makes a huge difference in overcoming the health apprehensions.
Do not hesitate to ask questions when you see your doctor. Get as much information as you can.
Treatment for ovarian cancers usually comprises surgery and chemotherapy, so you can see both your surgical and medical oncologist during the same hospital visit.
The doctor visits often include overall physical and pelvic examinations. Patients treated for ovarian cancer are usually recommended to have a pelvic examination every two to three months for the first four years post-treatment.
For the subsequent years, you may have a pelvic examination every three to six months.
The doctor may also inquire about problems you may have and recommend medical tests to look for the signs of cancer recurrence or treatment side effects. A track record of your recovery in the months and years post-treatment are maintained.
Don’t skip any tests
During the follow-ups, if the doctor comes across any suspicious findings, he may recommend imaging or blood tests. The type of tests may depend on the stage of cancer and several other factors.
X-rays, CT scan and ultrasound scans, PET scan are some of the common imaging tests recommended during the follow-up schedules.
The blood tests are used to look for tumor markers or hormones indicative for cancer recurrence. Apart from routine lab investigations, identification of serum tumor marker (CA-125) is used to check for cancer recurrence, especially for epithelial ovarian cancer.
Alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG) are also used as a tumor marker to help detect germ cell tumors. Monitoring the level of hormones like estrogen, testosterone, and inhibin used in stromal cancers.
In certain high risk cases and in women with a positive family history, genetic testing with germline mutation in BRCA1 and BRCA2 may be advised and accordingly the genetic counselling would be needed and also based on the genetic mutation testing, maintenance therapy may also be advised. In such cases frequent follow ups would be needed for monitoring the toxicities.
Maintaining personal records is important as it retains valuable information about diagnosis and treatment. Also, it helps the doctor ensure that you are regular with the follow-up care.
Personal health records also provide accurate information about your diagnosis and treatment, in case you have to change your doctor in future. Besides providing your information to doctors for their records, it is always recommended to keep copies for yourself.
The types of records that need to be stored include:
- Laboratory reports from all of your biopsies and surgeries.
- Imaging test results (CT or MRI scans, etc.)
- Discharge summaries and Operative reports of surgical treatment
- List of drugs along with dosage (chemotherapy)
- All the previous Treatment summaries.
- Genetic testing reports (if advised for)
Make healthy choices
The treatment for ovarian cancer can affect your nutrient requirements, eating habits and your digestion. Nutrition plays a key role in not only improving your overall health and well-being, but will also make you feel better.
Maintaining a healthy weight. Follow a healthy diet that includes proteins, vitamins and other nutrients to meet your body’s post-treatment needs.
Here are some ideas on what you can do to maintain a healthy lifestyle after your cancer treatment.
It also helps to manage uncomfortable symptoms associated with ovarian cancer, such as gas, bloating, or constipation. Limit high calorie foods and beverages.
Follow an exercise schedule as suggested by your doctor to maintain a healthy weight.
Recurrence: what to watch out for and what to do?
Sometimes, cancer may come back after the treatment. This is known as recurrence. It can happen months and even years later following the cancer treatment.
Latest advancements in the treatment for ovarian cancer have certainly improved the outcomes.
However, recurrences are common with ovarian cancers. Nearly about 70% of patients diagnosed with advanced stage ovarian cancer might have a recurrence. The stage of the cancer at diagnosis is the predominant factor that affects the risk of recurrence.
The cancer can recur anywhere. It can be either locoregional or metastatic, but the most common site for recurrence in the case of ovarian cancer is the abdominal cavity.
Hence, any abnormal symptoms like pain in the abdomen, bloating, nausea or vomiting, or changes in bowel or bladder habits need to be discussed with your physician.
Also check for these major symptoms associated with cancer recurrence.
- Return of cancer symptoms
- Unusual and persistent pain with no known cause
- New lumps or swelling with unknown cause
- Persistent cough
- Loss of appetite
- Unexplained weight loss
- Shortness of breath
Having a symptom may not always mean that your cancer has come back. The symptoms stated above may also show up due to more common conditions or medical problems.
However, when you feel worried or notice any new symptoms between your appointments, report to the doctor as soon as possible.
In fact, ovarian cancer is now being considered as a chronic disease and with more effective treatments for recurrent cancers, the condition is well-managed with many years of good quality of life.
Get emotional support
Along with physical health, cancer treatment also affects the way you feel, think, and do things. Your emotional well-being acts as a cornerstone to overcome the suffering and distress related to cancer and its treatment.
Anxiety and fear are common feelings in patients coping with ovarian cancer. Regular follow-ups and appointments can trigger anxiety and worry about the uncertainty of your cancer.
Seeking emotional support is critical at this point. Find support groups to share your worries and feelings that can make you comfortable. Some patients find it beneficial to have counselling after ovarian cancer treatment.
Your every effort in trying to stay positive and remaining hopeful will make a great difference, and help you lead a healthier and happier life.