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Follow-up after treatment for neuroendocrine cancer
Neuroendocrine cancer behaves differently in each person, and a standard follow-up schedule would not work for everyone. People with neuroendocrine cancer should talk to their doctor about a follow-up plan that suits their individual situation. Follow-up care is often shared among the cancer specialists (oncologists) and the family doctor.
After treatment has ended, new symptoms and symptoms that don't go away or increase should be reported to the doctor without waiting for the next scheduled appointment. These may often include:
- flushing of the skin
- wheezing and asthma-like symptoms
- weight loss
There is a chance of neuroendocrine cancer recurring or progressing after treatment, so close follow-up is needed.
Follow-up after neuroendocrine cancer varies. Follow-up visits are usually scheduled:
- every 3–4 months in the first year, and every 4–6 months in the second and subsequent years, for newly diagnosed and residual neuroendocrine tumours or carcinomas
- once every year after complete removal of the neuroendocrine cancer
During a follow-up visit, the doctor usually asks questions about the side effects of treatment and how the person is coping. The doctor may do a complete physical examination.
Tests may be ordered as part of follow-up or if the doctor suspects the cancer has come back (has recurred).
- Tumour marker tests like 5-hydroxyindoleacetic acid (5-HIAA), chromogranin A (CgA) or Ki-67 measurements may be done at each follow-up visit to assess the extent of tumour remaining or check for a recurrence.
- Once every year, or if tumour marker tests are positive, an OctreoScan, CT scan or an MIBG scan (in some situations) may be done.
- Conventional imaging, such as ultrasound scan, CT scan or MRI scan, may also be advised at each follow-up visit.
- In carcinoid heart disease, a doctor will assess the heart function. Annual echocardiograms and follow-up with a cardiologist may be advised.
If a recurrence or increase in tumour mass is found during follow-up, the oncology team will assess the person with cancer to determine the best treatment options.
Establishing a national caregivers strategy
The Canadian Cancer Society is actively lobbying the federal government to establish a national caregivers strategy to ensure there is more financial support for this important group of people.