Follow-up Care

What does ‘follow-up’ mean?

Once your course of radiation therapy is finished, it is important to have regular exams to check the results of your treatment. No matter what type of cancer you’ve had, you will need regular checkups and perhaps lab tests and x-rays. The radiation oncologist will want to see you at least once after your treatment ends. The doctor who referred you for radiation therapy will schedule follow-up visits as needed. Follow-up care, in addition to checking the results of your treatment, might also include more cancer treatment, rehabilitation, and counseling. Taking good care of yourself is also a part of following through after radiation treatments.

Who provides care after therapy?

Most patients return to the radiation oncologist for regular follow-up visits. Others are referred back to their original doctor, to a surgeon, or to a medical oncologist, a doctor who is trained to give chemotherapy (treatment with anticancer drugs). Your follow-up care will depend on the kind of cancer you have and on other treatments that you had or may need.

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What other care might be needed?

Just as every patient is different, follow-up care varies. Your doctor will prescribe and schedule the follow-up care that you need. Don’t hesitate to ask about the tests or treatments that your doctor orders. Try to learn all the things you should do to take good care of yourself.

Following are some of the questions that you may want to ask your doctor after you have finished your radiation therapy:

  • How often do I need to return for checkups?
  • Why do I need more x-rays, scans, blood tests, and so on? What will these tests tell us?
  • Will I need chemotherapy, surgery, or other treatments?
  • How will you know if I’m cured of cancer? What are the chances that it will come back?
  • How soon can I go back to my regular activities?
    • Work?
    • Sexual activity?
    • Sports?
  • Do I need to take any special precautions?
  • Do I need a special diet?
  • Should I exercise?
  • Can I wear a prosthesis?
  • How soon can I have reconstructive surgery?

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What if pain is a problem?

A few patients need help to manage pain if it continues after radiation therapy. You should not use a heating pad or warm compress to relieve pain in any area treated with radiation. Mild pain medicine may be enough for some people. If you have severe pain, ask the doctor about prescription drugs or other methods of relief. Be as specific as possible when telling the doctor about your pain so you can get the best treatment for it. If you are unable to get relief from pain, you may want to talk with a doctor who is a pain specialist.

Because pain can be worse when you are afraid or worried, it may help to try relaxation exercises. Other methods such as hypnosis, biofeedback, and acupuncture may be useful for some cancer patients.

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How can I help myself after radiation therapy?

Patients who have had radiation therapy need to continue some of the special care used during treatment at least for a short while. For instance, you may have skin problems for several weeks after your treatments end. You should continue to be gentle with skin in the treatment area until all signs of irritation are gone. Don’t try to scrub off the marks in your treatment area. They will fade and wear away.

You may find that you still need extra rest while your healthy tissues are rebuilding. Keep taking naps as needed and try to get more sleep at night. You may need some time to test your strength, little by little, so you may not want to resume a full schedule of activities right away.

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When should I call the doctor?

After treatment for cancer, you’re likely to be more aware of your body and to notice even slight changes in how you feel from day to day. The doctor will want you to report any unusual symptoms. If you have any of the problems listed below, tell your doctor at once:

  • A pain that doesn’t go away, especially if it’s always in the same place.
  • Lumps, bumps, or swelling.
  • Nausea, vomiting, diarrhea, or loss of appetite.
  • Unexplained weight loss.
  • A fever or cough that doesn’t go away.
  • Unusual rashes, bruises, or bleeding.
  • Any other signs mentioned by your doctor or nurse.

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What about returning to work?

Many people continue to work during radiation therapy, but if you have stopped working, you can return to your job as soon as you feel up to it, even while your radiation therapy is continuing. If your job requires lifting or heavy physical activity, you may need to change your activities until you have regained your strength.

When you are ready to return to work, it is important to learn about your rights regarding your job and health insurance. If you have any questions about employment issues, contact the Cancer Information Service or the American Cancer Society. They can help you find local agencies that respond to problems cancer survivors sometimes face regarding employment and insurance rights.

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This material was taken from the booklet “Radiation Therapy and You” published by the National Institutes of Health.