The end of surgery means that you have achieved a “stage victory,” but it does not mean the end of treatment. In terms of clinical perspective, this state is generally referred to as “clinically cured,” meaning that theoretically you have no cancerous tissue or cells in your body and are able to survive long-term. However, the true cure rate for early-stage lung cancer is only about 90%, and for mid-stage cancer only about 50%, given the state of the art.
So after surgery, you need to keep in close contact with your doctor, or “follow up,” to check some of your indicators and report your health status to your doctor, so that he or she can keep track of your progress and adjust your treatment plan. Here is a “follow-up calendar” for you to keep in mind.
Follow-up calendar
Follow-up calendar
1. About 2 weeks after surgery
Usually you have an appointment to have your stitches removed. Your doctor will instruct you on what to expect in terms of post-op diet and post-discharge recovery. In the meantime, you can make an appointment for some tests, including an enhanced CT of the chest, ultrasound of the abdomen and neck, supraclavicular lymph nodes, and tumor markers.
2. 1 month postoperatively
There is usually an outpatient visit to tell the doctor about recent symptoms and activity levels, etc., so that the doctor can assess whether any additional dietary and lifestyle modifications are needed and prescribe medications to relieve symptoms, such as cough suppressants and analgesics.
In addition, it will be necessary to review those items from the last appointment. This is very important, as your doctor will need to tell you which stage I-IV you are in based on the final post-operative pathology, both to roughly assess the cure rate and to guide how to follow up.
Stage I (early) is the most fortunate, meaning that not only is the cure rate very high, but there is no need for chemotherapy, radiation, targeted therapy, etc., just a healthy lifestyle and regular follow-ups. Any stage beyond that may require appropriate treatment.
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3. Within 2 years after surgery
If the review does not show any signs of recurrence or metastasis, a review every 3 to 6 months for 2 years after surgery should be done, basically the same as 1 month after surgery, to detect signs of recurrence and metastasis as early as possible and to treat them in a timely manner.
Doctors also usually recommend that you have a cranial MRI once a year to rule out brain metastases. Bone scans and PET-CT are usually needed if there are significant symptoms, such as pain, hemoptysis, or prolonged fever, but are not otherwise routinely reviewed.
4. Within 2 to 5 years after surgery
During this period, it is generally recommended that you have a review every 6 months, with items similar to those mentioned above.
5, 5 years after surgery
The chances of recurrence are relatively low after surviving more than 5 years after surgery, and it is generally recommended to review it once a year, treating it as a chest checkup.
What to look for at follow-up?
At each follow-up visit, you should report the most significant problems to your doctor as concisely as possible, such as whether you have symptoms such as cough, pain, fever, or hemoptysis. Don’t report everything in detail so that your doctor doesn’t “lose track” of what’s important, which is not conducive to efficient care.
After each review, it’s a good idea to ask your doctor when the next review will be and what additional tests will be needed, and to keep a record of them.
Co-reviewed by: Guangdong Provincial People’s Hospital Guangdong Lung Cancer Institute Dr. Xie Liang, deputy chief physician Dr. Xia Jin
Co-authors: Dr. Wang Xing, Peking University Cancer Hospital