Regardless of whether you have early or advanced lung cancer, it is very important to have regular follow-ups after treatment. Internationally, the goal of lung cancer treatment is to manage it as a chronic disease, like hypertension or diabetes. Since it is a chronic disease, you need to be prepared to build a good relationship with this special “friend”. It is like taking care of a child, you need to take care of it regularly and know how it is “growing”. Of course, the most important thing is to develop a good, harmonious mindset for living with or without a tumor, which will help you live and work with your disease.
So, how do you “care” for an old friend?
Patients with early-stage non-small cell lung cancer
If you are a post-operative patient with early-stage non-small cell lung cancer (NSCLC), your primary care provider will develop a review plan tailored to your tumor invasion and pathology at the time of discharge.
According to our lung cancer guidelines, early-stage patients after surgery, and patients after stage IIIA R0 resection, can be reviewed every 6 months for the first 2 years after surgery. By R0 resection, we mean complete resection of lung cancer with no tumor remaining. At this review, your doctor may choose a plain CT scan of the chest and abdomen, and in some cases, an enhanced CT scan of the chest. Starting in year 3, the chest and abdominal CT scans can be repeated annually.
Patients with intermediate-stage non-small cell lung cancer
If you have stage IIIA or IIIB NSCLC, are inoperable but have received radiotherapy, are asymptomatic, or have a stable cough or other symptoms in the past, you can have follow-up CT scans of the chest and upper abdomen every 3 to 6 months for the first 3 years after treatment ends, and every 6 months for years 4 to 5. After 5 years, you can have annual reviews.
Patients with advanced non-small cell carcinoma
If you have advanced NSCLC, you can have CT scans of the chest and upper abdomen every 8 to 12 weeks if you are asymptomatic or previously stable after systemic therapy such as chemotherapy. If you have metastases to the brain or bone, you will need to have a magnetic resonance imaging (MR) scan of the head and a bone scan. If your cough, coughing up blood, shortness of breath, or chest tightness worsens, or if you develop new symptoms such as dizziness, vomiting, or pain, you need to see an oncology clinic as soon as possible.
If you are participating in a clinical trial, then you should be reviewed regularly as required by the clinical trial.
It is important to note that the above is a general principle and that you will need to review as recommended by your primary care physician. If you notice changes in your disease, your doctor may recommend that you increase the frequency of testing or add other tests to clarify your condition.
Co-authors: Guangdong Provincial People’s Hospital Guangdong Lung Cancer Institute Dr. Bai Xiaoyan Dr. Zhang Yichen