Patients who receive adjuvant radiotherapy after radical surgery need to have a repeat chest CT, abdominal CT, neck ultrasound or CT, and gastrointestinal imaging after treatment is complete to determine if there are signs of recurrence. If your disease is stable and tests do not show tumor recurrence or metastasis, that marks the end of treatment.
However, even after surgery and postoperative adjuvant therapy, there is a risk of recurrence. The longer the time until the end of treatment, the lower the risk of recurrence. Therefore, you will still need to come in for regular follow-ups after adjuvant therapy ends.
How do I schedule my follow-up appointments?
In principle, you should follow these timelines. However, please follow your doctor’s instructions for the exact time of your follow-up.
1. Follow-up exams every 3-6 months for 2 years after the end of adjuvant therapy;
2. If the disease is stable 2 years after the end of treatment, it can be reviewed every 6 months;
3. follow-up review every 6-12 months starting in year 3;
4. From year 6 onwards, follow-up visits can be done once a year.
If there are no special circumstances, you can follow the review schedule for regular follow-ups.
If you experience any specific discomfort between reviews, such as difficulty swallowing again, bleeding, fever, etc., you should always go to the hospital to find out what’s going on, if the disease is recurring, if the tumor has recurred or metastasized, and so on, so that you can start the next step of treatment as soon as possible.
What do I need to check?
As part of your regular review after adjuvant therapy, you will need to have the following tests:
1. Medical history taking. At each follow-up visit, you will need to meet with your doctor. Your doctor will ask you about any recent symptoms of discomfort, the course of your previous tumor treatment, and so on. If you have trouble swallowing again, and it is worse than it was, for example, you were able to eat normally and now you have a little difficulty eating, or even only a semi-liquid or liquid diet, please let your doctor know promptly.
2. Physical examination. The positive signs that can be detected by physical examination of esophageal cancer are mainly enlarged lymph nodes in the neck. If a neck lump (enlarged lymph node) is felt, it may be a sign of recurrent metastasis, and your doctor will ask you to do a neck ultrasound or neck CT to clarify.
3. Imaging. This includes chest CT, abdominal CT, neck ultrasound or CT, and upper gastrointestinal imaging. Any imaging finding of a neoplastic mass may indicate a recurrence, at which point gastroscopy needs to be repeated.
4. Hematologic tests. This includes routine blood work, liver and kidney function, etc. These are the most basic indicators of your body’s function and are designed to see if your body is functioning normally.
It is important to note that since your supervising physician knows your condition best, it is recommended that you complete your follow-up appointment at the hospital where you were treated. If you are out of town and it is not convenient to come to the hospital where you are being treated, it is recommended that you follow up at a relatively authoritative local hospital and bring all of your documentation with you.
Co-written by: Dr. Rong Yu Dr. Jing You, Peking University Cancer Hospital