How should I be reviewed regularly after radiation therapy?

by Specialist

What makes oncology treatment different from other disease treatments is that there is a possibility of recurrence. Even after undergoing surgery and the lesion has been removed, there is a risk of recurrence. The longer the time until the end of treatment, the lower the risk of recurrence.

In addition, after radiotherapy, the effects of treatment are not immediate and there may be certain toxic side effects that need to be dealt with, so it is recommended that you visit the treatment hospital for regular review.

When should I go for a review?

    After 4-6 weeks of treatment, you will need to have your first review to objectively evaluate the efficacy of your radiation therapy and the condition of your tumor. If the treatment is not effective or if the disease progresses, your doctor will develop a further treatment plan for you. In addition, if you experienced a drop in white blood cells during radiotherapy, your blood should be retested weekly for 1 month after the end of radiotherapy.

  1. If no abnormalities are found at the first review and no further treatment is needed, then you can have your blood reviewed every 3 to 4 months for 2 years after that.

  2. For years 2 to 5, you can review every 6 months.

  3. After 5 years of treatment, you may have annual follow-ups.

At each review, you will need to report to your doctor if you have had any recent symptoms of discomfort, such as a return or worsening of dysphagia, painful swallowing, bleeding, or fever. Your doctor will assess whether your discomfort is an adverse reaction to radiotherapy or is due to something else, and manage it promptly.

If you have a new onset of symptoms between reviews, it is important to visit the hospital as soon as possible to avoid delays, even if it is not time for your next scheduled review.

What needs to be rechecked?

The routine review items after radiation therapy for esophageal cancer include two main areas: hematology and imaging:

Hematologic tests

Including routine blood, liver and kidney function, electrolytes, and esophageal cancer-related tumor markers. The blood work, liver and kidney function, and electrolyte tests are to see if your body is returning to normal; the tumor markers are to assist with imaging and to determine the efficacy of your treatment.

Imaging

This includes an enhanced CT of the chest, an ultrasound or CT of the abdomen, an ultrasound or CT of the neck, and an upper gastrointestinal tract imaging. These tests are done to determine the effectiveness of your treatment. A full-body bone scan is completed when there is pain and bone metastases are suspected, and a cranial MRI (magnetic resonance imaging) is completed when there is a headache and brain metastases are suspected.

Co-written by: Dr. Rong Yu, Peking University Cancer Hospital, Dr. Jing You