CANCER AND COVID-19: After Cancer Treatments
Now that we have reviewed cancer diagnosis and treatment during the COVID-19 pandemic, what if you had just completed treatment and/or completed months, or years ago and follow-up during the pandemic is required. How should this be prioritized? In this blog we will address the 3rd category, After Cancer Treatments, during the COVID-19 pandemic.
There are many established guidelines on the follow-up plan after cancer treatment. Your team should have provided or outlined for you the 1yr – 3yr – 5yr plan, also referred to as the “Survivorship plan” in some clinics/centers. Depending on the cancer type, follow-up may be limited to less than 3 years. It truly all depends. This is where engaging with your cancer care team and writing the information down in the follow-up section of the Cancer Journal & Guide will be helpful. Below is an outline of some follow-up routines for each major part of cancer treatment team. However, if any of the cancer treatment was combined, the toxicities and side effects would greatly change recommendations. Be sure to ask of each specialty how your overall treatment plays a role in the follow-up plans.
SURGERY: Typically, after any cancer surgery is completed, a follow-up will be scheduled with the surgeon for 2-4 weeks after the procedure/release from the hospital (can be seen sooner if there are any problems, or suspected complications). With the on-going COVID-19 pandemic, many are taking to the phones and/or video-conferencing platform for non-urgent follow-ups. Using this medium, sometimes it is possible to have patients show the doctor the area of surgery and the appearance can be evaluated, along with guiding the patient through an examination (e.g., push gently on the area, any pain? Any opening along the suture lines? etc., ) After the acute follow-up phase (2-6 months after surgery), the follow-up times can be made longer, or shorter, based on the type of surgery and guideline. Simply ask, “What is my follow-up plan for the next 2-3 years? What side effects should I expect? How would I know to come in sooner?”
CHEMOTHERAPY: Chemotherapy is very involved, and the side effects can affect your ADLs (activity of daily living – taking a bath, making a meal, etc.,) for long period after completing treatment. Additionally, many patients who received chemotherapy may have been (and remain) “immuno-compromised”, in the immediate phase after completing chemotherapy. Precautions remain in effect against COVID-19 and any other opportunistic bugs. When the main regimen of chemotherapy is completed, there may still be recommended on-going treatments in other forms (e.g., Tamoxifen/Arimidex in Breast Cancer) for many years. Follow-up with Medical Oncologist tend to be more frequent as they monitor side effects and will also consider adjusting treatment plans, if necessary. It is still ok to ask for a big picture approach from your Oncologist as well. Some Medical Oncologist are also using phone and/or video-conferencing platforms for follow-ups during the COVID-19 pandemic, and others are delaying follow-up, if non-urgent and several years from completing initial treatment.
RADIATION THERAPY: Typically, after any course of radiation treatment a follow-up will be scheduled 4 weeks completion. With the on-going COVID-19 pandemic, many are taking to the phone and/or video-conferencing platform for follow-ups. For those who have completed radiation therapy treatments many months, or years ago, these appears to be routinely delayed, for a later date if patients are unable to follow-up using the above stated methods. A follow-up plan and/or survivorship guide is very important after any cancer treatment. Monitoring side effects from treatments, scheduling recommended follow-up scans, evaluating area treated during a physical exam, are all very important. If for any reason, a follow-up plan is not available, try using the follow-up outline in the back of any of the Journal and Guide books. Don’t forget the basics. Talk to your cancer care team. They are all there to help and will guide you through this time. I hope that these past 3 blogs proved useful to you. Please continue to be safe.
Life is beautiful and God is awesome. And know… you are pure awesomeness!
Until next time,
Ipsa Scientia Potestas est ——— Knowledge itself is power!
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