Follow-Up Care for Kidney Cancer

Executive Summary

Follow-up care for kidney cancer refers to the after-treatment protocols conducted by the healthcare team to look after recurrence, manage the side effects, and monitor the patients’ overall health. The follow-up care will include routine physical examinations, various medical tests (blood tests, urine tests) and scans to monitor a patient’s overall health status. A survivorship care plan is designed with the physician as per the health condition and requirements. The doctor may recommend rehabilitation. Rehabilitation includes various services such as therapies (physical and mental), pain management, career counselling, emotional counselling, diet and nutrition planning. Rehabilitative therapies and sessions help cope with, treat, and relieve these symptoms or side effects post successful cancer treatment. In the case of patients who have received treatment for kidney cancers, rehab services will include physical therapies to help people in the movement and other physical activities. Proper care and guidance should be provided for patients to cope with mental stress, anxiety, and depression post-treatment of kidney cancers. The primary goal of follow-up care post successful treatment is to check for any possible recurrence. Another important aspect of follow-up care is managing and relieving the side effects of treatment.

Follow-Up Care for Kidney Cancer

Care for people detected with kidney cancers doesn’t end with active treatment. The health care team will develop a post-treatment care strategy as per a patient’s disease condition, called follow-up care. Every disease survivor should have a proper follow-up care routine. Follow-up care refers to seeing the health care provider post-treatment for regular medical check-ups and screening to evaluate your post-treatment health progress and disease condition. 

The follow-up care will include routine physical examinations, various medical tests (blood tests, urine tests) and scans, to monitor a patient’s overall health status ​1​. These tests and scan results will help the doctor analyze and detect any variation in the patient’s well-being, any other complication, symptoms or signs indicating any disease or side effects due to the treatment. Follow-up care focuses on addressing a patient’s physical health issues and prioritizes their mental well-being. Kidney cancer survivors should utilize the opportunity to address any emotional, mental concerns to their doctor or health care team. 

You can design a survivorship care plan along with your physician. A survivorship care plan will consist of a full, detailed summary of your treatment, along with a follow-up plan designed as per your health condition and requirements. This plan will function as a tracker to monitor your condition post-treatment. It will ensure that you get regular, competent care to prevent any chance of the disease condition recurring or any side effects of treatment becoming worse. Follow up care should not be missed, especially in the case of severe disorders like kidney cancers, as their behavior cannot be predicted, and the possibility of these cancers recurring post successful treatment also cannot be discarded. Doctors can check for recurrence or distant metastasis through these follow-up check-ups and help treat them.

In Follow-up care, the doctor may recommend rehabilitation. Rehabilitation includes various services such as therapies (physical and mental), pain management, career counselling, emotional counselling, diet and nutrition planning ​2​. The ultimate goal of rehab is to aid survivors to regain control over their lives and encourage them to be self-sufficient, active and productive as much as possible. Rehabilitative therapies and sessions help cope with, treat, and relieve these symptoms or side effects post successful cancer treatment. Follow-up care and rehabilitation collectively focus on improving the quality and comfort of the life of cancer survivors. 

In the case of patients who have received treatment for kidney cancers, rehab services will include physical therapies to help people in the movement and other physical activities. A rehabilitation medicine specialist can ensure that the patient gets the most appropriate and effective rehab services.

Sometimes after treatment, the patient may find it challenging to perform basic physical tasks like walking, exercising etc. Hence, in such circumstances, caregivers and healthcare teams should provide sufficient mental support and encouragement to the patient and help them find support groups or services to strengthen their body and mind.

Proper care and guidance should be provided for patients to cope with mental stress, anxiety, and depression post-treatment of kidney cancers (or any disease in general). Today, most cancer care centres have support groups and services that offer survivors the support they require. These support services will have various therapies, counselling and other sessions to address the emotional concerns of the survivors.

The primary goal of follow-up care post successful treatment is to check for any possible recurrence. Kidney cancers can be unpredictable at times; hence, proper follow-up check-ups are vital even after successful treatment and cure. A doctor who is familiar with your medical history will be able to guide you with personalized information regarding your risk of disease recurrence during follow-up check-ups.

The doctor may ask you different questions to evaluate your health condition. Depending on your disease condition’s type, stage, and gravity during the initial diagnosis and treatment, the doctor may prescribe various medical tests (blood/urine/imaging tests) and scans.

Survivors can get triggered by anxiety and stress while coming for follow-up check-ups and waiting for the test results. They will be constantly worried about cancer recurring again in the body. In such cases, survivors are encouraged to openly communicate their fears with their doctor, who will help them get the necessary support. 

Another important aspect of follow-up care is managing and relieving the side effects of treatment. People may experience many long-term and short-term side effects while receiving treatment for cancer. The late side effects or long-term side effects tend to last for a more extended period (even months or years) post-treatment. These side effects can affect the physical and mental well-being of a survivor. 

Kidney cancer survivors often have a single kidney post-treatment; hence monitoring the kidney function is extremely important for the rest of their lives. Some people experience long-term side effects of the surgical procedures, and some survivors experience shooting pain from the surgical scar. Also, kidney cancer survivors who have received treatment for the disease are at a higher risk of developing prostate and colon cancers.

Patients should talk with their doctor or health care team regarding the treatment they will receive as per their cancer condition and what side effects they should expect, well before the treatment begins. If any side effects are expected to cause troubles, proper treatment and care should be provided to the patients to manage and relieve them. 

People who have received treatment for kidney cancers are urged to make healthy life choices. They are encouraged to follow established guidelines like eating a healthy balanced diet, maintaining healthy body weight, undergoing screening tests as and when required, not indulging in unhealthy practices like drinking, smoking etc. They are also encouraged to perform physical activities without straining their bodies. Talk with your doctor or healthcare team, and design a plan to keep up a healthy lifestyle.

Survivors and the doctor should work together to design a personalized follow-up check-up and care plan. Survivors should make it a point to address or discuss any fears or concerns regarding their mental and physical health with their health care provider. Also, survivors should record all their treatments and medical history for future reference.  

Survivors can also enquire about who will lead their follow-up care to their doctor. Some people continue to see their oncologists or health care team, whereas others transition back to the supervision of another medical professional or their family doctor. Several factors like the type, grade, gravity of the disease condition, possible side effects, personal preferences etc., shape such decisions. 

If, in case, a medical professional who was not a part of your treatment lead your follow up care, be sure to share all relevant medical history and survivorship plan with them. This applies in the case of all future health care providers. This is very important, as it will help the new doctor plan your care based on your past medical details.

References

  1. 1.
    Kassouf W, Siemens R, Morash C, et al. Follow-up guidelines after radical or partial nephrectomy for localized and locally advanced renal cell carcinoma. CUAJ. Published online April 25, 2013:73. doi:10.5489/cuaj.1028
  2. 2.
    Doehn C, Grünwald V, Steiner T, Follmann M, Rexer H, Krege S. The Diagnosis, Treatment, and Follow-up of Renal Cell Carcinoma. Deutsches Ärzteblatt international. Published online September 5, 2016. doi:10.3238/arztebl.2016.0590