Follow up care for neuroendocrine tumor treatment

Summary

Once primary treatment for neuroendocrine tumors (NETs) has been completed, survivors usually visit a doctor or cancer care provider for regular check-ups and consultations. here are various types of follow ups for cancer patients such as follow-up for surveillance and screening, assessment and management of long-term effects, health promotion, and care coordination.

Introduction

Once primary treatment for neuroendocrine tumors (NETs) has been completed, survivors usually visit a doctor or cancer care provider for regular check-ups and consultations. This is called follow-up. How often cancer survivors should contact the doctors or care providers depends on many factors, including:

  • Cancer type and stage
  • the kind of treatment received
  • the need of the individual
  • the arrangements at the hospital where the follow up are provided.

The patients usually have to follow up appointments to check how they are and see whether they have any problems or worries. The appointments also give the patient’s the chance to raise any concerns they have about their progress.

Decisions about follow up

How often the patient should visit the doctor depends on:

  • The grade of the NETs
  • If the tumor has spread to other body parts
  • what type of treatment regime was provided
  • any side effects the patient is having

How often do the patients have appointments

If the patient had surgery to completely remove the tumor, those patients are more likely to get a return visit every 6 to 12 months. If the tumor was grade 3 and the patient had surgery to completely remove the tumor, the patient would see the doctor every three months.

If the patient has a grade 1 or 2 tumor that the doctor thinks cannot be removed surgically, then the patient is more likely to see the doctor every 3 to 6 months. Or if the patient is being treated to control the symptoms rather than treat the NET.

What happens during the follow up

The doctor or nurse examines the patient at each appointment. They also ask about the patient’s feelings, the presence of any side effects or symptoms, and if they are worried about anything.

The patient might be required to take some tests at some visits. The common tests during follow up include:

  • A CT scan
  • blood tests
  • urine tests

The doctor might also refer to a PET/CT scan or radioactive scan during some such appointments.

Between appointments

If the patient faces any problems between appointments, he/she should talk to the doctor or the nurse. If the patient discovers new symptoms, he/she should contact them. They need not have to wait until the next visit.

Many people find their tests very scary. All concerns about cancer can be restored by making an appointment with the hospital.

It can be helpful to tell someone close to the patient about their feelings. Sharing a concern can mean it doesn’t seem that huge. Many people find it helpful to go for counselling during or after cancer treatment​1​.

A detailed description of various types of follow up for cancer patients is given below:

  • Follow up for surveillance and screening

One of the most frequent concerns of cancer patients is the fear of cancer recurrence. Doctors in such cases should respond with careful examination and investigation to detect signs and symptoms of local and distant recurrence.

  • Assessment and management of long-term effects

Many cancer patients experience long-term physical and psychosocial effects from cancer and the associated treatment, including pain, lymphedema, fatigue, and psychological discomfort. Risk factors for increased suffering include a history of depression or anxiety, poor social support, and young age. Physicians should look for these symptoms and carefully assess those at risk. Studies have reported that early diagnosis of distress using standardized screening tests improves outcomes, and recently published guidelines are a valuable resource for physicians to assess and manage the psychosocial consequences of cancer and its treatment.

  • Health Promotion

The involvement of physicians is essential to ensure optimal follow-up care. Studies show that survivors who visit a primary care provider in addition to an oncologist are more likely to receive recommended preventive care as well as quality treatment for other illnesses. In health promotion and disease prevention, doctors should approach cancer survivors like those diagnosed with the acute coronary syndrome, who want to improve their health through counselling by modifying their lifestyle.

  • Care Coordination

Although physicians are increasingly advocating medical follow-up for cancer survivors, the challenges faced by some cancer patients are best addressed using a multidisciplinary approach. The physician should actively consider whether other healthcare professionals can assist the patient’s recovery and initiate referrals immediately. It starts with building relationships with local oncologists or doctors who focus on oncology, who can oversee cancer treatment and serve as an excellent resource for comprehensive care for cancer survivors​2​.

References

  1. 1.
    Follow up for small bowel neuroendocrine tumours. .cancer research uk. Published 2021. Accessed March 2022. https://www.cancerresearchuk.org/about-cancer/neuroendocrine-tumours-nets/small-bowel-nets/follow-up
  2. 2.
    Sisler J, Chaput G, Sussman J, Ozokwelu E. Follow-up after treatment for breast cancer: Practical guide to survivorship care for family physicians. Can Fam Physician. 2016;62(10):805-811. https://www.ncbi.nlm.nih.gov/pubmed/27737976