Follow-Up Care for Small Cell Lung Cancer

Executive Summary

Individuals with small cell lung cancer undergo effective treatment that removes and destroys tumour cells in the body. The treatment procedure has been quite stressful and a little exciting. The small cell lung cancer patients may find relief from the treatment after going through all the treatment protocols. But they might be anxious about a possible relapse. Some of the patients suffer from the cancer symptoms throughout their life. At the same time, some of them opt for regular chemotherapy, radiation therapy and other related therapies . This might help to control cancer for a possible longer duration. Hence, follow up care is necessary.

Cancer patients need to undergo regular follow-ups, and their diagnostic process never ends, although the active treatments have finished. The healthcare team is responsible for regularly checking the cancer symptoms. If they have gone or returned among the patient, determining the side effects, and monitoring overall health. Therefore, this care is the follow-up care among cancer patients. The follow-up care mainly includes conducting regular physical examinations, medical tests, or both. The doctors are responsible for keeping the record of every recovery phase of the patients concerning the months and the years ahead. 

Cancer rehabilitation recommends physical therapy, career counselling, pain management, nutritional planning, and emotional counselling. The primary aim of cancer rehabilitation is to help the patients regain control over different aspects of their lives and further remain independent. 

Recurrence of small cell lung cancer

One of the primary goals of follow-up care is the regular check for recurrence, ensuring that cancer has come back or not. Cancer recurrence occurs due to small regions of cancer cells that may remain undetected within the body. These cells tend to increase with time until they show any signs and symptoms after the test results. The follow-up involves the doctor’s familiarity with the patients’ medical history, providing personalized information regarding the risk of recurrence. The individual goes through blood tests or imaging tests, part of regular follow-up care. Still, the testing recommendations depend upon several factors, mainly involving the type and stage of diagnosed cancer and the types of treatment given.

Follow-up Interventions

Different organizations have evolved follow-up care interventions for small cell lung cancer.

Most of small cell lung cancer patients after a successful treatment from stage I to stage III undergo an imaging scan every six months for the first two years after complete treatment to look for any recurrence. The preferable test is the CT scan of the chest. The small cell cancer patients are given low-dose chest CT scans once a year after the first two years of treatment.

The follow-up care involves the recommendation of undergoing brain MRI every three months for the first year after the treatment. And then, once every six months during the second year after treatment, only to those patients who did not undergo radiation therapy to the brain (prophylactic cranial irradiation). Periodic brain MRI is recommended for individuals who have undergone prophylactic cranial irradiation. Usually, PET-CT scans with fluorodeoxyglucose (FDG) or blood tests are not recommended for observing the cancer recurrence. Some other organizations have also recommended imaging scans every three months for the first two years after treating limited-stage small cell lung cancer, then every six months for the third year, and later annually.

The small cell lung cancer patients undergo regular follow-up after the treatment. The survivors of small cell lung cancer who had smoking habits in the past are prone to the risk of heart disease, stroke, emphysema, and chronic bronchitis. Hence, the patients must adopt appropriate follow-up care needs that will result in healthy lifestyle choices for the patient’s overall well-being.

Follow-up with palliative care

Follow-up care for small cell lung cancer patients involves support services that entirely depend upon symptomatology and treatment methods used. Documentation is necessary for the efficacy and side effects of the therapies given for small cell lung cancer. The palliative care provided to the patients in the form of follow-up care showed an impact on the patients with unrealistic expectations for continued remission. A well-structured follow-up recommendation offered reassurance and psychological support to the requirement of the small cell lung cancer patients. The expert should recommend a palliative patient follow-up of the patient. The small cell lung cancer patients followed by their referring expertise, the related expertise also act as a consultant if requested.

Maintaining the personal health records

The patients and the doctors need to develop a personalized follow-up care plan. Concerns regarding the confirmation of future physical and emotional health also requires assurance. The ASCO has recommended maintaining the forms for keeping track of cancer treatment for receiving and developing a survivorship care plan after the complete treatment. 

Also, effective communication between the patient and the doctors regarding the leading of the follow-up care is essential. Some of the survivors tend to visit their oncologist regularly. While the others transition back to the supervision of their primary care doctor or another health care professional. The decision entirely depends on several other factors. It can be the type and stage of cancer, side effects, health insurance rules, and patient’s personal preferences.

The doctors unfamiliar with the primary cancer care of the patient may lead the follow-up care. Therefore, it is essential to share a summary of the cancer treatment and survivorship care plan forms while referring to future health care providers. The detailed information regarding cancer treatment has been considered crucial. As it will benefit the healthcare professionals who are supposed to provide care to the patients throughout their lives.