What Exactly Are They Looking for in Follow Up?

Those of us lucky enough to get past cancer treatment and to be declared NED (No Evidence of Disease) are put on a course of follow up from our oncologists. This can start out as every three months, then over time, progress to every six months, then yearly.

As far as I know, once you've had cancer, you'll always check in with an oncologist at some interval for the rest of your life. So, my question is: just what are they looking for?

Actually, I've never met an oncologist who explains this, which I think is odd. The follow up appointments themselves don't amount to much, in my experience. It's a quick physical along with general bloodwork. I think the idea is if there were anything really serious going on, like a cancer recurrence or new cancer, it would be very obvious to everyone. In my opinion, they aren't looking for little things, just big things.

It makes me wonder what those big things would be eight years out. I actually did a little research on this, since like I said, no oncologist tells you. I also looked into it because I have been feeling crappy lately--dead tired, constant headache, dizzy, etc.

I discovered that the risk for a blood cancer brought on by having received both chemo and radiation peaks 5-10 years past treatment. I'm 8 years out. I also discovered that there's a much greater risk for me to get MDS, a precursor to AML and/or AML.

This is because I was younger than 40 when I got treatment, which ups the risk considerably. So, too, does receiving two of the chemo agents I did--the A and the C of my ACT treatment. Getting these drugs in a dose-dense fashion also doesn't help. The usual dosing regimen is a dose every three weeks; I, like most young people getting cancer treatment, received my dose every two weeks. It also turns out that getting radiation boosts as I did, which means a few days of intensely stronger radiation, increases my risk.

I'm all about assuming I'm healthy until proven otherwise and still think this is the case, but I also believe oncologists and all doctors should be entirely up front and educational even about what they are looking for at what point so the patient can help with the monitoring.

Let's remember that I found my cancerous growths myself; if I had waited around for medical intervention to come to the rescue, I'd already be dead.

No Gratitude for this Idea

Here's a silly little article about "Cancer and the Case for Gratitude," where the author takes a doctor's study of cancer patients and draws some lame conclusions. Basically she says if people would face their misfortunes with a sense of gratitude, they might not get cancer. Or at least that's what she seems to be saying. She doesn't quite connect the ridiculous dots.

Like the hundreds of cancer patients the doctor studied in this article, I faced a big-deal stressor shortly before I was diagnosed with cancer. I was laid off from my job of many years. Did my lack of gratitude about this or my failure to find a bright spot in the disease--I got cancer at 37.5 years old, people!!!--make me get cancer?

Doubt it. There's a lot of research being done on women who get breast cancer within five years of giving birth. I'd be willing to throw in with that possibility for myself, since I discovered my cancer just two years after giving birth.

But this gratitude crap? Not at all. I put it up there with the popular media's all-too-energetic theories that my weight or diet somehow caused my cancer. Again, not likely since I was premenopausal when I got my cancer and this is more an issue (but not a definite or only issue by any stretch) for much older women.

This article is glib and clearly written by someone who has not faced the disease herself. I'd suggest she be grateful for that and leave those of us who didn't get off so easily alone.