Cancer Survivorship Guidelines & Recommendations

Doctor Visits
 

After finishing treatment for breast cancer, you’ll follow up with your Mercy cancer care team in the office. Your care team provides a schedule of these follow-up visits. It’s important to continue seeing your caregivers because they’ll want to watch you closely. For the first three to five years after treatment, you’ll likely see your oncologist or surgeon about two to four times per year. After five years, visits are usually annual. During these visits, your care team reviews your history, asks about new or persistent symptoms, examines you, and orders appropriate lab work or imaging tests. Office visits are an opportunity to ask questions and share any concerns you have.

Mammograms
 

If you had breast-conserving surgery (lumpectomy) or a unilateral mastectomy (the affected breast removed only), you’ll need a mammogram about six to 12 months after finishing treatment, then annually. If you had a bilateral mastectomy (removal of both breasts), you’ll likely no longer need mammograms.

Clinical Breast Exams
 

Your Mercy oncologist or breast surgeon performs professional breast exams in the office. Exams are recommended every six months for the first five years, then annually.

Pelvic Exams
 

If you take Tamoxifen and have an intact uterus, you’ll need annual pelvic exams because of the rare risk of uterine cancer associated with the drug. This risk is higher among postmenopausal women. Report any abnormal vaginal bleeding, such as spotting, postmenopausal bleeding, changes in periods or heavy periods to your oncologist and gynecologist right away.

Bone Density Tests
 

If you’re taking an aromatase inhibitor like anastrozole, letrozole or exemestane for hormone-positive breast cancer, you’ll need a baseline bone density exam. Aromatase inhibitors can cause bone thinning, leading to osteoporosis. If your bones start thinning, your doctor may prescribe bisphosphonate medicine or Prolia injections.

Breast MRI and Ultrasound
 

Although these screening tests aren’t standard after breast cancer treatment, a breast MRI and breast ultrasound may be recommended depending on how your cancer was detected and other factors like breast density. Ask your Mercy cancer care team whether these tests are part of your surveillance plan.

Blood Tests
 

Your Mercy oncologist may order bloodwork and repeat labs on a routine basis. Laboratory tests may include complete blood count, chemistry panel (evaluates electrolytes, liver and kidney function) or vitamin D levels. Tumor-marker tests, such as cancer antigen 15.3 or carcinoembryonic antigen (CEA) level, aren’t always recommended for surveillance. Tumor markers may not increase when cancer returns, making them an unreliable measure. But if you’re having symptoms that are concerning for cancer recurrence, your doctor may order tumor-marker tests.

Other Tests
 

Imaging tests like bone, PET and CT scans or chest x-rays aren’t part of standard follow-up care for stage zero to three breast cancer. But they may be needed if your symptoms or physical exam suggest cancer may have come back.

Doctor Visits
 

After finishing treatment for colorectal cancer, you’ll follow up with your Mercy cancer care team in the office. Your care team provides a schedule of these follow-up visits. It’s important to continue seeing your caregivers because they’ll want to watch you closely. For the first two years after treatment, you’ll likely see your Mercy oncologist or surgeon about two to four times per year. After two years, visits are usually biannual or annual. During these visits, your care team reviews your history, asks about new or persistent symptoms, and orders appropriate lab work or imaging tests. Office visits are an opportunity to ask questions and share any concerns you have.

Colonoscopy
 

You’ll need a colonoscopy a year after your initial diagnosis, and then as recommended by your Mercy gastroenterologist. If your doctor didn’t check your whole colon at the time your cancer was detected, then you’ll need a colonoscopy two to three months after treatment.

Imaging Tests
 

You’ll need a CT scan one to two times per year for five years. Your Mercy oncologist or surgeon determines the frequency.

Blood Tests
 

Your Mercy oncologist may order bloodwork and repeat labs on a routine basis. Blood tests may include complete blood count, chemistry panel (evaluates electrolytes, liver and kidney function) and carcinoembryonic antigen (CEA) level.

Doctor Visits
 

After finishing treatment for gynecologic cancer, you’ll follow up with your Mercy cancer care team in the office. Your care team provides a schedule of these follow-up visits. It’s important to continue seeing your caregivers because they’ll want to watch you closely. Visits will likely be every three to six months for the first two years, every six months to a year for five years, and then annually. Visit frequency depends on factors like cancer type, stage and treatments received. Some patients need more follow-up care, while others may be released to their regular gynecologist for routine exams. During these visits, your doctor reviews your history, discusses new or persistent symptoms, examines you, and orders appropriate lab work or imaging tests. Office visits are an opportunity to ask questions and share any concerns you have.

Mammograms
 

Annual mammograms are recommended as early as age 40. Ask your Mercy cancer care team when you should begin mammograms.

Clinical Breast Exams
 

Your Mercy gynecologist or primary care physician performs an annual professional breast exam in the office. Breast self-exams are recommended monthly.

Pelvic Exams
 

Your Mercy gynecologist or oncologist performs routine pelvic exams. Report any abnormal vaginal bleeding, such as spotting, postmenopausal bleeding, changes in periods or heavy periods, to your doctor right away.

Blood Tests
 

Your Mercy oncologist may order bloodwork and repeat labs on a routine basis. Tests may include complete blood count and chemistry panel (evaluates electrolytes, liver and kidney function). Tumor-marker tests aren’t always recommended for routine surveillance. Tumor markers may not increase when cancer returns, making them an unreliable measure. But if you’re having symptoms that are concerning for cancer recurrence, your doctor may order tumor-marker tests.

Other Tests
 

Ask your Mercy cancer care team whether you need bone density tests. Make sure all other screenings and CDC-recommended vaccinations are up to date. 

Doctor Visits
 

After finishing prostate cancer treatment, you’ll follow up with your Mercy cancer care team in the office. Your care team provides a schedule of these follow-up visits. It’s important to continue seeing your caregivers because they’ll want to watch you closely. For the first three to five years after treatment, you’ll likely see your Mercy oncologist or surgeon about two to four times per year. At five years, visits are usually annual. During these visits, your care team reviews your history, asks about new or persistent symptoms, examines you, and orders appropriate lab work or imaging tests. Office visits are an opportunity to ask questions or share any concerns you have.

Prostate Serum Antigen (PSA) Tests
 

If you’re treated with radiation therapy, radiation with androgen deprivation therapy (ADT) for four or six months, or radical prostatectomy, your PSA levels are measured every six to 12 months for the first five years, then annually. PSA testing may be done every three months for men at higher risk of cancer recurrence. Discuss recommendations with your Mercy oncologist.

Digital Rectal Exam (DRE)
 

An annual DRE is appropriate to monitor for prostate cancer recurrence. Your physician may not perform a DRE if your PSA levels remain undetectable.

Other Tests
 

Diagnostic imaging tests like bone, PET and CT scans or chest x-rays aren’t standard for men with stage one to three prostate cancer. But they may be done if your symptoms or exam suggest cancer may have come back.

Doctor Visits
 

After you’ve finished testicular cancer treatment, you’ll follow up with your Mercy cancer care team in the office. Your care team provides a schedule of these follow-up visits. It’s important to continue seeing your caregivers because they’ll want to watch you closely. Your follow-up care depends on factors like cancer type, stage and treatments received. During follow-up visits, your care team reviews your history, asks about new or persistent symptoms, examines you, and orders appropriate lab work or imaging tests. Office visits are an opportunity to ask questions or share any concerns you have.

Lab Work
 

At your follow-up visits, your Mercy cancer care team will explain any lab tests that should be done and how frequently. If you had a non-seminoma, tumor-marker tests may be ordered. Tests may include alpha-fetoprotein (AFP), human chorionic gonadotropic (HCG) and lactate dehydrogenase (LDH). These tests aren’t always helpful for patients with seminoma, so they may not be needed.

Imaging
 

Chest x-rays and CT scans of the abdomen and pelvis may be part of your surveillance plan. The frequency of imaging testing is determined by multiple factors, such as cancer type, stage and treatments received. Your care team follows surveillance guidelines from the National Comprehensive Cancer Network, so they’ll know how often you need testing. Your Mercy oncologist may order testicular ultrasounds if needed.