Follow up care

Yatman Tsang is a Consultant Radiation Therapist at the Mount Vernon Cancer Centre, Middlesex, England. He is going to answer some common questions about what follow up care is, and why it is important for radiation therapy patients.

Mount Vernon Cancer Centre is a well renowned, highly specialised cancer centre. Our staff are a highly trained group of people in non-surgical oncology. We treat from a large catchment population of almost 2 million people and some patients are referred to us from across the country into areas where we have specialist knowledge and expertise in radiation therapy. Over 5,000 new patients are registered with us each year.

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Common side effects from radiation therapy

Patients who undergo radiation therapy may experience side effects from the treatment, although most side effects can be treated and may settle down when radiation therapy finishes. Side effects can vary from person to person and they can be heavily dependent on the type of radiation therapy being given, and the anatomical sites being treated.

Common radiation therapy side effects are fatigue, sore skin, hair loss, nausea, dry mouth, difficulty of swallowing, breathing problems, diarrhoea, stiff joints and muscles, lymphoedema, sex and fertility issues.

Why do radiation therapy patients need follow up care?

These checkups are often called “follow-up’.

Follow-up appointments:

• Give patients an opportunity to discuss any problems or worries that they have with the clinical team.
• Deal with post radiation therapy side effects
• Detect any signs of recurrent disease

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How long is follow up care after radiation therapy treatment?

The length and frequency of follow-up appointments can vary based on the type of cancer and how well the cancer responds to radiation therapy. For the majority of patients, the first follow-up appointment usually happens about 4 to 6 weeks post radiation therapy and patients can be followed up to 24 months.

Where does follow up care happen?

These appointments can be scheduled at the radiation therapy department, or at the original referring hospital. For some patients, they may be followed up by telephone with a radiation therapist or a nurse specialist. If any concerns are flagged up at the telephone follow-up, the patients will be arranged to have an appointment to be seen at the clinic.

What type of follow up care do patients need?

As every patient is different, follow-up care varies. During a typical follow-up appointment, the clinical team may carry out investigations such as physical examinations, blood tests and imaging scans. Patients may need to continue some of the special care they used during radiation therapy, at least for a short while after treatment.

For instance, some patients may find that they still need extra rest after they have finished the whole course of radiation therapy. It may take them some time to gain their strength back and resume their normal schedule of activities gradually.

There is no doubt that some patients may prefer to carry on working during radiation therapy because each treatment appointment is short. For those who have stopped working, they are advised to return to work when they feel up to it. If patients express the need for emotional, social and financial support during or after radiation therapy, they can discuss them with their clinical team or social workers for information about support groups or other ways to express their feelings and concerns.

It is important for cancer patients to learn about their specific rights at their resident country about their job and health insurance when they are ready to return to work post radiation therapy.

Tips for Post Treatment

• You will be given specific advice by radiation therapists about the problems you should look out for and the details of special care that you can follow to manage the side effects.
• After radiation therapy, you may need to continue some of the special care you use during radiation therapy for a short while.
• Contact your clinical team if you notice any new symptoms or feel unwell
• Talk to a support group
• Learn about your rights about going back to work
• Take plenty of rest if you feel that you need it

Yatman Tsang In his current role as the consultant radiation therapist at Mount Vernon Cancer Centre, Yatman acts as both a clinical and technical expert to lead and coordinate the Trust’s specialised radiotherapy service, including the Cyberknife stereotactic radiotherapy service. His membership of UK Stereotactic Ablative Body Radiotherapy (SABR) consortium steering group and NCRI Clinical and Translational Radiotherapy Research Working Group (CTRad) has enabled evidence practice and research to be introduced into clinical practice.