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Everyone who has gone through treatment for breast cancer should receive a Cancer Follow Up Plan, no matter how limited treatment may have been. If you don't have one - now is a good time to ask for one.

The purpose of a cancer follow up plan: The idea of the plan is to give people who have been through cancer treatment information to:

  • Spot side effects that may occur long after treatment.
  • Watch for early signs of a cancer recurrence or the appearance of a new cancer. The earlier a new situation is detected, the more likely treatment will be successful.
  • Inform doctors who are not specialists in a particular disease about symptoms to watch for.

A cancer follow up plan should include each of the following:

  • The medical name of your diagnosis. (Ideally, a hard copy of your diagnosis will be attached, though this is not necessary.)
  • All treatments you received, including:
    • The medical name
    • Dates
    • Dosage
    • Other pertinent facts
  • What signs or symptoms to watch for in the future.
  • Which doctor(s) to call if any of the subject signs or symptoms appear.
  • What the lasting effects of your treatment(s) could be. If you know what could happen as a result of your cancer and/or treatment, you can take steps to help reduce the possibility they may happen. For instance, if you had a type of chemotherapy that could result in a heart condition in years to come, you would know to start living heart wisely - such as doing aerobic or other exercise and eating a heart friendly diet.
  • What follow up visits to have with doctors and when to have them. In general, patients usually return to a doctor every 3 to 4 months during the first 2 to 3 years after treatment, and once or twice a year after that. Before setting a follow-up schedule with your doctor, it is advisable to check your health insurance plan to see what follow-up care it allows.

You can see a template for a Breast Cancer follow-up Plan at the website of the American Society of Clinical Oncologists (ASCO) at www.cancer.net  offsite link Search for: "Breast Cancer Survivorship Plan."

What to do with a cancer follow up plan

Give a copy of your Cancer Follow Up Plan to your primary care doctor or other doctor who is responsible for your overall health as well as to any other doctors you see. They are not cancer specialists and may not know everything to watch for because of your condition and/or treatment.

Use your Plan as a guide for symptoms that should trigger action (generally to call your doctor), as well as preventive measures to take about conditions for which you may be more prone than the general population.

Keep your specialist informed about any changes in your health. Even with a Cancer Follow Up Plan, a primary care doctor may miss signs that would be meaningful to an oncologist or other specialist. You don't have to set an appointment. You can correspond by email, fax or snail mail. If you are no longer seeing the specialist, the doctor will let you know if she or he no longer wants to hear from you. If this happens, consider engaging another specialist who will agree to receive your updates. For information about how to choose a specialist, click here.

Your role with respect to follow up visits

Meet with a doctor according to the follow up schedule no matter how well you feel.

Prepare for visits by keeping track of your symptoms (we provide a chart to help) and noting questions as they come up.

At your first follow-up visit:

  • Give your doctor a copy of your disease specific follow-up plan.
  • Talk with your doctor about your follow-up schedule.
  • Ask your doctor to help you create a Wellness Plan and/or refer you to the appropriate specialists who can help (for example, to a nutritionist).

It is worth noting that experience indicates that getting involved in decisions about your medical care and lifestyle is a good way to regain some of the control many people feel gets lost during treatment.

What doctor to see

Depending on where you live, it may make more sense to get follow-up care from your family doctor rather than your oncologist or other specialist.

There are also clinics that specialize in long-term follow-up after treatment ends. For instance, these clinics most often see people who are no longer being treated by an oncologist and who are considered disease-free.

NOTE: Some insurance plans only pay for follow-up care provided by certain doctors and only for a set number of visits.

What follow up care involves

Appropriate follow-up care depends on a variety of factors such as:

  • The type of cancer
  • Treatment or treatments you had
  • Other health conditions you have or have had
  • Your overall health.

Because of the number of factors involved, follow-up care is usually different for each person who has been treated for cancer.

During follow up visits, the doctor will look for side effects from treatment and check to find out if your condition has returned (recurred). Your doctor will do this by:

  • Reviewing your medical history.
  • Giving you a physical exam.
  • Running tests relevant to your health history.