For some people with stomach cancer, treatment may remove or destroy the cancer totally. Completing treatment can be both stressful and exciting. You may be relieved to finish treatment, but find it hard not to worry about cancer coming back. (When cancer returns, it is called recurrence.) This is a very common concern among those who have had cancer.
It may take a while before your fears lessen. But it may help to know that many cancer survivors have learned to live with this uncertainty and are leading full lives. Our document, Living with Uncertainty: The Fear of Cancer Recurrence, gives more detailed information on this.
In others, the cancer may never go away completely. These people may get regular treatments with chemotherapy, radiation therapy, or other therapies to try to help keep the cancer in check. Learning to live with cancer that does not go away can be difficult and very stressful. It has its own type of uncertainty. Our document, When Cancer Doesn't Go Away, talks more about this.
Follow-up care
When treatment ends, your doctors will still want to watch you closely. It is very important to go to all of your follow-up appointments. During these visits, your doctors will ask questions about any problems you may have and may do exams and lab tests or x-rays and scans to look for signs of cancer or treatment side effects. Almost any cancer treatment can have side effects. Some last for a few weeks to months, but others can last the rest of your life. This is the time for you to talk to your cancer care team about any changes or problems you notice and any questions or concerns you have.
Most doctors recommend careful follow-up, with a physical exam and review of symptoms every 4 to 6 months for the first 3 years, then at least yearly after that. Scans and lab tests are not usually needed at each visit, but should be done if there are any suspicious symptoms or physical findings. However, your doctor will probably check your vitamin B12 levels regularly if the upper part of your stomach has been removed.
Having surgery for stomach cancer will probably mean that your eating habits will have to change to some degree. You might not be able to eat large amounts of food at one time. Your health care team may suggest that you meet with a nutritionist, who can help you adjust to this.
People who have had surgery — especially if they had the upper part of their stomach removed (in either a subtotal or total gastrectomy) — will probably need to have their vitamin blood levels tested regularly and may need to get vitamin supplements, which may include B12 injections. (The pill form of vitamin B12 isn't absorbed if the upper part of the stomach has been removed.)
It is important to keep your health insurance. Tests and doctor visits cost a lot, and even though no one wants to think of their cancer coming back, this could happen.
Should your cancer come back, our document, When Your Cancer Comes Back: Cancer Recurrence can give you information on how to manage and cope with this phase of your treatment.
Seeing a new doctor
At some point after your cancer diagnosis and treatment, you may find yourself seeing a new doctor who does not know anything about your medical history. It is important that you be able to give your new doctor the details of your diagnosis and treatment. Make sure you have the following information handy:
- A copy of your pathology report(s) from any biopsies or surgeries
- If you had surgery, a copy of your operative report(s)
- If you were in the hospital, a copy of the discharge summary that doctors must prepare when patients are sent home
- If you had radiation therapy, a copy of the treatment summary
- If you had chemotherapy or targeted therapies, a list of the drugs, drug doses, and when you took them
- Copies of your x-rays and imaging tests (these can often be placed on a DVD)
The doctor may want copies of this information for his records, but always keep copies for yourself.
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