For some people with ovarian cancer, treatment may remove or destroy the cancer. Completing treatment can be both stressful and exciting. You will be relieved to finish treatment, yet it is hard not to worry about cancer coming back. (When cancer returns, it is called recurrence.) This is a very common concern for 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.
For other people, the cancer never goes away completely. These women may be treated with chemotherapy on and off for years. 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 gives more information about this.
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 may 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.
Follow-up for ovarian cancer usually includes a careful general physical exam and blood tests for tumor markers that help recognize recurrence. For epithelial ovarian cancer, it is not clear if checking for CA-125 levels and treating you before you have symptoms will help you live longer. Treatment based only on CA-125 levels and not symptoms can increase side effects, so it is important to discuss the pros and cons of CA-125 monitoring and quality of life with your doctor.
The choice of which tumor marker blood tests to check depends on the type of cancer a woman has. CA-125 is the tumor marker used most often to follow-up women with epithelial ovarian cancers. Others, such as CA 19-9, CEA, and HE-4, are used most often in patients whose CA-125 levels never went up.
For women with germ cell tumors, blood is tested for alpha-fetoprotein (AFP) and/or human chorionic gonadotropin (HCG). Checking levels of hormones like estrogen, testosterone, and inhibin is sometimes helpful for women with stromal cancers.
After your cancer treatment is finished, you will probably need to still see your cancer doctor for many years. So, ask what kind of follow-up schedule you can expect.
It is important to keep 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. Gathering these details soon after treatment may be easier than trying to get them at some point in the future. Make sure you have this information handy:
- A copy of your pathology report(s) from any biopsy or surgery
- If you had surgery, a copy of your operative report(s)
- If you were hospitalized, a copy of the discharge summary that every doctor must prepare when patients are sent home from the hospital
- If you had radiation therapy, a copy of the treatment summary
- If you had drug therapy (such as chemotherapy, hormone therapy, or targeted therapy), a list of your drugs, drug doses, and when you took them
- Copies of x-rays and imaging tests (these can be put on a DVD)
The doctor may want copies of this information for his records, but always keep copies for yourself.
Last Revised: 02/04/2016