One-Year Follow-Up with a Surgical Oncologist

What the follow-up includes

• review of laboratory test results — including the tumor markers monitored after surgery;
• review of CT and MRI scans — the images themselves, not just the reports, and comparison with previous ones;
• answers to questions — about recovery, diet, physical activity, new symptoms;
• help with decisions about further treatment — together with the doctor who manages it;
• recommendations on an in-person examination or additional tests based on the review.

The specific way of staying in touch and how often results are reviewed are agreed at the consultation — they depend on the diagnosis, the extent of surgery and further treatment.

Why a surgeon after surgery

The first year after cancer surgery is a time of recovery, the start of further treatment and the first follow-up tests. Questions may arise during this period, and postoperative changes on scans sometimes need additional assessment: scar changes after a resection can be mistaken for a new lesion, and vice versa.

A surgeon who knows exactly what was done during the operation sees these changes in context. And a new lesion does not always mean that the options have been exhausted: for example, in colorectal cancer liver metastases a repeat resection or ablation is possible if the same conditions as for the first operation are met. Early detection may make it possible to consider additional treatment options.

What is monitored in the first year

The follow-up schedule is set by the doctor — it depends on the diagnosis, stage and further treatment. General guidance:

• colorectal cancer and liver metastases — CT or MRI and CEA levels; in the first years follow-up is more frequent;
• liver cancer — contrast-enhanced CT or MRI and alpha-fetoprotein every few months;
• ovarian cancer — a check-up, usually with CA-125, every 3–4 months; CT for symptoms, a rising marker or on schedule;
• cervical cancer — a check-up every 3–6 months for the first 2 years;
• adrenal tumors — hormonal monitoring depending on the type of tumor; after adrenocortical carcinoma — also regular CT or MRI on the doctor’s schedule.

More about each operation and the follow-up after it is on the pages “Bowel Cancer Surgery”, “Liver Metastases Surgery”, “Liver Cancer Surgery”, “Ovarian Cancer Surgery”.

How it works

1. After dischargeWe agree on the follow-up schedule and how you will send the results.
2. TestsYou have them wherever is convenient — where you live or in another country — and send the laboratory test results and CT or MRI discs.
3. ReviewI review the results and explain whether there are grounds for additional tests or an in-person examination.
4. DecisionIf a decision about further treatment is needed, I help make it, with a tumor board discussion when necessary.

What follow-up does not replace

Follow-up is an advisory service. It does not replace:

• emergency care — with severe pain, bleeding, a high fever or a sudden deterioration, go to the nearest hospital or call an ambulance, and then let me know;
• the doctor who manages further treatment — the medical oncologist or oncologist where you live;
• an in-person examination when it is needed: I will say so directly.

Cost and terms

One-year follow-up is a separate paid service. I set the cost individually at the consultation, depending on the complexity of the case. The in-person consultation is free. The cost of the operations themselves is described on the page “Cost of Surgery: What It Depends On”.

How to start

You can ask about follow-up at the consultation, when we discuss the treatment plan. If you are from another city, a first assessment can be done remotely — how to do this is described on the page “Online Oncologist Consultation”.