Follow-up after treatment for biliary tract cancers

Follow-up care lets your healthcare team keep track of your health for a period of time after treatment ends. This important part of cancer care is often shared among the cancer specialists and your family doctor. They will help you recover from treatment side effects and monitor you for any signs that the cancer has come back (recurred).

Follow-up care may not seem that important to you, especially if your treatment was long or very hard. You may find the idea of follow-up care stressful because it reminds you of your cancer experience or because you are worried about what a test might reveal. Talk to your healthcare team about how you feel and about why follow-up matters. Your healthcare team is there to help.

Don't wait until your next scheduled appointment to report any new symptoms or symptoms that don't go away. Tell your healthcare team if you have:

• jaundice

• pain or an increase in pain on the upper-right of abdomen
• fever
• nausea or vomiting
• bloating
• any new lump or swelling in your abdomen

The chance that gallbladder or bile duct cancer will recur is greatest within 3 years, so you will need close follow-up during this time.

Follow-up visits for gallbladder or bile duct cancer are usually scheduled:

• every 3 to 6 months for the first 2 years after you finish treatment

• every 6 to 12 months for the next 3 years

• once annually every year after

Your healthcare team may suggest a different schedule based on your cancer type, stage and treatments.

During a follow-up visit, your healthcare team will usually ask questions about the side effects of treatment and how you're coping.

Your doctor may do a physical exam, which includes:

• feeling the abdomen for any lumps, tenderness, swelling or fluid
• looking at the whites of the eyes and skin for yellowing (a sign of jaundice)
• feeling the lymph nodes in the groin

Tests are often part of follow-up care. If you have new symptoms, you may have:

• imaging tests (such as a CT scan) to look for tumours or abnormal growths that may be cancer
• blood tests (including a complete blood count, liver function tests and tumour marker tests) to look for cell abnormalities or growths that may be a sign of cancer

If the cancer has come back, you and your healthcare team will discuss a plan for your treatment and care.

The following are questions that you can ask the healthcare team about follow-up after treatment for cancer. Choose the questions that fit your situation and add questions of your own. You may find it helpful to take the list to the next appointment and to write down the answers.

• What is the schedule for follow-up visits?
• How often is follow-up scheduled with the cancer specialist?
• Who is responsible for follow-up visits?
• What will happen at a follow-up visit?
• What tests are done on a regular basis? How often are they done?
• Are there any symptoms that should be reported right away? Who do I call?
• Who can help me cope with long-term side effects of treatment?