Follow-up after treatment for ovarian cancer

Follow-up after treatment is an important part of cancer care. Follow-up for ovarian cancer is often shared among the cancer specialists (oncologists, surgeon) and your family doctor. Your healthcare team will work with you to decide on follow-up care to meet your needs.

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

• pain in the legs, lower back, pelvis or abdomen
• swelling of or pain in the abdomen
• change in bowel habits
• increasing bloating, nausea or vomiting
• weight loss

The chance that ovarian cancer will come back (recur) is greatest within 5 years, so you will need close follow-up during this time.

Follow-up visits for ovarian cancer are usually scheduled:

• every 3 to 4 months for the first 2to 3 years after finishing initial treatment
• every 4 to 6 months for the next 3 years
• then once a year

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, including:

• a pelvic and rectal exam
• feeling the neck, abdomen and legs for swelling
• feeling the lymph nodes in the groin

Tests are often part of follow-up care. You may have:

Tumour marker tests may be done to monitor how the treatment is working. Rising levels of a tumour marker may mean that the cancer has recurred. The doctor may order tests for different tumour markers for different types of ovarian cancer:

• cancer antigen 125 (CA125)
• alpha-fetoprotein (AFP)
• human chorionic gonadotropin (HCG or b-HCG)
• carcinoembryonic antigen (CEA)

Blood chemistry testsmay be done to show how well certain organs are working. They can also be used to find abnormalities that may mean the cancer has spread to certain organs.

Complete blood count (CBC) may be done to check for anemia from long-term bleeding, especially if the ovarian cancer has spread to the small or large intestine (also called the bowel).

Imaging tests may be ordered to check how the treatment is working or investigate new symptoms:

• chest x-ray
• CT scan
• PET scan

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

To make the decisions that are right for you, ask your healthcare team questions about follow-up.