There is little evidence that follow-up of asymptomatic cancer patients influences survival or quality of life. This is not surprising, since for the majority of cancers there is no curative treatment for relapse or progression. Effective therapy for relapse is rare. Some of the reasons why physicians consider follow-up useful for cancer patients include evaluation of response to treatment, early detection and treatment of recurrence, monitoring of late effects of therapy, patient rehabilitation and psychological support, family and patient risk counselling, early detection of second malignant lesions, medical education for health professionals, research and investigation of new treatment for cancer relapse. It is unclear to what extent patients share these views or what follow-up services they want and from whom they prefer to receive those services.
Patients worry about recurrence and about missing symptoms of new cancer.
Differences of opinion about the roles of various caregivers in the follow-up of patients with cancer suggest that changes to current practice will have to be carefully introduced in consultation with family physicians, specialists and patients. It seems inevitable that changes are needed in the traditional system of cancer follow-up. Objectives must be articulated and the respective roles of institutions and other caregivers clarified. Any improvement in the effectiveness and efficacy of follow-up care should, at a minimum, seek to preserve and enhance those characteristics. The role of family physicians in the management of cancer patients.