Cure is also possible in some cases if recurrent tumor is discovered at an early stage. Appropriate palliative measures should be instituted as early as possible. The patient is then seen at four month intervals for the next two years, when the chance of recurrence is highest, and at six month intervals thereafter, for the rest of his life. At follow up, a history and physical examination are done. This examination should include all items mentioned in the pre-operative examination.
Special attention is paid to functional status and possible recurrence of tumor.
PFTs are done at four months to establish the function of the lungs after surgery. A chest x-ray is imperative. In my experience this is not the case. I note delayed recognition of recurrence and second tumors, and improper management of these events when follow-up is not managed by an expert. Furthermore, I have found that follow-up by inexperienced physicians is usually more expensive, because inappropriate tests are more frequently ordered.