DX, Sept., 2011, Stage 3b, Mucinous Adenocarcinoma. Large lower right primary tumor, extensive lymph involvement, pleura involvement. ALK+. Treated at M.D. Anderson of Houston, TX included: 2 (21 days) chemo; Surgery; followed by 6 chemo/ 30 radiations. Presently take " Warfarin" for PE which occurred during treatment.
Since 2012, periodic CT Scan Reports by SCOA show cancer as “stable” with a large to moderate pleura effusion. My SCOA oncologist states if my October (2016) CT Report shows “stable” no future blood work or follow-up scans will be needed because it has been 5 years since occurrence. I will be dismissed as a patient as NED. When I completed treatment in 2012, I understood I should be followed for life as the cancer was extensive. Has protocol changed? Do I no longer need to be monitored? Can the “Warfarin” also be stopped? (Monitored by my GP). Gramme
Reply # - August 1, 2016, 08:49 AM
Hi gramme,
Hi gramme,
There really isn't a universally accepted set of guideline on follow-up, as described by Dr. West in this post, but even though the risk of recurrence drops quite a bit as you reach five years, there is also the higher-than-normal risk of a new cancer, so continued follow-up is recommended, with some organizations recommending yearly scans.
There's also the question of what is meant by "stable" in your case. If there is a tumor that remains visible on scans but has not increased in size (which is the usual definition of stable, no growth in visible tumors), then I would expect continued follow-up (with scans) is necessary. If there is no evidence of cancer (which would usually be referred to as such, or as "NED"), then perhaps continued scanning is not as vital.
Of course, if you are not confident in your current physician's recommendation, then this might be a good point to seek a second opinion.
Whether you need to continue warfarin is a question best left to your personal medical team.
JimC
Forum moderator