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What advice do you give to patients about how best to monitor and track their long-term side effects? What are the most important things to monitor?
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Expert Answers
NancyJoBushRNONP (Nurse (Verified) ) - 03 / 24 / 2012
Routine, follow-up physical examinations are vital for the cancer survivor. Communication with the physician of any side-effects experienced is the best way to monitor and keep track of long-term side-effects. The healthcare provider will be able to follow, monitor, and chart in the medical record any and all of the side-effects experienced. This helps the physician look for any patterns or changes in symptoms over time. Many cancers also give off tumor markers that can be followed by specific blood tests, warning the physician that there is a possibility that cancer changes are occurring; for example, the CEA test for colorectal cancer or the CA 125 test for ovarian cancer.
Hopefully, the healthcare team educates the patient about which long-term side-effects may be expected from which specific cancer and treatment experienced, for example, radiation therapy to the chest may cause long-term fibrosis of the lung fields causing a dry, non-productive cough or shortness of breath on exertion with exercise. The patient will then know what may be a permanent long-term side-effect and be able to differentiate this from an abnormal symptom that arises; for example, a wet productive cough.
Every survivor should be familiar with side-effects that are not normal from expected long-term side-effects. The American Cancer Society uses the algorithm C-A-U-T-I-O-N to outline the seven warning signs of cancer: C=changes in bowel or bladder habits, A= a sore that does not heal, U= unusual bleeding or discharge from any place, T= thickening or lump in the breast or elsewhere, I= indigestion or difficulty swallowing, O= obvious change in a wart or mole, and N= nagging cough or hoarseness. These warning signs can be indicative of a new cancer or a recurrent cancer and any change in symptoms should warn the patient to bring these to the attention of the physician. Other symptoms that should be monitored include any unusual fever, chills, or night sweats which can be indicative of malignancy or recurrence along with any unusual nausea, vomiting, or anorexia. A very important symptom to monitor is unusual, unintended weight loss.
Hopefully, the healthcare team educates the patient about which long-term side-effects may be expected from which specific cancer and treatment experienced, for example, radiation therapy to the chest may cause long-term fibrosis of the lung fields causing a dry, non-productive cough or shortness of breath on exertion with exercise. The patient will then know what may be a permanent long-term side-effect and be able to differentiate this from an abnormal symptom that arises; for example, a wet productive cough.
Every survivor should be familiar with side-effects that are not normal from expected long-term side-effects. The American Cancer Society uses the algorithm C-A-U-T-I-O-N to outline the seven warning signs of cancer: C=changes in bowel or bladder habits, A= a sore that does not heal, U= unusual bleeding or discharge from any place, T= thickening or lump in the breast or elsewhere, I= indigestion or difficulty swallowing, O= obvious change in a wart or mole, and N= nagging cough or hoarseness. These warning signs can be indicative of a new cancer or a recurrent cancer and any change in symptoms should warn the patient to bring these to the attention of the physician. Other symptoms that should be monitored include any unusual fever, chills, or night sweats which can be indicative of malignancy or recurrence along with any unusual nausea, vomiting, or anorexia. A very important symptom to monitor is unusual, unintended weight loss.
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