Follow-up of Patients with Gynaecological Cancer


East Gloucestershire NHS Trust, St. Paul's Hospital, Swindon Road, Cheltenham, Gloucestershire GL50 4BW, United Kingdom.


EDITORIAL COMMENT: In the editor's private practice the follow-up of survivors of treatment of invasive cancer is favoured by both practitioner and patient - we have become friends and are dependent upon each other - our annual meeting allows mutual documentation of survival and morbidity as each assesses the effects of the ageing process on the other. The brief annual meeting is surely cost-effective in terms of mutual morale - and occasionally an unsuspected local recurrence or metastasis is detected and managed effectively after referral and discussion of treatment strategies with the appropriate oncologist. Nonetheless the questions asked by the authors after their analysis of our colleagues' regimens of follow-up require answers, although the woman's wishes for continued surveillance should be heeded.

Additional Comment by our Oncologist Reviewer: The follow-up of the cancer patient is an essential part of the management of cancer and should follow a strict protocol. The objectives of follow-up are:

1. Assessment and documentation of the results of therapy with regard to cure, time to relapse and survival time.

2. Early detection of recurrence and institution of further therapy when appropriate. On-going surveillance wilt vary according to disease site, prognostic factors and family history of cancer. Routine investigation should include vaginal cytology, chest X-ray, renal ultrasound, CT scans, mammography and tumour markers such as CA 125.

3. Quality of life assessment with regard to the early and late sequelae of cancer therapy and the appropriate therapy for these side-effects i e. lymphoedema, psychosexual problems, bladder or bowel problems.

The value of a comprehensive follow-up protocol is seen in many cancer clinical trials. The overall improvement in survival of patients entered into trials relates in part to early detection of recurrence and institution of salvage therapy.