Testicular Cancer

Follow-up

The aim of follow up care is to detect a relapse at a stage when further treatment has the best chance of being effective, to monitor and treat any side effects of therapy, and to offer support and information. 

The frequency and nature of men's check-ups varied according to the type of tumour the men had had removed, the type of treatment they had received, and on whether or not cancer had spread to other parts of the body. 

Most men had weekly or monthly checks to start with, followed by six monthly, and then yearly checks. Some experts think that it may be reasonable to discharge some men five years after treatment. However, most men here were followed up for ten years. During the check-up men usually had a chance to talk to a doctor about their health, ask questions and seek reassurance. One man said that he made a list of questions before he went for his appointments. Men normally had a physical examination too.

At each appointment blood tests were usually done. The results of these blood tests are particularly helpful as indicators of any recurrence for men who have had a tumour called a teratoma. Blood tests are less useful as indicators of recurrence for men who have had a seminoma. Chest x-rays were also done routinely to make sure cancer had not spread to the lungs and other organs.

Some men had a single CT (CAT) scan soon after the operation. Further CT scans are not necessary in every case, and one man was worried that his frequent CT scans might cause another cancer later in life. However, two men asked to have another scan after five years, just to reassure themselves that they were really clear of cancer.

Some men, particularly those who had had metastases (cancer spread), those who were on new treatments, and those who had chosen surveillance (see 'Surveillance'), had CT scans more frequently. One was having CT scans every two months, another every three months, and another every six months. One, who was taking part in a trial, had a second CT scan after a year.

Many men feared a recurrence, and found the uncertainty of not knowing whether or not the cancer would return hard to bear. Some found the period immediately before their check-ups very stressful indeed, but this diminished as the months went by.

One man found his check-up appointments tiring because he worked nights, and the long time he spent at the clinic cost him valuable sleep.

Other men, however, said they didn't worry about their check-ups. Most found it reassuring that they were being closely monitored. Some said that they enjoyed their check-up appointments at the hospital, and one man said that when his check-ups came to an end after 10 years he felt that part of his support system had disappeared.

After ten years of check-up appointments one man felt 'wonderfully liberated'. He found that after a number of years the check-ups ceased to be reassuring, but instead put him back in a 'cancer mode'.

Last reviewed December 2014.

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