Follow-up and surveillance of the lung cancer patient following curative-intent therapy.
The following two distinctly different issues should be taken into account when planning patient care following curative-intent therapy for lung cancer: adequate follow-up to manage complications related to the curative-intent therapy; and surveillance to detect recurrences of the primary lung cancer and/or development of a new primary lung cancer early enough to allow potentially curative retreatment. Follow-up for complications should be performed by the specialist responsible for the curative-intent therapy and should last 3 to 6 months. Recurrences of the original lung cancer will be more likely during the first 2 years after curative-intent therapy, but there will be an increased lifelong risk of approximately 1 to 2% per year of developing a metachronous, or new primary, lung cancer. A standard surveillance program for these patients is recommended based on periodic visits, with chest-imaging studies and counseling patients on symptom recognition. Whether subgroups of patients with a higher risk of developing a metachronous lung cancer (eg, those patients whose primary lung cancer was radiographically occult or central and those patients surviving for > 2 years after treatment for small cell lung cancer) should have a more intensive surveillance program is presently unclear. The surveillance program should be coordinated by a multidisciplinary tumor board and overseen by the physician who diagnosed and initiated therapy for the original lung cancer. Smoking cessation is recommended for all patients following curative-intent therapy for lung cancer.
Colice
Gene L
GL
Critical Care and Respiratory Services, Washington Hospital Center, 110 Irving Street NW, Washington, DC 20010, USA. gxc@mhg.edu
Rubins
Jeffrey
J
Unger
Michael
M
D000970:Antineoplastic Agents / Q000009:adverse effects; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000628:therapy*; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000628:therapy*; D016609:Neoplasms, Second Primary / Q000175:diagnosis* / Q000628:therapy*; D011013:Pneumonectomy / Q000009:adverse effects; D011878:Radiotherapy / Q000009:adverse effects; D016540:Smoking Cessation
D000970:Antineoplastic Agents