Follow Up Care

After her initial treatment is over, a woman should have follow-up treatments with her doctor. During follow-ups, doctors do thorough physical exams and may also monitor a patient’s blood for an elevated CA-125 level, other blood tests and imaging to determine if cancer has returned.

In general, women treated for ovarian cancer have follow-up exams (including a pelvic exam) every 3 to 4 months for the first few years after treatment. Then the exams go to every 6 months. In addition, imaging studies such as x-rays, CT scans or MRIs are periodically performed.

Some patients have a sensitive CA-125 that will rise before their CT scan shows evidence of recurrent disease; a recent study suggests that it may be more useful to wait until a woman experiences symptoms of ovarian cancer before starting treatment. Women are encouraged to contact their doctor, if they experience any health problems between checkups.

Others will have evidence of the disease before their CA-125 rises. Doctors often use a combination of tests to monitor a patient because recurrent ovarian cancer has a wide spectrum of behavior making it difficult to monitor.  In addition to physical exams and a CA-125 test, doctors may request CT and/or PET scans to look for tumor growth.

You should also ask your healthcare provider if the potential use of maintenance therapy drugs such as PARP inhibitors or Avastin is right for you.

Physicians should discuss a follow-up plan and survivorship plan with their patients, clearly outlining a plan of action post-treatment. A survivorship plan that addresses long-term issues is critical for a woman to have and discuss with her regular internist and other health care professionals outside of her cancer treatment.

Emotional Health Post-Treatment
Many women report mixed emotions following treatment for ovarian cancer. While they are excited to have no evidence of disease, fears of recurrence are common. For some women, the hardest part of treatment for a woman with ovarian cancer is when chemotherapy is finished and she goes on with life. When she had surgery and chemotherapy she was getting regular care, fighting the cancer and taking active steps in her treatment. But the uncertainty about whether the cancer will return and concerns that every little sign or symptom may indicate a recurrence can be very anxiety-producing for some women. Support from family and friends is critical at this time.

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