Follow-up after endometrial cancer
Can Med Assoc J 1998;158:588-90
In response to: C. Aquino-Parsons; C.E. Danjoux et al; E. Warner
The purpose of our study was not to discount the experience and judgement that oncologists bring to the follow-up care of cancer patients but to highlight the fact that if improved survival is the endpoint of such follow-up practice, it is not achieving its purpose.
Of the cancers that recur after curative treatment, few are treatable and in most cases the survival of the patient or the control of the cancer depends to a greater extent on the biology of the tumour than on the intervention.
The assumption that the quality of life or care of asymptomatic patients is better for those followed at a cancer centre than for those cared for by their family physician has not been proven by randomized clinical studies. For example, a significant proportion of these patients experience increased anxiety in anticipation of their visits to the cancer clinics, which could have a negative impact on their quality of life.
The results of our study on endometrial cancer should not be applied to all cancer types, but the current practice of intense, lengthy follow-up of patients who have undergone curative treatment and whose disease has a good prognosis needs to be reviewed.
Olu Agboola, MB, BS
Head
Department of Radiation Oncology
Ottawa Regional Cancer Centre
Ottawa, Ont.
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