Ongoing Monitoring and Care
Whether you are still in treatment or have finished, it is important to continue to be proactive about your health, including making and keeping follow-up appointments. Regular monitoring will help your doctor manage any long-term side effects and detect warning signs of a recurrence or a second cancer so early treatment is possible. These appointments also give you the opportunity to continue communicating with your health care team as you transition back into former activities and explore new ones.
Your doctor or nurse will work with you to develop a customized follow-up care plan that may include the following:
- Appointment schedule for ongoing monitoring
- Palliative care for physical and emotional side effects
- Medications or therapies, including type, dosage, frequency and duration
- Referral(s) for cancer rehabilitation services, such as physical or occupational therapy
- Information about your risk of a recurrence, second cancers, long-term treatment-related side effects and late effects
- Recommended screening guidelines for other types of cancer
- Other things you can do to stay healthy
All of the detailed information you share with your doctor can be vital. Be sure to tell your doctor how you are feeling physically, mentally and emotionally, and include the following:
- New or ongoing pain that is not adequately relieved
- New or ongoing physical symptoms, including leg swelling, abdominal distention, jaundice, weight loss or gain, bladder/bowel control; deep fatigue or insomnia; sexual dysfunction or lack of desire; mobility issues; signs of infection; tingling or numbness; fluid buildup; or changes in appetite, sense of taste, vision or hearing
- Cognitive (thinking-related) symptoms, such as difficulties with memory, concentration, processing information, word-finding or completing tasks
- Emotional issues, including depression, anxiety, fear, anger, grief, hopelessness, emotional numbness, feeling overwhelmed or other concerns
- New medications, over-the-counter remedies, vitamins, supplements or herbs
- Visits to the emergency room, urgent care or other doctors, even if not cancer-related
- Homeopathic or naturopathic therapies
How often you see your doctor depends, in part, on your unique diagnosis and the chance of recurrence. It also depends on your overall health. Continue to keep copies of your medical records. That is especially helpful if you see a new doctor.
Moving into Survivorship
To assist with the transition, your doctor may recommend a survivorship care program. Although doctors are not required to give you a survivorship care plan, many cancer centers provide survivorship educational programs about ongoing care.
This plan is designed to keep track of all pertinent information about your care and to guide you moving forward. The information may include your medical history, which may contain diseases, conditions or disorders, surgeries and treatments, hospitalizations, pregnancies, lab reports, test results and ongoing health medications; a list of health care team members with contact information; your specific diagnosis, including type, subtype, stage and date of diagnosis; and pathology and consultation notes. It may also include the tests you may need after treatment.
If you do not receive a survivorship plan from your doctor, ask your nurse navigator or case manager to help you. Or, create your own. Download a sample Survivorship Care Plan at PatientResource.com/SurvivorshipPlan.aspx, then request copies of all of your tests, biopsies, surgeries, pathology and consultation notes from your doctor’s office.
Pay attention to over-the-counter medications
As an essential part of the digestive system, the liver performs critical functions such as filtering the blood, processing and storing nutrients, converting nutrients into energy, removing toxins and maintaining proper sugar levels.
Many people with liver cancer already have some level of damage to their liver, so preventing further damage to it will be crucial. That includes being careful about the medications and supplements you take in order to prevent interference with medications prescribed by your physicians or toxicity to your liver.
Your doctor may advise you to avoid or reduce the use of an over-the-counter medication called acetaminophen. It is known to cause liver damage if taken in large quantities with compromised liver function, can interact with other medications and increase side effects. It is frequently used for headaches and other common ailments, but you may not be aware that it is a very common drug ingredient in many prescription and over-the-counter medications. These include generic and store-brand pain relievers, fever reducers and sleep aids as well as cough, cold and allergy medicines. It may be easy to take too much without realizing it if you are using multiple products containing this active ingredient. A list of active ingredient names can help you identify these drugs. Ask your doctor if you can take medications that contain acetaminophen and, if so, how much.
Follow these steps
- Read all medicine labels, and look at the active ingredient. Ask your doctor how to read medication labels if you are not familiar with them.
- Find out whether your doctor recommends limiting your intake of acetaminophen.
- Check the label for acetaminophen and its shorter versions, “APAP,” or “acetam.”
- Check with your pharmacist every time you start, stop, change or fill a prescription.
- Take your medicine as directed. Only take the recommended dose. Do not take more.
- Use the same pharmacy each time so your pharmacist can help you keep track of what you are taking.
- Do not take medicine that has expired.
- Do not take or share medicines with others.
- Always keep a list of your current medications with you.
- Take your medications with you when you travel.