After local surgery, chemotherapy, radiotherapy and other treatment methods, cancer patients may still have cancer cells in their bodies, and regular reexamination is the most effective and direct way to capture the signs of cancer recurrence and metastasis after surgery.
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"What are the items to be done in the re-examination that have radiation?" "Is there a way to get all the re-examination items in half a day? "Do I have to pay again to register the report to the doctor?"
The following is a "nanny-level" review strategy, which is worth forwarding and collecting!
01 What tests will cause radiation?
(1) Color ultrasound is an ultrasound examination, which does not have any radiation to the human body;
(2) MRI is a completely radiation-free examination;
(3) CT was divided into non-contrast and contrast, and the radiation intensity of the latter was higher than that of the former.
(4) PET/CT is generally not suitable for routine re-examination of patients due to its large amount of radiation compared with other examinations, but it is still preferred in some necessary cases (such as when the condition cannot be clarified by other detection methods). If this test is done, other CT scans can be omitted.
According to the recommendations of the International Commission on Radiological Protection, the annual radiation exposure of a single tissue or organ should be controlled within 50 mSv [5], and doctors will choose the medical plan with the greatest health benefits and the least risks under the premise of comprehensive risk assessment.
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02 5 "Unspoken Rules" for Efficient Review
If you don't know, you'll lose:
(1) Draw blood in another hospital in advance and go to the target hospital for re-examination with the report
First, blood sampling projects often do not need to make an appointment, but most of the blood sampling projects cannot produce results on the same day; second, blood sampling items are basically machine testing, and different hospitals (medical conditions are similar) at most have different reference values, and the requirements for the level of doctors are not high.
It should be noted that the time of the examination and the time of the re-examination should not be too long, otherwise it may still need to be done again.
(2) It is not necessary to do all the inspections at once
In view of the fact that the review cycle of these items is generally relatively long, and the CT resources of many hospitals are given priority to inpatients, so that the appointment time is very long, we can try to stagger the time: for example, the gastroscopy is checked first, and then the CT is checked, and other non-urgent items can be checked again in 1-2 days or next week. This way, you don't have to run around on the same day and can't find the north.
(3) Pay attention to the appointment and registration dynamics of the target hospital, otherwise you may run in vain
Taking West China Hospital of Sichuan University as an example, a message was released in early July to remind patients that there is no on-site registration channel at the outpatient site...... When the online outpatient clinic cannot meet the demand for treatment, the attending doctor can transfer to the offline outpatient clinic through the referral channel after evaluation and screening.
Especially for cancer patients who need to be treated in other places, there may be more uncontrollable factors involved, and the cost of time and expenses will be greater, so it is more necessary to pay attention to the relevant notice information on the hospital's official official account/website in advance.
(4) Prepare for medical treatment in advance, and pack up medical records and daily necessities
The same is true for physical preparation, if you eat before the examination and eat high-fat, high-protein food, it will affect the accuracy of the test results.
The second is to prepare for the mind and knowledge, and familiarize yourself with the review indicators of ovarian cancer at home, so as to quickly understand what the doctor said and better understand the progress of your disease.
Taking tumor markers as an example, there are mainly the following types [6-8]:
CA125, or glycosyl antigen 125, is a specific marker for ovarian cancer and remains in the normal range below 35 μ/ml.
HE4, human epididymal protein 4, is the "second marker of ovarian cancer" under glycoprotein antigen 125 (CA125), and its normal reference values generally range from 0 to 90 pmol/L.
CA19-9,参考标准为CA199>35.5 IU/mL。
CA72-4,正常参考值为0~6.9 U/ml。
CEA carcinoembryonic antigen, a broad-spectrum tumor marker, is maintained in the normal range of ≤5ng/mL;
(Note: The above standard values are for reference only, different detection methods, different hospitals, etc. will affect the specific standard values)
(5) Some hospitals will offer a review package, so you can complete all the examinations in one morning
Cancer patients in need, especially those who are seen in other places, can check if the hospital you are going to has it.
In addition, for cancer patients who have been re-examined in other places, if multiple re-examinations are not a big problem, they can also consider completing the re-examination project in the local hospital first, bringing the results to the attending doctor for interpretation, and then doing additional examinations if necessary.
What is the general frequency of follow-up for cancer patients?
A[9]:
After initial treatment, follow-up should be conducted every 2~4 months for the first 2 years, every 3~6 months for the 3rd ~ 5th year, and once a year after 5 years. Follow-up includes pelvic examination and tumor markers. If you haven't done genetic testing before, you still need to improve genetic testing.
Patients without chemotherapy for initial treatment, regardless of CA125 elevation or clinical recurrence, are treated as treatment-naïve patients. If the initial treatment has been treated with chemotherapy, the current clinical recurrence is treated as persistent or recurrent disease, and if only CA125 is elevated, the option is to postpone recurrent retreatment until clinical relapse or immediate treatment for relapsed disease or participate in a clinical trial.
End
In addition to helping to detect recurrence and metastasis in time, in fact, there are many benefits of regular re-examination of cancer patients, for example, it is convenient for doctors to adjust the treatment plan according to our real-time physical condition, and it is also conducive to us to learn more about the new progress of cancer treatment from the attending doctor, so as to obtain the support of new technologies and drugs in the first time.
I wish you all a good job in the re-examination, and the cancer cells will be driven away!
Warm reminder: The information involved in this article is intended to convey the cutting-edge medical information and research progress, and does not involve the recommendation of diagnosis and treatment plans.
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Editor in charge: Mijian Kepujun
Reference Sources:
[1] Expression of LINC01535 in epithelial ovarian cancer and its clinical significance
[4] Hu Panpan, Bian Yanyu, Luo Lingling.^(99)Tc^(m)-MDP Whole Body Bone Imaging Subjects External Radiation Dose Study [J] .International Journal of Radiation Medicine and Medicine.2020,11 (44)
Radiation Protection,2000(05):266-274.
[6] Feng Mingyang, Liu Fangsong, Wei Wei.Diagnostic value of serum CEA, CA19-9, CA15-3, CA125 and CA72-4 in ovarian cancer.Chinese Journal of Health Engineering,2021,20(6):981-988.
[7] LV Wenyan, Liu Jiale, Liu Hang, Bi Lili, Zhang Lin.Changes in serum AFP, CEA, CA19-9, CA125 levels in patients with early ovarian cancer before and after chemotherapy and their predictive value for lymph node metastasis[J].Hainan Medicine,,2024,35(1):100-104.
[8] Li Jian, Liu Xiongying, Peng Haihong, Xie Shuguang.Discussion on the diagnostic value of four tumor markers in ovarian cancer[J].China Modern Drug Application,2023,17(21):49-52.
[9] Chinese Society of Clinical Oncology Guidelines Working Committee.2023 CSCO Guidelines for the Diagnosis and Treatment of Ovarian Cancer