Every time I open the mutual aid group of breast cancer sisters, I am always very happy when I see that the sisters have a smooth re-examination and have passed one level after another in the fight against cancer.
So now, let's congratulate another sister in the group on successfully crossing the 3-year mark.
Secretly sharing a good news with my sisters, I had a re-examination yesterday, and after 3 years of treatment, I passed it with trepidation. Don't let the "bad guys" hear it!
Let's pick up the good luck together, may all the follow-up results go well, and may the cancer roll further and further!
Also taking advantage of the good news of this sister, Mutual Aid Jun would like to talk to you about why we and the doctor are repeatedly emphasizing the importance of regular review, and what should be checked for regular review?
01 What is the importance of regular review?
Some sisters may wonder: "I have been fighting cancer for many years, my condition is also stable, and the doctor asked me to go for a check-up once a year, do you want me to spend more money?"
Regular reviews are not really trying to make you spend more money, but there are a few considerations:
1. Monitor treatment effects and side effects:
Regular follow-up helps doctors evaluate the effect of previous treatment, and follow-up can help monitor the side effects of medications, such as osteoporosis, dyslipidemia, endometrial thickening, etc., so that they can adjust the medication regimen or take interventions in time to ensure the quality of life of the sisters and maintain the continuity of treatment.
2. Early detection of recurrence and metastasis
Tumour cells are very cunning, so even if the primary tumour is surgically removed, there is still a risk of recurrence and metastasis of breast cancer. Regular follow-up can help to detect potential metastatic lesions early, ensure early diagnosis and intervention, and improve treatment effectiveness.
3. Adjust your treatment strategy
Based on the results of the review, the doctor can also adjust the treatment plan in a timely manner, such as changing the drug dose, changing the treatment method, or initiating a new treatment course when recurrence or metastasis is found, so as to ensure that the treatment is targeted and effective.
Knowing the importance of regular review, what do we usually do when we review?
02 Frequency and items of review
Clinical physical examination
The frequency of the examination is recommended to be once every 3~6 months for the first 2 years, every 6 months for the next 3 years, and once a year after 5 years.
Self-examination and physical examination
After treatment, it is recommended to do a breast self-examination once a month to detect changes in the lesion in time.
In addition, the doctor will also ask for a medical history at each visit and arrange a specialist physical examination to explore the breast for lumps, as well as to make a preliminary judgment on the size and range of motion of the lumps.
Blood tests
Including blood routine, liver and kidney function, blood lipids, blood glucose, electrolytes, tumor markers, hormone levels, etc.
Blood tests can be done every 6 months at the time of initial diagnosis and once a year after 3 years to determine the efficacy and recovery. If you are in the chemotherapy period, it is recommended to have a weekly blood routine to monitor white blood cells, red blood cells, platelets and other indicators.
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Imaging tests
(1) Breast imaging: including X-ray, ultrasound, chest CT, MRI. Imaging is recommended annually to explore the unaffected breast and the chest wall on the affected side, as well as the lymph node drainage area, for recurrence and metastasis. MRI of breast cancer is more suitable for breast-conserving surgery patients and other complementary imaging tests.
(2) CT of chest and abdomen, abdominal ultrasound: it is recommended to be once every 6 months, and once a year after 3 years, to judge whether there is distant metastases such as lungs and liver.
(3) CT/MRI of the head: It is recommended to check whether there are brain metastases, dizziness, headache, projectile vomiting, epilepsy and other symptoms.
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(4) PET-CT: It can be used to detect recurrent metastases throughout the body, but it is not a routine re-examination item, and is generally used selectively under the comprehensive clinical judgment of doctors.
(5) Bone scanning: Patients with high-risk factors such as more than 4 axillary lymph node metastases should undergo baseline bone scanning, and if necessary, whole body bone scans should be performed once every 1~2 years to determine whether there is bone metastasis.
(6) Bone density test: generally once a year, or monitor the changes in bone density according to the situation, to help patients prevent and treat osteoporosis after endocrine therapy.
It is important to note that the frequency and program of examinations may vary from patient to patient.
Professor Song Chen from the Department of Breast Oncology, the Second Affiliated Hospital of Dalian Medical University, said:
As for the frequency of reexamination, domestic and foreign guidelines stipulate that once every 3 months within 2 years after surgery, once every 6 months after 3~5 years after surgery, and once a year for more than 5 years after surgery.
However, considering the differences in the condition of each breast cancer patient, it is recommended that you still follow the guidance of the attending doctor when you have a follow-up examination. For example, patients with early-stage breast cancer (such as stage 0 and stage 1) with relatively good pathological classification and relatively low risk of recurrence can consider extending the interval between reexaminations: every 6 months for 2 years after surgery, and once a year from the 3rd year after surgery.
On the contrary, breast cancer patients with relatively poor pathological classification and high risk of recurrence, such as the number of lymph node metastases is more than 4 and the mass is relatively large, it is necessary to appropriately shorten the interval between reexaminations.
It should be noted that no matter what type of breast cancer patient has, if he or she has clinical symptoms such as chest pain, long-lasting cough, bone pain, etc., he or she should immediately go to the hospital for examination, and the real cause should be clarified as soon as possible and targeted treatment should be carried out.
03 The review is more efficient, and five lessons can help you
1) Draw blood in another hospital in advance and go to the target hospital for re-examination with the report
First, blood draw items often do not need to make an appointment, but most blood draw items do not have results on the same day;
Second, the blood sampling items are basically machine testing, and different hospitals have different reference values at most, 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) X-rays can be done at one time
In view of the fact that the review cycle of these items is generally 1 year, and the CT resources of many hospitals are prioritized for inpatients, so that the appointment time is very long, we can try to stagger the progression: for example, CT 12 months after surgery, mammography 15 months after surgery, and bone mineral density 18 months after surgery. 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
For example, the Breast Disease Center of West China Hospital of Sichuan University issued a message in early July to remind patients:
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.
In particular, breast cancer patients who need to be treated in other places may involve more uncontrollable factors, and the cost of time and expenses will be greater.
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 may affect the accuracy of the test results.
The second is to prepare yourself mentally and familiarize yourself with the review indicators of breast cancer at home, so that you can 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:
CEA, or carcinoembryonic antigen, is maintained in the normal range at 3 μg/L;
CA15-3, i.e., carbohydrate antigen 15-3, remains below 20 μ/ml as the normal range;
CA125, i.e., glycosyl antigen 125, is within the normal range if it is kept below 30 μ/ml, and is positive if it exceeds the upper limit of normal.
5) Some hospitals will offer a review package, so you can complete all the tests in one morning
Breast cancer patients in need, especially those who are visiting a different place, can check if the hospital you are going to has it. In addition, for breast cancer patients who have been re-examined in other places, if several re-examinations are not a big problem, they can also consider completing the re-examination project in a local hospital, bringing the results to the attending doctor for interpretation, and if necessary, it is good to do additional examinations.
In addition to regular check-ups, breast cancer sisters in recovery can also help recover better from these aspects!
04 Do these things during the recovery period to help the success of the fight against cancer
1. Eat a nutritious diet
As a consuming disease, the need for nutrition for patients is greater than that of normal people. Therefore, a rich and balanced diet and good nutritional maintenance can improve and consolidate the anti-cancer efficacy, which will help the sisters recover better.
Diet can be matched according to the patient's different conditions, age, constitution, taste preferences and other factors. The general principle of the diet is fresh, clean, rich and balanced, light and tasteful. If necessary, a medical professional can be consulted for nutritional therapy.
2. Keep moving
Exercise is also a good medicine for cancer and recovery. Appropriate and reasonable exercise can not only alleviate the physical discomfort of cancer patients to a certain extent, improve the body's immunity, but also help improve fatigue, insomnia, etc., reduce patients' psychological problems and negative emotions, such as anxiety and depression, and help improve the quality of life.
It should be noted that when exercising, you need to follow the principle of step-by-step, pay attention to warming up in advance, and can choose rehabilitation exercises, slow walking, housework, Tai Chi, etc.
3. Psychological adjustment
Happiness is the best partner in life, and happy emotions are also conducive to better recovery of cancer patients.
Sisters can do things that are easy and simple, require concentration, and give themselves a sense of accomplishment after completion, such as participating in public welfare activities, cultivating simple hobbies, such as fishing, flower arrangement, walking, painting, reading, square dancing, etc., to find happiness and maintain a fresh sense and love for life.
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4. Change your habits
During the recovery period, you also need to develop healthy and good lifestyle habits, eat a balanced diet, go to bed early and wake up early, and live a regular life. Stay away from carcinogenic factors as much as possible, such as quitting smoking and alcohol, not drinking raw food and water, not eating moldy and spoiled food, and eating less high-fat, high-sugar, high-salt food.
A good living environment is also conducive to the physical and mental relaxation of patients. The home needs to be kept clean and hygienic, open the windows every day for ventilation, and dry the bedding regularly to ensure that the air is fresh, and the temperature and humidity are appropriate.
5. Heavy return society
Psychotherapy is one of the important components of therapy. The purpose of social reintegration, that is, to return to the work and life before treatment, is to allow patients to divert their attention through normal work and life, gradually "forget" that they are cancer patients, cultivate hobbies, and find a sense of social belonging and value.
Paying attention to the combination of work and rest, clarifying goals and building self-confidence are more conducive to the recovery of cancer patients.
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6. Scientific and unfounded beliefs
Cancer treatment is a long process, and as the saying goes: the disease comes like a mountain, and the disease goes like a thread. And the scammers take advantage of people's psychology of survival and urgency, both seeking money and "killing". If cancer patients believe in scams, they will not only delay treatment, but may even accelerate the deterioration of their condition. Only by adhering to scientific treatment can it be a long-term solution.
Sisters must pay attention not to believe in home remedies, and they must keep their eyes open and carefully screen when learning about various information.
7. Actively learn and don't get confused
The confusion and helplessness caused by the lack of medical knowledge are the truest feelings of most sisters after being diagnosed.
Choosing a hospital, a doctor, a treatment plan, etc., are all life-threatening choices. For some sisters, a clearer understanding of their own situation, learning about cancer-related medical knowledge, and understanding the latest dynamic information can also better cope with various side effects that occur during treatment and arrange a good recovery life.
Warm reminder: The purpose of this article is to convey disease knowledge, and it is not used as a recommendation for diagnosis and treatment plans and medical basis.
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Editor in charge: Mijian Mutual Aid Jun