Renal Cell Carcinoma
Some types of treatment can remove or destroy kidney cancer, but care for people with renal cell carcinoma (RCC) doesn’t end when active treatment is completed. Your health care team will follow up with you on a regular basis to monitor your overall health, make sure the cancer has not metastasized (spread) or returned (called recurrence) and manage any side effects or late effects. This is known as follow-up care.
You and your doctor should work together to create a personalized follow-up care plan. You may choose to work with your oncologist or your primary care physician for follow-up care. Before making that decision, consider the type and stage of your cancer, potential side and late effects you may be facing, your health insurance and your comfort level.
Your follow-up care plan likely will include schedules and other information to manage the following.
Routine Care and Recurrence
Cancer recurs because small areas of cancer cells may remain undetected in the body, sometimes only showing up on test results or through symptoms after they have increased in number over time. As a result, it’s very important to attend all of your follow-up appointments. During those appointments, your doctor can give you personalized information about your risk of recurrence.
To track your condition, your doctor likely will order physical examinations and/or medical tests in your follow-up care. Routine follow-up care usually includes regular blood tests to check kidney function and chest X-rays, CT scans of the abdomen and chest and other imaging tests to watch for recurrence or metastasis (cancer that has spread to another part of the body). Your schedule for and type of follow-up appointments will depend on your original diagnosis and the type of treatment you received. If you had surgery to remove a kidney and are living with one kidney, for example, your kidney function will be monitored for the rest of your life.
Another reason to be diligent about follow-up appointments is because being treated for kidney cancer doesn’t mean you can’t get a different type of cancer. People who have had kidney cancer have an increased risk for a second kidney cancer (not a recurrence of the first cancer), bladder cancer, cancer of the ureter (the tube that connects the kidney to the bladder), prostate cancer, thyroid cancer and melanoma of the skin.
Communication is crucial to your follow-up care. Keep a list of your questions to take to your appointments. Use these appointments to talk to your health care team about any changes in your health or new problems or symptoms you notice, no matter how minor they may seem, in addition to any general questions or concerns you have. If you see doctors who were not directly involved in your cancer care, it’s helpful to share your cancer treatment summary and follow-up care plan forms with them.
Side Effects and Late Effects
Each type of treatment for kidney cancer has side effects that can last from a few weeks to a few months, throughout treatment or for the rest of your life (see Side Effects). Some side effects begin when treatment begins, and others may not appear until much later. These are known as late effects. Late effects can cause physical and emotional changes.
Talk with your doctor early on, if possible, about your risk for the development of side and late effects based on the type of treatment you had so you can be prepared for what to expect. Continually communicating with your health care team about your symptoms may help you manage these effects more successfully.
You may find yourself seeing a new doctor who is unaware of your RCC history. It’s important to be able to give your new doctor the details of your diagnosis and treatment. Gathering these details soon after treatment may be easier than trying to get them later. Keep copies of the following for any new doctor you see and for yourself:
- Pathology report(s) from any biopsies or surgeries
- Operative report (if you had surgery)
- Treatment summary (list of the drugs you received, including the dose and schedule, and details on radiation therapy, if you received it)
- Discharge summary that your doctor prepared when you were sent home (if your treatment included a hospital stay)
- Copies of the images of your CTs, MRIs, or other imaging tests (these may be available on a DVD)
Finishing treatment or moving to a less frequent treatment schedule may be exciting for some people but may cause worry for others. You may feel a variety of emotions during and after your cancer treatment:
- You may be anxious that your cancer will recur or that another type of cancer will develop.
- Without frequent doctor’s appointments, the additional free time you have in your schedule may make you feel unsettled.
- Going back to work and interacting with coworkers and friends may be a difficult transition.
- Financial concerns may weigh heavily on your mind.
- You may feel the need to re-evaluate the personal or business relationships in your life.
All of these emotions are valid. Just like during treatment, you are not alone. It’s important to remember that you don’t have to try to sort out these feelings on your own.
Different sources of support include friends and family members, religious or spiritual groups, local and online support groups or a counselor. Think about how you relate to others and whether you’d prefer one-on-one type of support or interacting with others in a group setting. Choose a forum that best fits your personality. If you aren’t sure where to get help, ask your health care team for a referral.