After treatment, you have regular check ups to look for signs of the cancer coming back or spreading. This is called follow up.
You usually have follow up appointments for at least five years. This is so any cancer can be found and treated early.
After surgery for early or locally advanced kidney cancer, you usually have your first follow up appointment 4 to 6 weeks after you leave hospital. This is to make sure you’re recovering well from your operation.
You then have regular follow up appointments for at least five years. After surgery for early kidney cancer, the more time that passes with no sign of it, the smaller the risk is of the cancer ever coming back. But there is still a small risk, even after 10 years.
Low risk of cancer coming back
If your risk of the cancer coming back is low, you might have a chest x-ray:
- every 3 months for 2 years
- then every 6 months for three years
Higher risk of cancer coming back
You'll probably have regular CT scans for the first 3 years if the risk of your cancer coming back is higher.
Things that increase the risk of the cancer coming back include:
- having a tumour larger than 5cm across
- changes in the tumour cells (called sarcomatoid dedifferentiation)
- tumour cells at the edge of the tissue that the surgeon removed (called a positive margin)
- raised levels in the blood of a chemical called alkaline phosphatase
- raised levels in the blood of a chemical called lactate dehydrogenase
After 3 years, you might just have x-rays every 6 months if all is well. But this follow up may continue for life.
If you had advanced cancer, or your cancer wasn't completely removed but isn't growing, you and your doctor will decide together how often you need follow up appointments. This will depend on any treatment you may need to help control the cancer.
After cryotherapy or radiofrequency ablation
You have follow up appointments and scans every 3 to 6 months after having a small kidney cancer treated by cryotherapy or radiofrequency ablation.
During biological therapy
You have regular follow up appointments with your specialist and scans every 3 to 6 months if you are having biological therapy treatment for advanced cancer. The scans check how well the treatment is working.
At your appointments, the specialist will also discuss any symptoms or side effects you have. They can suggest treatment to help control them. They can also check whether they need to change your treatment to control the cancer better.
Your doctor will:
- examine you
- check your lymph nodes and abdomen
- listen to your chest
- ask how you are
You also have blood tests to check that your remaining kidney is working well.
You might have a chest X-ray, or a CT or ultrasound scan, to check for any signs of cancer spread. You may only be offered scans if you have a symptom that concerns you or your doctor.
Tell your doctor or specialist nurse as soon as possible if you’re worried or notice any new symptoms between appointments.
How you may feel
Some people find it very stressful to know they need follow up for cancer. You can talk this through with your doctor or specialist nurse. They can:
- reassure you
- explain how often you will have checks
- explain the treatment you may have if the cancer does come back
There is currently no evidence linking stress to cancer.
It can be very helpful to have counselling after cancer treatment or during longer term treatments.
What you can do for yourself
To keep healthy and feel you are doing something positive you can:
- eat a healthy diet
- try to learn to relax
- try to stop smoking
- note any new symptoms and report them to your doctor
A diet high in fresh fruit, vegetables and fish and low in animal fats is good for your health.
Relaxing will help you feel better and may help you cope better too. You could try a new hobby or relaxation techniques.