Survivorship

What survivorship actually means

The word "survivor" begins from the day of diagnosis, not from a finish line. But practically, when we talk about survivorship care, we mean the months and years after active treatment ends — when scans become routine rather than urgent, when energy slowly returns, and when the questions shift from "Will this work?" to "What now?"

It is a phase that catches many people by surprise. The treatment team you saw every week suddenly steps back. The friends and family who rallied during chemotherapy assume you are "done". And yet, inside, you may still feel halfway there. That is normal. Survivorship care is built around it.

"The hardest week for many of my patients is not the first week of chemotherapy. It is the week after the last cycle, when everyone congratulates them and they suddenly do not know what to do with themselves. We plan for that week as carefully as we plan for treatment."

Follow-up schedule — what to expect

Follow-up visits are how we catch a recurrence early if it happens, and how we keep the long-term effects of treatment in check. The exact schedule depends on the cancer type, stage, and treatment received, but the broad rhythm looks like this:

• The first 1–2 years: visits every 3 months. This is the window when most recurrences, if they are going to happen, would happen.
• Years 2–5: visits every 4–6 months. Risk drops with each passing year clear.
• Beyond 5 years: visits once or twice a year, often shifting toward survivorship and general health rather than cancer-specific surveillance.

Each visit includes a focused history, a physical examination, the blood tests that matter for your specific cancer, and a discussion of any new symptoms. Imaging is added when the evidence supports it — not as a reflex every time.

Surveillance scans — done thoughtfully

It is tempting to think that more scans equal more safety. The evidence shows that for many cancers, this is not true — too-frequent scans cause anxiety, false alarms, and unnecessary procedures without finding recurrence any earlier. For each patient, we agree on a scan schedule that matches the cancer's actual behaviour. Some cancers warrant regular imaging; others are best monitored mainly through symptoms and examination, with scans triggered by anything new.

Long-term effects to keep an eye on

Cancer treatment is powerful, and a small percentage of that power lingers after treatment ends. Survivorship care means watching for, and managing, the late effects that matter most for your situation.

Your survivorship care plan

Before active treatment ends, we put together a written survivorship care plan — a single document you keep. It includes:

1. A summary of the cancer you had — type, stage, and key biology.
2. The treatments you received — drug names, doses, surgery details, radiation fields.
3. The follow-up schedule, with dates of the next few visits.
4. The specific late effects to watch for, given your treatment.
5. Lifestyle guidance — diet, exercise, vaccinations, screening.
6. Symptoms that should prompt an urgent call, not a routine visit.
7. Contact details for the clinic and your wider care team.

This plan is also useful for any other doctor who looks after you in future — a GP, a cardiologist, a gynaecologist — so they understand what you have been through.

Returning to work and life

There is no single right time to go back to work, exercise, or travel. Some patients return part-time during the last cycles of treatment; others take several months after treatment ends. We will give you an honest opinion on what is reasonable for your specific situation, and write a letter for your employer if that helps.

Exercise is one of the most evidence-backed parts of survivorship — even moderate walking improves fatigue, mood, and long-term outcomes for many cancers. We will guide you on how to start, how fast to build up, and when to pull back.

When to call between visits

The follow-up schedule is a safety net, not the only line of defence. Between visits, please call us promptly if you notice:

• A new lump, swelling, or change in a previous surgical site.
• Unexplained pain that lasts more than a couple of weeks, especially bone pain.
• Unintended weight loss.
• Persistent cough, breathlessness, or change in voice.
• New headaches that wake you at night, or new neurological symptoms.
• Any bleeding that does not have an obvious cause.
• Symptoms that feel like the ones you had when you were first diagnosed.

Most of these turn out to be something benign. But we would much rather hear about them early than late.

Celebrating the milestones

The one-year, two-year, and five-year marks after treatment matter — quietly or loudly, however you wish. They are evidence of something hard done. Some patients ring a bell at the end of treatment; others prefer no ceremony at all. Both are right. Survivorship is yours to define.