Importance of a proper medical follow-up program. We have been very clear on the reason behind each of our treatments, as well as their mechanism of action, we have talked about the dynamics of the program, its need for an initial comprehensive assessment as the appropriate starting point behind any treatment.
Now we will talk about a part that integrates the management of any chronic disease: Monitoring.
The follow-up program consists of a series of steps that will guide the medical team in the decision making process to continue treatment, this is, a continuous communication between the doctor and patient for purposes of feedback, as well as the series of medical studies required which will give us a better understanding of the patient’s well being and possible adjustment, modifications, or changes in post- hospital-discharge medical management.
The oncological field has fully established which tests are considered as the gold standard for follow-up and an adequate measurement of the condition, as well as the time or space required between each measurement, they correspond to a mechanic called, dose-response, that is, the patient is treated with X therapy and wait the established time to see the measurable results.
Explaining this dynamic to our patients is of paramount importance, since, from the point of view of the patient, any moment could be adequate to perform tests; however, this is not correct since as we explained, each therapy will require different times to reflect their effect., because of the aforementioned, it will be crucial to reach the cut-off point where the series of studies necessary to evaluate the response to treatment will be carried out once again.
The tests that are required for an optimal and objective follow-up are:
Mainly but not limited exclusively to: CT scans, MRI’s and PET scans, imaging studies allow us to see “inside” for purposes of locating, measuring, as well as identifying possible causes of the presented problems.
Range of tests taken mainly through blood sampling, to measure different specific markers related to the disease, as well as to have a broad overviewabout organic function. With these tests we are coming to an analysis of this function, previously with the imaging studies “we saw” what was going on inside the body, but seeing does not tell us the full story, conduction a proper chemical analysis via the lab work, we will know the whole story about organ function and the real condition of the patient, hence its great need and close relationship with the rest of the required studies.
This is where the patient tells us how he feels; During the follow-up calls we are able to identify the series of symptoms that the patient has been noticing and in which he has been working through the treatment, directing our attention towards the changes that the patient is experiencing at that moment. Where what is mainly sought is the general improvement of the patient’s symptomatology. There will be symptoms that will require prolonged and constant work to bring about change or control over them. The symptoms should be correlated with the tests performed, they should be able to integrate and make sense with the rest of the findings by the other conducted studies.
This is primary, since, along with the symptoms, it justifies the proper use of any medical test. This is limited to the physician’s ability to find any finding through sight, touch or smell. Once again our objective is the integration of the findings by this exploration with the rest of the carried out tests.
Subsequent to the individual analysis of each of these forms of measurement, we find the correlation between each of them, to achieve the final step, the medical impression. This will be the guideline for taking the next step, only at this moment we will know with certainty what the therapeutic results where.
It is important to let the patient know about the different limitations that we face, even on this day of high-end technology. Despite these technological advances, each of the monitoring tools will have certain limitations as to the results they provide. However, we can rest assured that this technology has shown to be accurate enough and therefore reliable.
It is essential to establish that we have no other objective way of reaching a medical impression, if not with the use of these tools; Each providing specific information that will allow us as physicians to establish a well thought-off plan.
Communication between the doctor and patient throughout this process is vital, it is the only way in which the doctor will obtain a better feedback about their interventions, in turn it can allow us to prevent certain situations or complications common in a cancer diagnosis. For this reason, providing not only the space but the adequate time to achieve efficient communication, as physicians, it allows us to individually evaluate what our patient experiences, feels and lives.
To finish, the follow program takes as much responsibility from the doctor as it does from the patient. The doctor will lay down a treatment plan and it is the patient’s responsibility to follow these instructions to achieve the goals in time and form.
We have already established the need to respect our patients in terms of their decisions once being fully informed about what is intended.
The follow-up is not an exception where if a patient decides not to perform any of the studies for X or Y reason, he will in no way, be denied follow-up care by our medical group.
We will do our best to provide a proper medical impression, however, omission in any of these tools may result in a limited view of the real medical state of the patient.