Somewhere between my last scan and the next blood draw, I realized my calendar had turned into a second medical chart. It wasn’t just dates; it was the quiet rhythm of survivorship—figuring out when to check, what to check, and how to keep the rest of life spacious in between. I wanted a kinder, clearer system for organizing imaging and labs after treatment without getting lost in acronyms or fear. So I sat down with a notebook, a mug of something warm, and the best guidance I could find, and I built a plan that I could actually live with.
The moment the calendar started to matter
What finally clicked for me was that surveillance isn’t about “chasing a cure”—it’s about structured watching. It’s the bridge between finishing treatment and re-learning normal life. The schedule depends on the cancer type, treatments received, personal risks, and local guidelines, but a few ideas felt solid:
- Front-load the follow-up: Many care teams see people more frequently in the first 2–3 years (often every 3–6 months), then gradually widen the intervals (6–12 months) through year 5, and then yearly if things stay stable. This varies by diagnosis, so it’s a conversation, not a template.
- Match the test to the risk: Not everyone needs scans at every visit; sometimes a good history and exam are the most powerful tools. Imaging and labs are chosen for a reason—ask what the reason is.
- Write it down once: A survivorship care plan summarizing treatments, late-effect risks, and recommended surveillance saves so much confusion later.
- Quick, reliable places I leaned on for clarity:
A simple map to tame all the moving parts
I use three columns—When, What, and Why—and I fill them in with my team. Here’s the skeleton I start from, then personalize:
- Every visit: Symptoms check, exam, medication review, side effects, vaccines due, lifestyle questions (sleep, movement, nutrition, mood). Why: Many recurrences and late effects announce themselves through new symptoms long before a scan.
- Imaging: Only the studies that actually inform decisions (for example, annual mammography for those who had breast-conserving therapy; CT or MRI only if the cancer type and stage suggest it, or if symptoms change). Why: Balance benefit, radiation exposure, cost, and anxiety.
- Labs: Choose purposefully—some markers are powerful for specific cancers (PSA after prostate cancer, thyroglobulin after thyroid cancer) while others aren’t useful in routine follow-up. Why: Avoid noise, catch signal.
Then I anchor everything to real dates—birthdays, seasons, or family events—to avoid piling tests into the same month. I also write a one-sentence purpose next to each item. That single line helps me tolerate nerves on the day-of.
Imaging without overwhelm
Here’s how I think through the big imaging questions, always with the understanding that my plan could (and should) look different from yours:
- Breast: After breast-conserving therapy, annual mammography is commonly recommended; MRI or ultrasound may be added for higher-risk situations. After bilateral mastectomy without reconstruction, routine imaging may not be needed unless symptoms arise. The details depend on surgical and reconstruction choices.
- Colorectal: Colonoscopy intervals typically follow a structured cadence after surgery (for example, one year, then at 3 years, then every 5 if normal), but polyp findings, tumor features, and prior results can change this.
- Prostate: Imaging is generally symptom- or PSA-driven rather than automatic at fixed intervals.
- Lung: Low-dose CT may be part of surveillance after treatment in some scenarios, but schedules vary widely. History and new respiratory symptoms often trigger imaging.
- Head and neck / thyroid: Ultrasound or targeted imaging can be useful depending on anatomy and markers; again, the cadence is personalized.
I remind myself that more imaging is not automatically better. Over-scanning can detect harmless “incidentalomas” that lead to extra procedures and worry. The milestone isn’t the test—it’s the conversation about whether the test changes what we would do next.
Labs that actually serve a purpose
It took me a while to learn which labs were for me and which labs were just “for everyone.” These are common patterns my clinicians and I talk through:
- Tumor-specific markers:
- PSA after prostate cancer.
- CEA after some colorectal cancers.
- Thyroglobulin and TSH after thyroid cancer.
- CA-125 in select ovarian cancer follow-up (with a clear plan for how results would guide action).
- Treatment-effect labs:
- CBC if prior therapy could affect marrow function.
- Comprehensive metabolic panel to watch kidneys and liver when relevant.
- Lipids and A1c if steroids, hormonal therapy, or weight changes might raise cardiovascular/metabolic risk.
- Thyroid function after neck radiation or certain systemic therapies.
- Vitamin D and bone markers if on aromatase inhibitors or long-term steroids.
I ask one question for any lab: “If this number changes, what will we do differently?” If we don’t have a good answer, we don’t draw it routinely.
Side-effect monitoring that sneaks up on you
Survivorship isn’t only about recurrence. It’s also about late effects—issues that can unfold months or years after treatment. Building them into the timeline helps me feel proactive instead of caught off guard.
- Heart health: If I received anthracyclines or HER2-targeted therapy, we discuss if and when to get echocardiograms, and we track blood pressure, lipids, and activity. Cardiovascular risk sometimes becomes the bigger long-term story.
- Bone health: DEXA scans if I’m on aromatase inhibitors, have induced menopause, or prolonged steroid use. Calcium, vitamin D, resistance exercise, and fall prevention live on my checklist.
- Endocrine and fertility: Hormonal changes, menstrual changes, and fertility goals deserve regular check-ins with clear referrals when needed.
- Neuropathy, brain fog, fatigue: We document symptoms over time so small improvements and setbacks are visible, not dismissed.
- Mental health and social health: Anxiety spikes before scans (“scanxiety”) are normal; having a plan—breathing routines, scheduling scans earlier in the day, or connecting with support—helps.
My low-friction system for keeping it all straight
Low friction is the name of the game. I tried perfection; it did not try me back. Now I use what I can maintain on an ordinary Tuesday:
- One-page timeline: I keep a single-page “year at a glance” with months across the top and rows for “visit,” “imaging,” “labs,” and “late effects.” I pencil in planned months, not fixed dates, to keep it flexible.
- Color-coded calendar reminders: Imaging is one color, labs another, clinic visits a third. Reminders ping two weeks before to leave room for scheduling and insurance authorization.
- Prep notes a week ahead: I write down new symptoms, medication changes, and one question I don’t want to forget. It keeps the visit focused and less rushed.
- Share the survivorship care plan: I ask for a printed or digital version to share with my primary care clinician and any specialists, so everyone is working from the same playbook.
Mini cheat sheets I keep in my notebook
These are not prescriptions—just the kind of high-level sketches that help me frame a conversation. Your timeline should be built with your team.
- Breast — Clinic visits every 4–6 months in early years then less often; annual mammography if breast tissue remains; consider bone health if on endocrine therapy.
- Colorectal — Clinic visits spaced over five years; CEA for select patients; colonoscopy typically at 1 year then based on findings; imaging considered for higher-risk features.
- Prostate — PSA at defined intervals; imaging only if symptoms or rising PSA; discuss urinary/sexual health at each visit.
- Lung — Focused history and exam; CT imaging schedules vary by stage and treatment; aggressive support for smoking cessation and pulmonary rehab if helpful.
- Thyroid — TSH/thyroglobulin monitoring; neck ultrasound when indicated; lifelong thyroid hormone management after total thyroidectomy.
What I ask at each follow-up
- “What are we watching for between now and the next visit?”
- “Which test is essential, which is optional, and why?”
- “What symptoms should trigger a sooner call?”
- “How does my other health (blood pressure, lipids, A1c, bone density) fit into this plan?”
- “Can you update my survivorship care plan so I can share it with primary care?”
Signals that tell me to slow down and double-check
I keep an honest list of caution signs. Not to alarm, but to empower a timely check-in:
- Sudden, unexplained symptoms: new severe pain, shortness of breath, neurological changes, or persistent fevers.
- Progressive changes over weeks: a lump that’s new, weight loss without trying, worsening fatigue that interrupts daily life.
- Medication and device issues: new side effects after dose changes; problems with ports or reconstruction.
- Life events: planning pregnancy, surgery for another issue, or big travel—these can change surveillance timing or precautions.
If I’m ever worried about an emergency—chest pain, severe trouble breathing, stroke-like symptoms—I call emergency services immediately. For non-urgent concerns, I message the clinic and include dates, symptoms, and what changed.
Little habits that make a big difference
- Batch the admin: I set aside 30 minutes monthly to handle scheduling, insurance messages, and refills. Saves me from “medical whack-a-mole.”
- Pair the unpleasant with the pleasant: I plan a favorite meal, a walk, or a friend check-in on scan days. Mood matters.
- Track what’s meaningful: Instead of hoarding every number, I keep just a few—weight trend, blood pressure range, sleep hours, daily steps. Enough to see patterns, not drown in data.
What I’m keeping and what I’m letting go
I’m keeping the parts that make the plan mine: the purpose statements next to each test; the small rituals that soften the edges; the courage to ask “why.” I’m letting go of the idea that survivorship has to look like anyone else’s spreadsheet. The truth is, a good plan is both evidence-informed and life-shaped. It leaves room for birthdays and soccer games, for quiet mornings and spontaneous road trips. It catches what matters and lets the rest pass by without stealing every ounce of attention.
FAQ
1) How often should I get scans after treatment?
Answer: It depends on your cancer type, stage, and treatments. Many people are seen more often in the first 2–3 years and less often later, with imaging only when it helps guide decisions. Ask your team to tailor a schedule and explain the “why” behind each test.
2) Which blood tests do I really need?
Answer: Only the ones that change care. Some cancers use specific markers (like PSA or thyroglobulin), while others rely more on symptoms and exams. If a result won’t change the plan, it may not need to be drawn routinely.
3) What is a survivorship care plan and how do I get one?
Answer: It’s a summary of your treatments, potential late effects, and recommended follow-up. You can request one from your oncology team and share it with your primary care clinician so everyone is aligned.
4) How do I handle scan anxiety?
Answer: Normalize it, plan for it, and get support. Schedule earlier appointments when possible, bring a grounding activity, and ask how and when results will be shared to reduce limbo time. Counseling and peer support can help.
5) Can lifestyle changes replace surveillance tests?
Answer: Healthy habits support long-term wellbeing and reduce some risks, but they don’t replace recommended imaging or labs. Use both: a smart surveillance plan and sustainable habits.
Sources & References
- NCI Follow-Up Care
- ASCO Survivorship
- ACS Follow-Up Care
- NCCN Patient Guidelines
- USPSTF Recommendations
This blog is a personal journal and for general information only. It is not a substitute for professional medical advice, diagnosis, or treatment, and it does not create a doctor–patient relationship. Always seek the advice of a licensed clinician for questions about your health. If you may be experiencing an emergency, call your local emergency number immediately (e.g., 911 [US], 119).