What follow-up tests do I need after Stomach Cancer treatment ends

Follow-Up Testing After Stomach Cancer Treatment

Great question—understanding your surveillance plan is an important part of your recovery. The specific tests you'll need depend on several factors, including the type of surgery you had, whether you received chemotherapy or radiation, and your cancer stage. Let me walk you through what's typically recommended.

General Follow-Up Framework

According to the NCCN Guidelines for Gastric Cancer, follow-up care is individualized based on your treatment and stage, but generally includes:

Physical Exams & Blood Work

• History and Physical (H&P): Every 3-6 months for the first 1-2 years, then every 6-12 months for years 3-5
• Complete Blood Count (CBC) and Comprehensive Chemistry Profile: As clinically indicated by your doctor

Imaging Tests

• CT Scan of Chest/Abdomen/Pelvis with oral and IV contrast: The frequency depends on your specific situation
  • If you had partial or subtotal gastrectomy (part of stomach removed): Every 6 months for the first 2 years, then annually for up to 5 years
  • If you had total gastrectomy (entire stomach removed): As clinically indicated based on symptoms
• FDG-PET/CT: May be used if your doctor is concerned about possible recurrence

Endoscopy (EGD - Upper GI Scope)

The frequency depends on your treatment:

• If you had surgery: EGD as clinically indicated (meaning your doctor will order it if symptoms develop or there's concern for recurrence)
• If you had endoscopic resection (ER) for early-stage cancer: Every 6 months for 1 year, then annually for up to 5 years

Important Nutritional Monitoring

This is especially critical if you had a total gastrectomy. Your doctor should monitor you for nutritional deficiencies because removing the stomach affects how your body absorbs certain nutrients. The NCCN Guidelines recommend:

• Regular screening for deficiencies in:

  • Vitamin B12 (very common after total gastrectomy)
  • Iron
  • Zinc
  • Calcium
  • Vitamin D

• Routine supplementation is typically recommended with:

  • Daily multivitamin/mineral complex
  • Vitamin B12 (often given as injections)
  • Calcium
  • Vitamin D

Your doctor may refer you to a nutritionist or dietitian who specializes in post-gastrectomy care to help manage these issues.

What "As Clinically Indicated" Means

You'll see this phrase often in guidelines. It means your doctor will order tests based on:

• Any symptoms you develop (like difficulty swallowing, pain, weight loss, or vomiting)
• Your individual risk factors
• Your overall health status
• Findings from your physical exam

Questions to Ask Your Oncologist

To create your personalized follow-up plan, ask:

1. "What stage was my cancer, and what type of surgery did I have?" (This determines your specific surveillance schedule)
2. "How often should I have imaging scans, and for how long?"
3. "Will I need regular endoscopy, and if so, how often?"
4. "What nutritional supplements should I be taking, and should I see a dietitian?"
5. "What symptoms should prompt me to call you between scheduled visits?" (Examples: persistent vomiting, difficulty swallowing, unexplained weight loss, abdominal pain)
6. "How long will I need follow-up care?" (Generally 5 years minimum, but may be longer depending on your situation)

Long-Term Survivorship

After 5 years, additional follow-up may be considered based on your risk factors and overall health. Your oncologist and primary care doctor should work together to monitor your long-term health, manage any treatment side effects, and screen for other health conditions.

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This information is for educational purposes only. Always consult your healthcare team for personalized medical advice and decisions.