We have an extensive program to follow up patients with gastric cancer in a dedicated clinic. They are usually seen 1 week after discharge, then 1 month, then 3 monthly for a year, then 6 monthly for ever. This frequency reverses when recurrence happens. I realise that it does not deflect from the pre-determined prognosis of the patients, but it helps in many ways:
1. The patients feel reassured.
2. Patients with total gastrectomy, or subtotal + achlorhydria get the vital B12
injections, all get vitamin + iron syrup.
3. We are able to keep tight follow up data for research.
4. We have support systems with councellors, social workers, hospice associations etc.
We dont actively look for recurrence with ultrasound, CT, CEA etc etc. There is nothing to be done for the usual ascitic, retroperitoneal, hepatic recurrence picture. When recurrence does occur [weight loss, back pain, "dont feel right"], we do ultrasound confirmation, and then switch into a support mode with selective analgesia, family support systems, occasional admission etc.