What Does "Followup" Mean?
Once you have completed your radiation treatments, it is important for your doctor to monitor the results of your therapy at regularly scheduled visits. These checkups are necessary to deal with radiation side effects and to detect any signs of recurrent disease. During these checkups your doctor will examine you and may order some lab tests and x-rays. The radiation oncologist also will want to see you for followup after your treatment ends and will coordinate followup care with your doctor.

• How often do I need to return for checkups?
• Why do I need more x-rays, CT-scans, blood tests, and so on? What will these tests tell us?
• Will I need chemotherapy, surgery, or other treatments?
• How and when will you know if I'm cured of cancer?
• What are the chances that it will come back?
• How soon can I go back to my regular activities? Work? Sexual activity? Sports?
• Do I need to take any special precautions like staying out of the sun or avoiding people with infectious diseases?
• Do I need a special diet?
• Should I exercise?
• Can I wear a prosthesis?
• Can I have reconstructive surgery? How soon can I schedule it?

It's a good idea to write down the questions you want to ask your doctor. Use the "Notes" page at the back of this booklet for your questions and take it with you when you have your appointment with the doctor. Some patients find that it's helpful to take a family member with them to help remember what the doctor says.

What if Pain Is a Problem?
Radiation therapy is not painful. However, some radiation side effects may cause discomfort. In addition, when radiation is used for palliation (see section above), some discomfort or pain may remain. Sometimes patients need help to manage cancer pain. Over-the-counter pain medicine may be enough for mild pain. Remember that you should not use a heating pad or a warm compress to relieve pain in any area treated with radiation.

If your pain is severe, ask the doctor about prescription drugs or other methods of relief. Try to be specific about your pain (how severe is it on a scale of 0-10 where 0 is no pain and 10 is the worst pain you can imagine? where is your pain? is the pain throbbing, stabbing, searing? is it continuous or intermittent? what makes it better or worse?) when you tell the doctor about it so you can get the best pain management. If you are unable to get pain relief, you may want to ask your doctor for a referral to a pain specialist.

Because fear and worry can make pain worse, you may find that relaxation exercises are helpful. Other methods such as hypnosis, biofeedback, and acupuncture may be useful for some cancer pain. Be sure to discuss these complementary or alternative treatments with your doctor or nurse. Sometimes complementary therapies can interfere with other treatment you are having. They can also be harmful when combined with other treatment.

"Questions and Answers About Pain Control: A Guide for People with Cancer and Their Families" is a free booklet that may help you understand more about controlling cancer pain. (To obtain this booklet, see the section at the end of this page, "Additional Resources for Cancer Information.")

How Can I Help Myself After Radiation Therapy?
Patients who have had radiation therapy need to continue some of the special care they used during treatment, at least for a short while. For instance, you may have skin problems for several weeks after your treatments end. Continue to be gentle with skin in the treatment area until all signs of irritation are gone. Don't try to scrub off the marks in your treatment area. If tattoos were used to mark the treatment area, they are permanent and will not wash off. Your nurse can answer questions about skin care and help you with other concerns you may have after your treatment has been completed.

You may find that you still need extra rest after your therapy is over while your healthy tissues are recovering and rebuilding. Keep taking naps as needed and try to get more sleep at night. It may take some time to get your strength back, so resume your normal schedule of activities gradually. If you feel that you need emotional or social support, ask your doctor, nurse, or a social worker for information about support groups or other ways to express your feelings and concerns.

When Should I Call the Doctor?
After treatment for cancer, you're likely to be more aware of your body and to notice even slight changes in how you feel from day to day. The doctor will want to know if you are having any unusual symptoms. Promptly tell your doctor about:

• A pain that doesn't go away, especially if it's always in the same place.
• New or unusual lumps, bumps, or swelling.
• Nausea, vomiting, diarrhea, or loss of appetite.
• Unexplained weight loss.
• A fever or cough that doesn't go away.
• Unusual rashes, bruises, or bleeding.
• Any symptoms that you are concerned about.
• Any other warning signs mentioned by your doctor or nurse.

What About Returning to Work?
Many people find that they can continue to work during radiation therapy because treatment appointments are short. If you have stopped working, you can return to your job as soon as you feel up to it. If your job requires lifting or heavy physical activity, you may need a change in your work responsibilities until you have regained your strength. Check with your employer to see if a 'return to work' release from your doctor is required.

When you are ready to return to work, it is important to learn about your rights regarding your job and health insurance. If you have any questions about employment issues, contact the Cancer Information Service (CIS). CIS staff can help you find local agencies that can help you deal with problems regarding employment and insurance rights that are sometimes faced by cancer survivors.