Follow up after cancer.

 I was diagnosed with stage 3 Hodgkin’s lymphoma 12 months ago today. I went through 6 cycles of ABVD chemotherapy. My last treatment was in December. Due to the chemotherapy it has caused the bones in my spine to fracture. I had surgery several weeks ago to have cement injected into these bones to try and stabilise them. 

I am on strong painkillers to help me maintain a near normal life as possible. 


I have been trying to find out what exactly has caused my bones to fracture. I have had a couple of appointments with a rheumatologist (by phone) and she said that I have osteoporosis and wants to start a course of medication which involves daily injections. 


I was 60 this year and I would like to class myself as being reasonably fit for my age. I don’t smoke and I am not a heavy drinker. 
My question is about heamotology. 


I was told in January that I currently have no current evidence of disease after my treatment and that I will have follow up checks for the next 5 years. This was explained to me and my wife as being every 3 months for first year. Followed by 4 monthly the second year and then every 6 months for the last 3 years. I felt that this was very reassuring. 


Once my treatment ended I have not had any contact with anyone concerning my follow up. I have chased haemotology to see when my follow up will be because I want to check that there is no further damage caused after my treatment and the symptoms that I had 12 months ago appear to be returning. 

Today I recieved a letter stating from a consultant haematologist stating that because my PET scan in January was all clear and that I had completed my chemotherapy and confirmed to be in complete remission I do not need to be seen more than once a year. This is in complete contradiction to what I was previously told. This letter has come from a consultant who is new to the hospital and I have never met. 

Is it right that after being told that their are currently no signs of decease that I will not be seen again for 12 months? Particularly as the cancer I had is one the ones most likely to return. 

I feel down that once my treatment ended no department wants to take ownership to confirm what my next course of action should be. 

I would like to hear from others if they have had a similar experience. If I am wrong in assuming that I should get 3 monthly follow ups then it will be okay but I am only repeating what I was told. 

thanks for all your support. 

  • Hello and thank you for your post,

    I am sorry to hear about your diagnosis but also about the fractures you have had. I can appreciate you have some questions.

    Osteoporosis can cause fractures, however, I am afraid that I am not able to tell you why you have it.  It may have been something you had before you started treatment or it may have been something that could have been caused or made worse by some of the treatments you had (for example steroids).  Unfortunately, people don't usually know they have it until they fracture. The NHS has information about osteoporosis which you may find helpful to read.

    How anyone is followed up after cancer treatment will be based on their individual situation and risk of the cancer returning. There is clinical guidance about how people with cancer are followed according to their cancer type.  We have information on the follow up of people with Hodgkin's lymphoma on our website. It may also be useful to know that some hospitals have a self-management system instead of set hospital appointments for follow up. Lymphoma Action explains this system on its website.

    You may find it helpful to talk to your team again about this, in particular your cancer nurse specialist.  However, if you still have concerns about how you are being followed up you may wish to ask the Patient Advice and Liaison Service (PALS) to look into this.

    I hope this has helped, you may find it helpful to talk things through with one of the nurses on our helpline.  The number to call is Freephone 0808 800 4040 and the lines are open from 9am till 5pm Monday to Friday.

    Take care,

    Caroline

  • Thank you Caroline for getting back to me so quickly. You have given me a lot to follow up and to try and get some answers.