Follow up differences across countries

[cohanja]

I was reading an article from the Journal of Clinical Oncology where it stated that in Germany, follow-up examinations are recommended to be performed every 3 months during the first 5 years after resection of the primary tumor, and every 6 months during the 6 to the 10 years after surgery; examinations comprise a physical examination and once-yearly lymph node ultrasound, abdomen ultrasound, chest x-ray, and blood examination. This is all for lesions under 1 mm. Just curious why it seems follow-up exams in Germany are much more thorough and involved than in the U.S. At least it has been my experience that here in the U.S. they aren’t doing ultrasounds, etc…. especially yearly.

[Catherine Poole]

You will find follow up differences from doctor to doctor in this country as well. It depends on the mindset of the doctor. My follow up at Penn was every three months the first year, every six months the second year and then annually.

[cohanja]

Ya, doctor to doctor in this country will differ; but, probably not many at all do what they do in Germany for lesions under 1 mm. . .once-yearly lymph node ultrasound, abdomen ultrasound, chest x-ray, and blood examination.. . I wonder if this at all improves survival or catches anything earlier. . . and what the cost is per patient that this helps in Germany.

[Worrywart]

In the U.S. you can go in anytime you want. If you worry, go in. In Germany, you have to rely on the Govrt to tell you when you can come in. I don’t follow a schedule. I go in when I have a concern – whether that be once a year or once every month.

[Catherine Poole]

I would find those diagnostics to go overboard in Germany, but you don’t pay for them as you would here. In the U.S. you have to worry what is being done with a profit incentive in mind. Blood work, chest xray both are helpful in finding early melanoma mets. Actually, most of our tests show only once a tumor has formed.

[cohanja]

“Blood work, chest xray both are helpful in finding early melanoma mets.” So, then should we be asking for these tests, blood work and chest XR?

[Worrywart]

I think she meant AREN’T helpful. Correct Catherine?

[Author]

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