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After care stomach cancer

kilmaryal
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My husband was diagnosed with stage 3 stomach cancer July 2024. He underwent 4 cycles of FLOT chemotherapy and then total gastrectomy. After 6 weeks recovery he started another 4 cycles of FLOT which is about to come to an end.

Can I ask about follow up - we have been told he will have a CT Scan in 6 weeks and then every 3 months - is this standard?

Also we thought the second cycles were to mop up any left over or transferred cancer cells after surgery but it seems there is no way of telling if the second cycles of FLOT have mopped them all up? Have I picked this all up right is this all standard.

This for me is the problem with telephone appointments which are sometimes difficult to understand and very quick it only after you think of the questions and the appointment is over.

Any help or info would be very much appreciated.

thank you 

  • Hello kilmaryal,

    Thanks for getting in touch. My name is Megan, I’m one of the Cancer Information Nurses on the Macmillan Support Line.

    I am sorry to hear your husband was diagnosed with stage 3 stomach cancer and do wish him all the best for his recovery after treatment finishes.

    Regarding follow up for stomach cancer, both Macmillan and Cancer Research UK advise that follow up will be tailored to each person’s individual needs. The British Medical Journal (BMJ) Best Practice explain that all patients should be reviewed every 4 months for 3 years, along with advice that radiographic imaging (like CT scans) and endoscopy should be performed as clinically indicated. Therefore, it sounds as though his follow up is in line with this advice. With time if he remains stable you may collectively decide to lengthen the time in between follow-ups whilst still having direct access to the hospital team if problems arise in between.

    Most FLOT regimes consist of 4 cycles given before surgery and another 4 cycles given thereafter. Research has shown that people who have perioperative chemotherapy, this is chemotherapy given before and after surgery, had improved survival outcomes and is the recommendation also given in National Institute of Clinical Excellence (NICE) guidelines section 1.4.8.

    For some this amount of chemotherapy will be sufficient in mopping up cancer cells but for others sadly not and so as with all cancer treatments, only with time and follow up can you know if the treatments have been successful.

    I appreciate telephone appointments can be quick and often you think of further questions thereafter. I hope you have been introduced to a Clinical Nurse Specialist; they might go by a different title such as Upper GI Clinical Nurse Specialist. If so, I would encourage you to contact them to ask questions or if possible, arrange to meet with them face to face to ask any further questions and get any further support you might both need.

    I hope this information is useful. Please don’t hesitate to get back in contact by email, webchat or phone, if you need further information or support.

    The Macmillan Support Line offers practical, clinical, financial and emotional support. You can call us free from landlines and from most mobile phone networks on 0808 808 00 00, 7 days a week, 8am – 8pm.

     

    Best wishes, Megan

    Cancer Information Nurse Specialist 

     

    Ref MD/HeP

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