STEP 6: Managing recurrent, residual or metastatic disease
Detection
Most residual local, recurrent or metastatic disease will be detected via monitoring, routine follow-up or by the patient presenting with symptoms.
Treatment
Evaluate each patient for whether referral to the original multidisciplinary team is appropriate. Treatment will depend on the location and extent of disease, previous management and the patient’s preferences.
Advance care planning
Advance care planning is important for all patients but especially those with advanced disease. It allows them to plan for their future health and personal care by thinking about their values and preferences. This can guide future treatment if the patient is unable to speak for themselves.
Survivorship and palliative care
Survivorship and palliative care should be addressed and offered early. Early referral to palliative care can improve quality of life and in some cases survival. Referral should be based on need, not prognosis.
Communication
The lead clinician and team’s responsibilities include:
- explaining the treatment intent, likely outcomes and side effects to the patient and/or carer and the patient’s GP.
Checklist