- •Cancer survivors are a rapidly expanding cohort, and many patients are being seen by primary care physicians.
- •This cohort has unique medical problems that result from the disease process itself as well as treatment.
- •Radiology plays an important function in evaluating these patients. This article reviews clinical imaging in common medical problems uniquely found in cancer survivors and which modalities will be helpful in evaluating these patients in common clinical scenarios.
- •Organ, tissue, or systemic damage related to therapy. Typically, this will include local scarring and inflammation due to surgery or radiation therapy. In addition, systemic therapy may cause inflammation, scarring, or necrosis in a broad range of target organs, including the lung, liver, kidneys, brain, and peripheral nerves.
- •Emergence of a new cancer site: This will most frequently represent late-recurrence of the initial treated tumor. However, second primary cancers may result from the same underlying germline mutation that produces the original tumor (eg, ovarian cancer in BRCCA1 mutations) or as a result of mutagenic effects of radiation or chemotherapy.
Monitoring for Recurrence
- Rheingold S.
- Neugut A.
- Meadows A.
|Symptom/Sign||Potential Cancer-related Cause||Imaging Options/Strategy|
|Plain film followed by CT with or without contrast as needed|
MRI of the chest may be considered in patients with iodinated contrast allergy or pregnant patients.
|Abdominal pain||Bowel obstruction due to adhesions or tumor|
Arterial or venous thrombosis
Fistulous connection or leak
|Plain film, CT|
Fluoroscopy can be used for evaluation of leaks and fistulas.
|Renal failure||Renal fibrosis|
Renal vein thrombosis
Ureteral obstruction from calculi, fibrosis, or tumor
|Plain film; MRI and CT for further characterization as needed|
Deep venous thrombosis
Fracture, pathologic, or insufficiency
|Plain film can be considered for first-line evaluation, especially if fracture is a concern.|
US if suspicion of DVT
MRI/CT/nuclear medicine study can be used to evaluate for metastasis.
|Monitoring for recurrence||CT|
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Conflict of Interest: None.
Authorship: All authors had access to the data and played a role in writing this manuscript.