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Amol Akhade: Should We Abandon Routine Cancer Surveillance?
May 2, 2025, 17:12

Amol Akhade: Should We Abandon Routine Cancer Surveillance?

Amol Akhade, Senior consultant medical oncologist and hemato-oncologist at Suyog Cancer Clinics and Reliance Hospitals, shared a post on LinkedIn:

“Devil’s Advocate Series | Should We Abandon Routine Cancer Surveillance?

A provocative NEJM editorial argues that routine post-treatment surveillance (imaging, labs—even ctDNA) in asymptomatic cancer survivors may do more harm than good.

NEJM’s Case AGAINST Routine Surveillance:

  •  No RCTs show a survival or QoL benefit
  •  Lead-time bias inflates perceived gains
  •  Scanxiety, false positives, radiation, and financial toxicity
  •  Surveillance often serves revenue, not outcomes

But here’s the COUNTER VIEW we must not ignore:

Why Routine Surveillance Still Matters (When Done Right):

  •  ctDNA can detect recurrence months before imaging
  •  MRD-guided escalation or de-escalation is real-time precision medicine
  •  Oligometastatic disease may be curable—if caught early
  •  Many patients value knowledge and psychological control

In the era of liquid biopsy and personalized oncology, should we rethink surveillance—or retire it?

We present both sides. You decide.”

Title: Routine Surveillance for Cancer Metastases — Does It Help or Harm Patients?

Authors: H. Gilbert Welch, Lesly A. Dossett.

You can read the Full Article on The New England Journal of Medicine.

 

Amol Akhade: Should We Abandon Routine Cancer Surveillance?

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