[New trends in the follow-up of malignant diseases]

For many of the frequent malignant diseases (e.g. breast cancer, lung cancer, gastrointestinal cancers and urological cancers--except germ cell tumors) there is no clear evidence (in the sense of "evidence-based medicine") for the efficacy of fixed schedules during follow-up using imaging or laboratory procedures. Intensive and expensive follow-up programs could be justified by proven results, e.g. a better chance of cure, a longer survival and/or a better quality of life. But unfortunately, such results are not available for most of the frequent tumors. The following criteria should lead every physician when guiding his patients through the follow-up period after the potentially curative treatment of a malignant disease: Every single diagnostic step must be backboned by a clear medical rationale. Alone the fact that technical investigations can be made easily and are available almost everywhere cannot be the rationale to perform these methods routinely. The wish of the patient alone, to have some technical applications, is not a plausible reason to perform it, unless there is a clear medical indication. The unfounded and private desire of the physician, that he should know some results (e.g. tumor markers), is in most cases, insufficient justification.