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Why is follow-up care necessary?
Surgery is the most effective treatment for colorectal cancer. But even when
all of the visible cancer has been removed, it still is possible for the cancer
to return or to be present in other areas of the body. Because these areas of
cancer can be very small, they may be undetectable at the time of surgery.
However, they can begin to grow at a later time. The chances of your cancer
recurring depend on several factors, including the characteristics of your
original cancer and the effectiveness of your treatment. If you do have a
recurrence of your cancer, early detection is important for treating the new
cancer successfully.
Another reason for follow-up care is so your doctor can look for new polyps
that may develop in your colon or rectum. About one in five patients with
colorectal cancer will develop a new polyp later in life. It is important to
find and remove these polyps before they become cancerous.
How long should my follow-up care last?
Most recurrent cancers are detected within the first two years after
surgery. For that reason, follow-up is most critical during this time. After
five years, nearly all of the cancers that are going to recur have done so.
After five years, follow-up care focuses mainly on detecting new polyps. While
your follow-up care will be less frequent after five years, it is important to
continue checking for cancer for the rest of your life.
What will my follow-up care include?
Your doctor will examine you about every three months for the first two
years after treatment. These regular checkups ensure that any changes in health
are noticed. This way, if the cancer returns or a new cancer develops, it can be
treated as soon as possible.
Your checkup may include one or more of the following:
- Physical exam
- Fecal occult blood test, which tests for blood in your stool
- Colonoscopy, a test in which a fiber-optic device is used to examine the
large intestine, or colon
- Sigmoidoscopy, a test in which the inside of the lower large intestine
(called the sigmoid colon) is examined using a special fiber-optic device.
- Chest X-rays
- Computerized axial tomography (CAT or CT) scan, an X-ray technique that
produces a film showing a detailed cross-section of tissue
- Ultrasound, a test used to diagnose various diseases and conditions
using high-frequency sound waves, which are inaudible to the human ear,
transmitted through body tissues
- CEA test – Some cancers, but not all, shed a protein called
carcinoembryonic antigen (CEA) into a patient’s bloodstream. This CEA
protein can be a "marker" for the return of cancer in some
patients.
The usual follow-up for cancers of the colon and rectum is an office visit
with CEA blood test every three months for two years, then every six months for
three years, then every year. Chest X-ray and colonoscopy are done one, four and
seven years after surgery. Usually, a CT scan is done only if the CEA test is
abnormal, if symptoms warrant it or if it is part of a chemotherapy program.
Between scheduled checkups, remember to report any health problems to your
doctor as soon as they appear.
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