Follow-up care for Colorectal Cancer

Executive Summary

Follow-up care for colorectal cancer refers to the after-treatment protocols conducted by the healthcare team to look after recurrence, manage the side effects, and monitor the patients’ overall health. Both medical and physical examinations are included in the follow-up care of colorectal cancer. Watching the recurrence of colorectal cancer is seen in test reports of follow-up care. The symptoms due to the long term effects of radiation therapy are treated. The methods of follow-up treatment are often associated with chemo sessions, radiation therapies, and more. It is essential to have a follow-up care plan for colorectal cancer as the patient tends to think majorly about colorectal cancer symptoms and related to them. Some of the recommended follow-ups for colorectal cancer are carried out every 3 to 6 months for five years after diagnosis. First-year after colorectal cancer treatment involves a physical examination and CEA testing, abdominal and chest CT scan, Colonoscopy, and Rectosigmoidoscopy every six months for rectal cancer patients. all the equivalent examinations are followed for second-year, third-year, fourth-year and fifth year after colorectal cancer treatment. The doctor will propose checks and testing to check for late effects based on the patient’s colorectal cancer treatment symptoms. Managing the side effects while receiving treatment is a critical follow-up care approach. Personalizing the follow-up care plan is essential for patients with colorectal cancer conducted by the medical care team. Effective communication with the doctor regarding the long term effects of all the treatments will be effective in the future.

Follow-up Care for Colorectal Cancer

Follow-up care for a colorectal cancer patient does not end with the end of active treatment that was going on ​1​. Even after that, the health care team looks after the cancer recurrence, managing the side effects developed due to the treatment and monitoring your overall health. This is called follow up care.

Your follow-up care for colorectal cancer includes medical tests, physical examination or both. Doctors usually keep track of your recovery in the months and years ahead. 

Cancer rehabilitation is usually recommended, and this could mean any of a wide range of services, such as physical therapy, career counselling, pain management, nutritional planning, and emotional counselling. 

Watching for recurrence of colorectal cancer

One of the things to take care of after cancer treatment is recurrence. Cancer recurrence happens when a few cancerous cells remain even after treatment; they again grow until they show up any signs or symptoms or are seen in test reports. 

Scan-xiety is often used for the patient or the family’s stress before the follow-up tests.

Recommended Follow-up care of colorectal cancer

The tests the doctor suggests and how often you need to have them will depend on the risk of recurrence and the overall health. Generally, you will visit your doctor and receive follow-up screening every 3 to 6 months for five years after diagnosis ​2​. It is noteworthy that different people have different recurrence risks, so it is essential to talk with your doctor about the possibility of cancer coming back.

First-year after colorectal cancer treatment

  • Physical examination and CEA testing every 3 to 6 months
  • Abdominal and chest CT scan each year (every 6 to 12 months for people with a high risk of recurrence)
  • For people with rectal cancer, a pelvic CT scan every 6 to 12 months
  • Colonoscopy 1 year after surgery
  • Rectosigmoidoscopy every six months for rectal cancer patients who did not have radiation therapy to the pelvis.

Second-year after colorectal cancer treatment

  • Physical examination and CEA testing every 3 to 6 months
  • CT scan each year (every 6 to 12 months for people with a high risk of recurrence)
  • For people with rectal cancer, a pelvic CT scan every 6 to 12 months
  • Rectosigmoidoscopy every six months for people with rectal cancer who did not have radiation therapy to the pelvis

Third-year after colorectal cancer treatment

  • Physical examination and CEA testing every 3 to 6 months
  • CT scan each year (every 6 to 12 months for people with a high risk of recurrence)
  • For people with rectal cancer, a pelvic CT scan every 6 to 12 months
  • Rectosigmoidoscopy every six months for people with rectal cancer who did not have radiation therapy to the pelvis

Fourth-year after colorectal cancer treatment

  • Physical examination and CEA testing every 3 to 6 months
  • For people with rectal cancer, a pelvic CT scan each year
  • Rectosigmoidoscopy every six months for people with rectal cancer who did not have radiation therapy to the pelvis

Fifth-year after colorectal cancer treatment

  • Physical examination and CEA testing every 3 to 6 months
  • For people with rectal cancer, a pelvic CT scan each year
  • Rectosigmoidoscopy every six months for people with rectal cancer who did not have radiation therapy to the pelvis

Managing long-term and late side effects of colorectal cancer treatments

Most people encounter different side effects while receiving treatment. But in some patients, side effects linger beyond the treatment duration. These are the long term side effects. 

Late side effects can develop after months or even after years of treatment. 

Keeping personal health records

Along with your doctor, you should develop a personalized follow-up care plan. Some patients, after the treatment, continue to see their oncologist, while others go back to the care of their family/primary care doctor. This usually depends on various factors, including the type and stage of colorectal cancer, side effects, health insurance rules, personal preferences, beliefs and expectations ​3​

References

  1. 1.
    Young JM, Jorgensen M, Solomon M. Optimal delivery of colorectal cancer follow-up care: improving patient outcomes. PROM. Published online May 2015:127. doi:10.2147/prom.s49589
  2. 2.
    Buie WD, Attard JAP. Follow-Up Recommendations for Colon Cancer. Clinics in Colon and Rectal Surgery. Published online August 2005:232-243. doi:10.1055/s-2005-916284
  3. 3.
    Godhi S, Godhi A, Bhat R, Saluja S. Colorectal Cancer: Postoperative Follow-up and Surveillance. Indian J Surg. Published online March 10, 2017:234-237. doi:10.1007/s12262-017-1610-6