NCCN Guidelines for Patients® | Colon Cancer - page 47

NCCN Guidelines for Patients
®
Colon Cancer, Version 1.2014
45
5
Treatment guide
Stage IV colon cancer
Chart 5.3.3
lists the follow-up tests for stage IV
cancer found at diagnosis. Follow-up testing is for
people who have no signs of cancer after treatment. It
can be helpful for finding new cancer growth early.
You should receive a medical history and physical
exam every 3 to 6 months for 2 years. If results are
normal for 2 years, then get these tests every 6
months for 3 years.
Ongoing tests of CEA levels are mainly used to find
cancer recurrences. CEA blood tests should be done
every 3 to 6 months for 2 years. If results are normal
for 2 years, get this test every 6 months for 3 to 5
years.
CT scans may help find metastases. Scans of your
chest, abdomen, and pelvis are suggested every 3 to
6 months for 2 years. If results are normal for 2 years,
then get these scans every 6 to 12 months for 3
years. CT should be done with both intravenous and
oral contrast. MRI may be done if you can’t have CT.
A colonoscopy is also needed since your risk for
another tumor is high within 2 years after diagnosis.
You may never have had a colonoscopy of your entire
colon if your gut was blocked. If so, get your first
colonoscopy within 3 to 6 months after treatment. If
you had a colonoscopy before, get another test 1 year
after treatment.
Your second colonoscopy after treatment is based
on the initial results. However, colonoscopies may be
needed more often if you are younger than 50 years
old or have Lynch syndrome. If results are normal,
have your next colonoscopy in 3 years and then
every 5 years. If the test finds an advanced adenoma,
your next colonoscopy will be needed within 1 year.
Advanced adenomas include a villous polyp, a polyp
larger than the width of an AAA battery, or a polyp
with pre-cancerous cells.
Chart 5.3.3 Follow-up testing
Test
Schedule
• Medical history and
physical exam
Every 3–6 months for 2 years
• If normal, then every 6 months for 3 years
• CEA blood test
Every 3–6 months for 2 years
• If normal, then every 6 months for 3–5 years
• CT of chest, abdomen,
and pelvis
Every 3–6 months for 2 years
• If normal, then every 6–12 months for 3 years
• Colonoscopy
Within 1 year if colonoscopy before treatment or within 3–6 months
if no colonoscopy before treatment
• If no advanced adenoma, repeat in 3 years
– If results are normal, then repeat every 5 years
• If advanced adenoma, repeat in 1 year
1...,37,38,39,40,41,42,43,44,45,46 48,49,50,51,52,53,54,55,56,57,...88
Powered by FlippingBook