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NCCN Guidelines for Patients



Colon Cancer, Version 1.2017


Nonmetastatic cancer

Stages II and III | Review

Ongoing colonoscopies are also part of follow-up

care. You may never have had a total colonoscopy

if your gut was blocked. If so, get a colonoscopy

within 3 to 6 months after treatment. If you had a

total colonoscopy before, get tested 1 year after


You’ll need a colonoscopy less often if results are

normal. The next test is advised in 3 years. If these

results are normal, get tested every 5 years.

If an advanced adenoma is found, another

colonoscopy within 1 year is advised. Advanced

adenomas include polyps with a ruffled structure

(villous), a polyp larger than the width of an AAA

battery (>1 cm), or a polyp with pre-cancerous cells

(high-grade dysplasia).

Side effect care

You may still have some side effects when follow-up

care is started. Ask your cancer doctor how long they

may last. Some side effects may appear months or

years after treatment has ended. Ask your doctor

what’s your chance that you’ll get these late effects.

There may be ways to help relieve side effects.

There are medicines and other methods to decrease

diarrhea. A medicine called duloxetine may help

painful neuropathy. Fatigue may be helped with

exercise or methods to conserve energy. Ask your

doctor about other ways to treat side effects.

Other care

It’s important to take care of other health issues

besides colon cancer. Take steps to prevent or detect

other diseases early. Such steps can include getting

immunizations like the flu shot.

Cancer screening is also important. Get a skin

cancer exam. Ladies—learn how to do a breast self-

exam. A mammogram may also be needed. Men—it

may be time to get screened for prostate cancer.

Start or keep a healthy lifestyle. Limit your alcohol

use. Quit smoking. Protect yourself from the sun. Be

at a healthy weight. Eat healthfully. Healthy eating

includes eating a balanced diet, eating the right

amount of food, and drinking enough fluids.

Many people benefit from some exercise. Exercise

tones muscles, lowers stress, and improves health.

Exercise programs differ between people based on

their needs. Talk with your treatment team about

which exercises would be best for you.




Stage I colon cancer has grown into the second

layer of the colon wall (T1 tumors) or into

the third layer (T2 tumors). Some T1 tumors

may not need treatment after a polypectomy.

Otherwise, T1 and T2 tumors may be treated

with colectomy and lymphadenectomy.



Surgery is advised for stages II and III colon

cancer if you are able and willing to have it.

You may receive chemotherapy before surgery

if you have a T4b tumor. Chemotherapy after

surgery may not be helpful for stage II cancers

but is helpful for stage III.



If you can’t have surgery, chemotherapy is an




Follow-up care is started when there are no

signs of cancer. It includes tests to look for

any new cancer and help for side effects. It

also includes help to prevent or detect other