NCCN Guidelines for Patients
Colon Cancer, Version 1.2017
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
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.
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