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51

NCCN Guidelines for Patients

®

:

Colon Cancer, Version 1.2017

5

Metastatic disease

Metastases at diagnosis

Guide 13

lists important follow-up care for stage IV

cancer. Follow-up care starts when there are no

signs of cancer after treatment. It is also called

survivorship care. This care should address your

whole health and well-being.

Your cancer doctor and primary doctor should work

together to help you. Each doctor can have a role in

survivorship. Talk with your doctors about the care

you want and need so you get the best plan.

Cancer tests

A medical history and physical exam are advised.

Get this care every 3 to 6 months for 2 years. If

results are normal for 2 years, repeat care every 6

months for another 3 years.

CEA blood tests are mainly used to detect the return

of cancer. CEA levels should be tested every 3 to 6

months for 2 years. If results are normal for 2 years,

get tested every 6 months for another 3 to 5 years

CT scans may help find metastases. Thus, scans

of your chest, abdomen, and pelvis are advised.

Get these scans 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 another 3 years.

CT should be done with both IV and oral contrast. CT

images may be unclear or not possible. In this case,

MRI of the abdomen and pelvis with non-contrast CT

of the chest is an option.

Guide 13. Follow-up care

Type of care

How often is this care needed?

Medical history and physical exam

• Every 3–6 months for 2 years

◦◦ If normal, then repeat every 6 months for 3 years

CEA blood test

• Every 3–6 months for 2 years

◦◦ If normal, then repeat every 6 months for 3 years

CT of chest, abdomen, pelvis

• Every 3–6 months for 2 years

Colonoscopy

• If no prior total colonoscopy, 3–6 months after treatment

• If prior total colonoscopy,

1 year after 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

Side effect care

• As needed

Prevent and screen for other diseases • Follow guidelines

Help for healthy lifestyle

• As needed