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NCCN Guidelines for Patients



Rectal Cancer, Version 1.2017


Nonmetastatic cancer

Stages II and III

immunizations like the flu shot. Taking low-dose

aspirin may be helpful.

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.

Guide 8. 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 6–12 months for up to 5 years


• 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

After treatment ends, don't fall

back into old habits, you've been

given a second chance, make up

a survivors plan and follow it.

Overcome the fear of recurrence

by advocating for your health and



Survivor, Stage III