Follow Up Evaluation After Surgery For Colorectal Cancer

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Why Should There Be a Postoperative Follow Up Program?
Surgery is the most effective treatment for colorectal cancer. However even when all visible cancer has been removed, it is possible for cancer cells to be present in other areas of the body. These cancer deposits, when very small, are undetectable at the time of surgery, but they can begin to grow at a later time. The purpose of the follow up program is to detect this recurrence of cancer. Patients with recurrent cancers - if diagnosed early - may benefit or be cured by further treatment. Unfortunately if the recurrence is detected late, the chances of survival are poor.

Another good reason for postoperative follow up is to look for new colon or rectal polyps. Approximately one in five patients who have had colon cancer will develop a new polyp at a later time in life. It is important to detect and remove these polyps before they become cancerous.

How Long Will My Follow Up Program Last?
Most recurrent cancers are detected within the first two years after surgery. Therefore, follow up is most frequent during this period of time, usually every 3 to 6 months. After 2 years a yearly visit to the doctor should be sufficient.

After five years, nearly all cancers that are going to recur will have done so. Follow up after five years is primarily to detect new polyps, and can, therefore, be less frequent but advisable for life.

What Might I Expect at My Follow Up Visit?
Your doctor will examine you approximately every three to six months for the first two years, and discuss your progress. A CEA blood test can be done, as a method of trying to detect recurrence of cancer. Because this test is not totally reliable, other follow up examinations may be advised. These examinations may include colonoscopy, chest x-rays, and sometimes CT scans or ultrasound tests.

What About My Family?
Close relatives of patients with colon and rectal cancer (parents, brothers, sisters, children) are at increased risk for the disease. It is advisable that they should undergo a screening colonoscopy at age 40 or even earlier. Ask your doctor for details. If polyps are promptly detected and removed by a colonoscopy, cancer can be prevented. You or your relatives may also have a simple blood test to see if there is an abnormal cancer-causing gene in your family.

* All information subject to change. Images may contain models. Individual results are not guaranteed and may vary.