Follow-up after treatment for colorectal cancer

Follow-up after treatment is an important part of cancer care. Follow-up for colorectal cancer is often shared among the cancer specialists (oncologists), the surgeon and your family doctor. Your healthcare team will work with you to decide on follow-up care to meet your needs.

Don’t wait until your next scheduled appointment to report any new symptoms and symptoms that don’t go away. Tell your healthcare team if you have:

  • pain in the abdomen or pelvis
  • dry cough
  • fatigue
  • nausea
  • unexplained weight loss
  • changes to bowel movements

The chance that colorectal cancer will come back (recur) is greatest within 5 years, so you will need close follow-up during this time.

Schedule for follow-up visits

Follow-up visits for colorectal cancer are usually scheduled every 3 to 6 months for the first 3 years and then every 6 months for the next 5 years. People treated for early stage cancer may be seen less often.

During follow-up visits

During a follow-up visit, your healthcare team will usually ask questions about the side effects of treatment and how you’re coping.

Your doctor may do a physical exam, including:

  • feeling lymph nodes in the chest, abdomen and pelvis
  • listening to the lungs
  • feeling the abdomen for an enlarged liver
  • a digital rectal exam (DRE)

Tests are often part of follow-up care. You may have:

  • a carcinoembryonic antigen (CEA) blood test every 3 to 6 months for about 3 years and then every 6 months for the next 5 years
  • a colonoscopy within a year after surgery and then every 3 to 5 years
  • a periodic CT scan of the chest and abdomen to check for cancer in the lymph nodes, lungs and liver every year for 3 years after surgery

If the cancer has come back, you and your healthcare team will discuss a plan for your treatment and care.

Questions to ask about follow-up

To make the decisions that are right for you, ask your healthcare team questions about follow-up.

Expert review and references

  • Alberta Health Services. Clinical Practice Guideline GI-002 Version 7: Colorectal Cancer Surveillance (Stages I, II, and III). Edmonton: 2019: https://www.albertahealthservices.ca/info/cancerguidelines.aspx.
  • American Cancer Society . Colorectal Cancer . 2018 : https://www.cancer.org/.
  • American Society of Clinical Oncology. Colorectal Cancer. 2017: https://www.cancer.net/cancer-types/colorectal-cancer/view-all.
  • Libutti SK, Saltz LB, Willett CG, Levine RA . Cancer of the colon. DeVita VT Jr, Lawrence TS, Rosenberg SA. Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015: 57: 768 - 812.
  • Saskatchewan Cancer Agency. Provincial Colorectal Cancer Treatment Guidelines. Regina, SK: 2019: http://saskcancer.ca/.
  • Wilkes GM . Colon, rectal, and anal cancers. Yarbro CH, Wujcki D, Holmes Gobel B, (eds.). Cancer Nursing: Principles and Practice. 8th ed. Burlington, MA: Jones and Bartlett Learning; 2018: 51: 1423 - 1485.

Medical disclaimer

The information that the Canadian Cancer Society provides does not replace your relationship with your doctor. The information is for your general use, so be sure to talk to a qualified healthcare professional before making medical decisions or if you have questions about your health.

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