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- Recommendations for following patients after treatment to detect recurrences may include:
- • History and physical examination every two to three months.
- • Chest x-ray every 6 to 12 months for three to five years.
- • CT scans of the abdomen and pelvis once or twice a year for one to two years if CEA or liver function tests are
- abnormal or liver becomes enlarged, then yearly as required.
- • Barium enema as required.
- • Complete blood count and serum chemistry profile every 3 months.
- • Measurement of the CEA level in the blood every 6 to 12 weeks for 3 to 5 years, since a rise in the level may
- occur before other clinical , x-ray or laboratory tests show recurrence. If the CEA rises above normal, about one
- third of patients may have a recurrent tumor that can be totally removed with surgery and so may be cured.
- • Periodic proctosigmoidoscopy or colonoscopy at least every year, or more often, depending on staging . If
- there are polyps, colonoscopy should be done one to three times a year. There is three to four times the risk of
- developing new tumors.
- Recommendations for follow-up after the successful surgical removal of Dukes' A, B and C tumors include:
- • History and physical examination every three months for detection of tumor recurrence.
- • Complete blood count, serum chemistry profile and CEA tests every three to six months.
- • Colonoscopy (rather than a barium enema) every year to detect recurrent or new polyps or cancer.
- • Since family members share the same genes and/or diet, first-degree relatives should be tested for hidden blood
- in the stool and have colonoscopy after age 30.
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