Recommendations for Follow-Up Care After Treatment for Colon Cancer

After treatment for colon cancer, it is important to follow your provider’s plan for follow-up care. This article reviews the most common follow-up recommendations. You should talk with your care team about your specific follow-up plan.

Screening for Recurrence or a New Cancer

Screening for recurrence in colon cancer is dependent on what stage of colon cancer you have.

Stage I Colon Cancer

• You should have a colonoscopy one year after your initial surgery.
  • If an advanced adenoma is present during this exam, you should have a repeat colonoscopy in 1 year.
  • If there is no advanced adenoma present, you should repeat your colonoscopy in 3 years; then every 5 years.

Stage II or III Colon Cancer

• You should see your healthcare provider and have a physical exam every 3-6 months for the first two years. After two years, you should be seen every 6 months until 5 years after you have completed treatment.
• You should also have a baseline CEA tumor marker test. This should be repeated every 3-6 months for 2 years; then every 6 months until 5 years after treatment.
• You should have a colonoscopy one year after surgery, or 3-6 months after surgery if you didn’t have a colonoscopy before surgery.
  • If an advanced adenoma is present during this exam, you should have a repeat colonoscopy in 1 year.
  • If there is no advanced adenoma present, you should repeat your colonoscopy in 3 years; then every 5 years.
  • You should have CT scans of your chest, abdomen, and pelvis every 6-12 months for 5 years.

Stage IV Colon Cancer

• You should see your healthcare provider and have a physical exam every 3-6 months for the first two years. After two years, you should be seen every 6 months until 5 years after you have completed treatment.
• Your CEA levels should be checked at each follow-up visit.
• You should have CT scans of your chest, abdomen, and pelvis every 3-6 months for the first 2 years, then every 6-12 months for a total of five years.
• You should have a colonoscopy one year after surgery, or 3-6 months after surgery if you didn’t have a colonoscopy before surgery.
  • If an advanced adenoma is present during this exam, you should have a repeat colonoscopy in 1 year.
  • If there is no advanced adenoma present, you should repeat your colonoscopy in 3 years; then every 5 years.

Healthy Living After Colon Cancer

Survivors often wonder what steps they can take to live healthier after cancer. There is no supplement or specific food you can eat to assure good health, but there are things you can do to live healthier, prevent other diseases, detect other cancers early, and in some cases, reduce the risk of your cancer coming back. After treatment for colon cancer, it is important to:

• Have your recommended cancer screenings. These can include screening for breast, skin, prostate or cervical cancers.
• Have your recommended adult vaccinations including annual flu, COVID-19, shingles and pneumovax. Talk with your provider about which vaccines you need and when.
• Have an active lifestyle and maintain a healthy body weight.
  • Aim for 30 minutes of moderate exercise/activity most days of the week with a goal of 150 minutes per week. Talk with your healthcare team about how to get started with (or back to) an exercise program.
  • If an ostomy or neuropathy from your cancer treatment impacts your ability to be physically active, ask for a referral for cancer rehabilitation and/or physical therapy.
• Eat a healthy diet rich in whole grains, fruits, and vegetables. Try to limit red and processed meats.
• Limit alcohol use - 2 or fewer drinks per day for men; 1 or fewer drinks per day for women.
• Quit tobacco. While the research has not shown a direct link to colon cancer recurrence and tobacco use, tobacco use causes many other cancers and health issues. Learn more about quitting here.
• It is important to maintain your health insurance so that you can continue to receive your follow-up care as recommended. If you are having insurance issues, ask your team for a referral to a social worker who can assist with this.