Recommended Stage 1 follow up?

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Utwo
Posts: 82
Joined: Mon May 23, 2016 10:14 am
Location: T.O.

Recommended Stage 1 follow up?

Postby Utwo » Sun Apr 09, 2017 7:42 pm

What is a standard follow up for Stage 1?

I got an appointment for a colonoscopy in a year after my surgery with the same GI surgeon.
What should also be done?

Based on the stories in this forum I am concerned about spread to liver or lungs and want to detect such spread (if any) as early as possible.
What is the best way to detect such spread? CT scan, MRI, ultrasound?

I live in Canada and do not have an oncologist so far.
Should I get one to facilitate all follow ups?
58 yo male at diagnosis - T1bN0, 0/15 lymph nodes
03/16 colonoscopy #1: 2 small polyps removed in left colon
04/16 colonoscopy #2: caecum 3 cm polyp piecemeal removed
05/16 CT, blood test ...
05/16 laparoscopic right hemicolectomy with a few complications (bleeding, leak, infection)

ozziej
Posts: 198
Joined: Thu May 21, 2015 8:35 pm

Re: Recommended Stage 1 follow up?

Postby ozziej » Mon Apr 10, 2017 5:57 am

I had a ULAR for rectal cancer in March 2015 and ileostomy reversal in May 2015. No chemo or radio, final staging was Stage 1. I have seen my colorectal surgeon every 3 months since reversal. Have my CEA monitored at each visit. Had a clear colonoscopy at 12 months post op so next colonoscopy is scheduled for 2 years time. I expect to move to 6 month reviews after this next one, and will be monitored closely for 10 years. Rectal cancer has a longer time frame for recurrence than colon cancer. I don't have regular scans as they are not part of the protocol for Stage 1 surveillance. I am in Australia.
F 56 dx 11/14 Stage 1 RC (post EMR)
No neo-adjuvant or adjuvant chemo/RD
3/15 ULAR (open) temp loop ileo
5/15 ileo reversal
NED and hoping to stay that way!! : )

Beckster
Posts: 56
Joined: Thu Jan 12, 2017 3:01 pm
Location: New Jersey

Re: Recommended Stage 1 follow up?

Postby Beckster » Mon Apr 10, 2017 6:32 am

Sounds like your cancer was in the ascending colon, so was mine, but I am Stage 2A. Even though you are stage 1 and do not need chemo, you will be under surveillance with your oncologist. You will have scheduled blood work, possible 12 month yearly CT, and another colonoscopy after one year. They will monitor you for about 5 years...
57/Female
DX:(CC) 10/19/16
11/4/16- Laparoscopic right hemi(cecum)
Tumor type: Adenocarcinoma
Tumor size: 3.5 cm x 2.5 x 0.7 cm
Tumor grade: G3 (surgical) G2 (biopsy from colonoscopy)
TNM: T3N0M0
Stage : Stage IIA
Positive lymph nodes: 0 out of 24
Preoperative CEA- 1.9, Postop(8weeks from surgery) 2.5
Lymphovascular invasion
Surgical margins: clear
MSI-Negative
Lynch- Negative
12/27/2016 - Capeox, anaphylactic reaction to oxaliplatin on first infusion-discontinued
1/2/2017- Xeloda monotherapy

Violet
Posts: 11
Joined: Mon Aug 15, 2016 6:43 am

Re: Recommended Stage 1 follow up?

Postby Violet » Tue Apr 11, 2017 5:36 am

Hi,

My husband was diagnosed with stage 1 rectal cancer 15 months ago. He has had CEA levels every 3 months (we were told 3 months by one oncologist and six monthly by another but elected to go with three monthly). He had a CT chest/abdo/pelvis at about ten months (funny timing but again told six monthly by one oncologist and yearly by another) and a colonoscopy at 12 months.

There isn't a consensus about surveillance for stage 1 and in a sense third monthly blood tests are both anxiety provoking (prior to them) but also reassuring for my husband as they have been normal to date.

You could do either and it would be reasonable. We are also based in Australia so it seems even within the same country the recommendations can be quite different looking at the first response from a fellow Australian.

Buckeye
Posts: 92
Joined: Mon Jan 18, 2016 7:02 pm

Re: Recommended Stage 1 follow up?

Postby Buckeye » Tue Apr 11, 2017 4:07 pm

According to my surgeon I see him every 3 months for 2 years with cea blood work and a physical exam. Then every 6 months for years 3-5 with cea and a physical exam. Also I get a Ct scan every year along with a colonoscopy since I am also positive for lynch. After year 5 I am considered cured, and only need yearly or bi- yearly colonoscopy depending on if I have polyps,
Dx 10/20/15 stage 1 T1N0M0 1.3cmx1.1cmx1cm low grade ( well to moderately differentiated) Rectal cancer age 47
Loving Husband and father of two girls age 19 & 15 Sole income provider
CEA <0.5
CT, MRI and PET show no metastatic spread
LAR Laparoscopic TME 11/30/15 with Illo
Pathology clean no lymph node or vascular involvement. Confirmed Stage1
No chemo/rad cancer free now and forever.
Illo reversal 01/26/16

del
Posts: 41
Joined: Thu Mar 03, 2016 11:21 pm
Location: Sydney, Australia

Re: Recommended Stage 1 follow up?

Postby del » Wed Apr 12, 2017 4:29 am

I'm also in Australia and it's 3 monthly CEA tests, 6 monthly CT scans and yearly colonoscopies for 5 years for me (and probably regular colonoscopies for the rest of my life). As others have said, there's not really any standard protocol for stage 1.
Male 33, stage 1 RC (T1N0M0 0/29 LNs)
2016-02 - Cancerous polyp removed during colonscopy, 0.5 mm margin
2016-03 - ULAR & TME surgery, temp ileostomy
2016-04 - DVT, pulmonary embolism
2016-08 - Clean CT
2016-11 - Ileostomy reversal
2017-03 - Clean CT & colonoscopy

ozziej
Posts: 198
Joined: Thu May 21, 2015 8:35 pm

Re: Recommended Stage 1 follow up?

Postby ozziej » Wed Apr 12, 2017 8:04 pm

I guess the variation in protocol might relate to presence or absence of high risk features such as degree of cell differentiation. My surgeon said the risk of regular scanning is greater for stage 1 than the risk of recurrence. I would have had mop up chemo if it had been offered but again this is not standard for stage 1.
F 56 dx 11/14 Stage 1 RC (post EMR)
No neo-adjuvant or adjuvant chemo/RD
3/15 ULAR (open) temp loop ileo
5/15 ileo reversal
NED and hoping to stay that way!! : )

User avatar
Hannah Faulkner
Posts: 15
Joined: Tue Feb 14, 2017 3:14 am

Re: Recommended Stage 1 follow up?

Postby Hannah Faulkner » Fri Apr 14, 2017 8:30 am

Preliminary scans are essential, they also do CT and put you under surveillance for years

Utwo
Posts: 82
Joined: Mon May 23, 2016 10:14 am
Location: T.O.

Re: Recommended Stage 1 follow up?

Postby Utwo » Mon Apr 17, 2017 9:10 pm

Is genetic analysis typically done in case of Stage 1?
58 yo male at diagnosis - T1bN0, 0/15 lymph nodes
03/16 colonoscopy #1: 2 small polyps removed in left colon
04/16 colonoscopy #2: caecum 3 cm polyp piecemeal removed
05/16 CT, blood test ...
05/16 laparoscopic right hemicolectomy with a few complications (bleeding, leak, infection)

del
Posts: 41
Joined: Thu Mar 03, 2016 11:21 pm
Location: Sydney, Australia

Re: Recommended Stage 1 follow up?

Postby del » Tue Apr 18, 2017 6:43 am

Utwo wrote:Is genetic analysis typically done in case of Stage 1?


Since genetic testing is expensive, I think you would usually only be sent for genetic testing if there was some reason to suspect your cancer was caused by genetics, like a family history of colorectal cancer, large number of polyps, etc. I don't think it really matters what stage you are. In my case I was referred for genetic testing due to my age at diagnosis.
Male 33, stage 1 RC (T1N0M0 0/29 LNs)
2016-02 - Cancerous polyp removed during colonscopy, 0.5 mm margin
2016-03 - ULAR & TME surgery, temp ileostomy
2016-04 - DVT, pulmonary embolism
2016-08 - Clean CT
2016-11 - Ileostomy reversal
2017-03 - Clean CT & colonoscopy

HoneyJack
Posts: 42
Joined: Thu Nov 13, 2014 11:32 pm

Re: Recommended Stage 1 follow up?

Postby HoneyJack » Thu Apr 20, 2017 8:47 am

Blood work including CEA every three months for the first year then every six months for years 2-5.

CT at one year (I've had no more since)

Colonoscopy every year for five years then possibly every 5 yrs after

I've had genetic testing-all went well and covered by my insurance so why not.
Wife & mom
Right colectomy 4/2014 @41yrs old
Tubulovillous T2-N0-M0 0/30 nodes (located in Cecum)
Stage 1 colon well-mod differentiated
Lynch negative
NED

5/2014 Chest CT showed enlarged lymph nodes/biopsied Sarcoidosis! (Not symptomatic)
3 incisional hernias fixed 3/2016

ChiMama
Posts: 19
Joined: Wed Jul 20, 2016 8:41 pm
Location: PHX

Re: Recommended Stage 1 follow up?

Postby ChiMama » Sat Apr 22, 2017 11:48 pm

My schedule is: 3 month bloodwork, 6 month CT, 1 yr colonoscopy. After a year if all is well, reassess the plan.

I may be having more regular CT because I had (have) a nodule in my lung that's being monitored. (So far, the pulmonary specialist thinks it's probably scarring from old valley fever infection. Fingers crossed!) Also have nodules in my thyroid they're watching.

Hope all goes well for you!
4/21/16 First Colonoscopy @59
DX "inflammatory changes" biopsy "high grade dysplasia"
CT & PET fibroid uterus, suspicious area near sigmoid/ovary, liver cysts, lung nodules
6/17/16 Open "combo" surgery: total hysterectomy, remove 12.5cm sigmoid, 29 LN
6/17/16 T2N0M0 Stage 1 Moderately differentiated adenocarcinoma 5.2 cm x 4.1. Clear margins, LN clear, Gyne benign
Lynch neg
CT 7/27/16 lung nodules undetermined
8/19/16 Scope: 3 polyps, 2 adenoma
Mama to a rescue Chihuahua


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