The Colon Club

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?

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.

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...

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.

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,

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.

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.

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

Is genetic analysis typically done in case of Stage 1?

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.

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.

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!