At the end of a potentially curative treatment of colorectal cancer which may
include surgery, radiotherapy and chemotherapy, there is no evidence of any
remaining cancer in the body.
Unfortunately recurrence may occur. As a matter of fact recurrence occurs in
approximately 50% of cases of colorectal cancer. Recurrence can happen at any
time up to 5 years after the initial treatment although 80% of recurrences will
occur within 3 years.
Recurrence can occur either in the same area of the original tumour, in which
case it is called “local recurrence” or can occur at a distant site and it is called
“metastatic disease” or “metastases”.
Even in case of recurrence there is still the possibility of cure and the treatment of
recurrent colorectal cancer is described elsewhere. However recurrence is
curable only if it is caught at an early stage, mainly before it has caused
symptoms.
The “follow up” process aims to discover any recurrence before it gives symptoms
on the hope that earlier treatment will offer better chances for cure. The issue on
whether follow up after colorectal cancer surgery succeeds in this aim has been
debated for a long time. Some doctors have not been convinced that there is a
benefit from follow up have argued that it may only be a cause of unnecessary
anxiety for the patient. Several studies have been conducted with conflicting
results. However the last 5 years a number of powerful studies (“meta-analyses”)
have proven beyond doubt that follow up has benefit for the patient and should
be followed for 5 years after surgery.
Follow up consists of pre-scheduled visits and investigations. The exact design
may vary from hospital to hospital, however it usually involves mainly 2
investigations: CT scan of abdomen/ chest and CEA (Carcino Embryonic Antigen)
which is a “tumour marker” elevated in the blood in the presence of cancer.
The regime of follow-up may also depend on certain features of the particular
tumour (stage, differentiation etc) and may also on the general condition and age
of the patient.
At King's College Hospital we follow up more intensively cancers of relatively
advanced stage (Dukes B and C). Early cancers (Dukes A) have less intensivce
follow up because the risk of recurrence is quite small (less than 10%).
The colorectal cancer follow up of King’s College Hospital can be seen by clicking
on the link.
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Follow - up after colorectal cancer surgery
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