Follow-up Schedule

The follow-up is based on the stage of the disease after ending of the first treatment, as well as on the individual progression during the treatment. The risk of a recurrence is statistically the highest during the first two years, decreasing slowly after two years. Usually, the recurrence of a successfully cured colorectal cancer occurs rather rarely. After 5 years or later, the risk of a recurrence is very low, if not impossible. In advanced colorectal cancer, the follow-up care is also meant to keep an eye on the disease, so as to immediately react, if necessary. In those cases of complete resection of the tumor, it is the aim to detect as early as possible a potential recurrence.

During follow-up all types of recurrence are to be looked after:

Local recurrence: A tumor growing at the same place where the first one developed. This occurs rarely in colon cancer, whereas the risk of not completely resecting all cancer cells is higher in rectal cancer surgery.

Second tumor: Discrete tumor, growing at a different portion of the colon and not necessarily related to the primary tumor.

Metastases: Metastases may develop if cancer cells have migrated from the tumor and reached other parts of the body via blood or lymph fluid. Metastases of colorectal cancer are more likely to develop in liver or lungs and may be treated in some patients.

In follow-up care, the tumor marker CEA (carcinoembryonic antigen) may indicate a recurrence or metastases, although an elevated CEA level does not necessarily mean that there is colorectal cancer, because also in healthy intestinal cells, benign diseases and after colonoscopy, an elevated CEA level may be produced. On the other hand, not every colorectal cancer produces an elevated CEA level. Still, an elevated CEA level is always a finding that needs to be followed upon.

Early detection is best for an optimal healing: This applies also for the follow-up surveillance.