Care of the Colorectal Cancer Survivor

Colorectal cancer is the fourth most common cancer in the United States and has a five-year survival rate of 65%. The American Cancer Society and other experts have released guidelines on surveillance, health promotion, screening for other malignancies, and management of treatment effects. Surveillance for disease recurrence should occur every three to six months for the first two to three years, then every six months for a total of five years. Each visit should include a history and physical examination, routine care for chronic medical conditions, and screening for other primary cancers according to guidelines for the general population. Topics addressed depend on the treatment utilized but generally include gastrointestinal issues, neuropathy, pain, urinary symptoms, fatigue, psychological issues, cognitive problems, sexual symptoms, and stoma care. Carcinoembryonic antigen testing should be performed at each visit in patients who are candidates for further intervention. Chest, abdomen, and pelvic computed tomography should be performed annually for five years after treatment. Colonoscopy should be repeated one year after treatment, then three years later if no advanced adenoma is identified.