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catherine58's picture
Posts: 92
Joined: Feb 2007

Hello everyone

I'd be interested to know what follow-up tests are normally recommended in the US (and elsewhere). Here (in the UK) I've been told I will have CT scans every six months for the first three years (no routine PET scans), then one a year, and a colonoscopy every three years. It doesn't sound very often ... I had a resection for Stage 3 colon cancer and am now on my fourth cycle of Folfox (out of 10). My first CT scan will be in September (I had one in March following surgery, which was all clear).

I wonder if I should push for more frequent screening?

Thanks for your help.


sladich's picture
Posts: 430
Joined: May 2007


I'm a stage 4 and since finishing chemo, I have CT/PET's every 2 months. It was every 3 months but since I've had 2 recurrences my oncologist checks often. With Stage 3, 6 months is probably good.


JoyceCanada's picture
Posts: 134
Joined: Mar 2006

Rectal stage III, 2 nodes involved.

Treatment 8 rounds folfox 28 continuous 5fu radiation. Completed treatment October 2006.

My follow-up treatment
Coloscopy November 2006
CT scan given in November 2006 showed nodes in lung. Had 2nd CT scan in February 2007 which showed nodes to be of no consequence - clear!

May 2007 blood work CEA.

I am scheduled to have blood work CEA done again in August.

CT scan and colonoscopy in November.

protocal is 1 CT per year (for rectal cancer because of the past radiation treatment). Too many X-rays are not good!!
Coloscopy 1 per year

Every 4 months for CEA blood work and visit with oncologist.

shmurciakova's picture
Posts: 910
Joined: Dec 2002

I was also Stage IV. I had mets to liver and lungs, with the lung resection 2 1/2 years ago. At first I had bloodwork and CT scans every 3 months. However, it took 8 months before my lung mets were large enough to light up on a PET scan and remove. I spoke to my onc about it and he agreed that every 4 months was probably often enough. I did that for 2 years and now am on a 6 month schedule. My CEA has remained very, very low however. So next time I may try just doing the bloodwork and skipping the CT scan. I will continue to be seen every 6 months until I am 5 years out. Then once a year forever I guess....
Maybe the 1st two years you could ask to be seen 3 times/year instead of 2. I guess it depends on how you are doing and your own personal comfort level.
Probably IMO the less radiation the better, but that is just my opinion.
I have never had routine PET scans either, only when lung mets showed up and even then, they did not light up on the PET scan for 8 months, like I said. I think the lesions need to be on the order of 1cm in size before they will generally show up on a PET scan.
Take care,

chynabear's picture
Posts: 483
Joined: Jul 2005

Hi Catherine,

I have had two oncologists (moved) and both have given me the same general follow-up plan. I have also been to 3 different gastro doc's and they have given me the same plan. I was Stage III with 1 node involved. I have been NED since surgery.

Had a PET and CT after surgery and one treatment.

Post chemo plan was to include a PET and CT or a PET/CT and bloodwork every three months for the first year, every four months the second year, and every six months for the third year (assuming all tests were clear). We haven't discussed the fourth and fifth year much, yet.

Insurance pitched a fit after my second PET and and I had to fight to have them approved and paid for. So, follow-up plan changed to just the CT unless something shows up.

My follow-up onc has also started changing the plan slightly. I am 2 years and 8 months post diagnoses and just had my CT on Tuesday. He said that he will schedule my bloodwork in 4 months and a CT in 6 instead of the 4.

I have been to 3 different gastro doc's and they all agreed on my treatment plan to include:

Colonoscopy at diagnoses, one year post diagnoses, and two years post diagnoses. At my two year mark, they all agreed that I would start going every three years for a while and then increase to every five years.

Hope this helps.


PS. Great to hear that the scan was clear in March as I'm sure it will be in Sept.

kerry's picture
Posts: 1317
Joined: Jan 2003

Hi Catherine,

I have CT scans every 3 months when on chemo and my last scan showed NED, however I am having another scan (3 months later) next week. My doctors at MD Anderson in Houston, TX keep pretty close tabs on me and I have been scanned every 3 months for over 2 years now. I know we hear that frequent scans are also bad, BUT, I had a recurrance and was restaged at Stage 4 - so maybe that is normal for that stage. Anyway I am so glad they watch me carefully.

I am looking forward to seeing you in England later this year. Take care.


Betsydoglover's picture
Posts: 1256
Joined: Jul 2005

Hi Catherine -

I was diagnosed Stage IV so my situation is a bit different.

I had CT and PET scans a few weeks post surgery, then again after 2 chemo cycles and again after the 6th (and last so far) cycle. Two months later I had CT and PET scans and since those were clean, I now have both CT and PET every 3 months. In my case PET may actually be more reliable that CT, so that's why I have both every time. Perhaps in 2008 when I am more than 2 years NED and off chemo we'll stretch out the scan cycle. But for now it is every 3 months.

As for colonoscopies, the one that diagnosed me couldn't get all the way thru, so 5 months post surgery I had another. That was clean and my GI doc said to wait two years for the next one. My oncologist however was very uncomfortable with that, which made me uncomfortable, so we did another a year later. After that my GI doc says 3 years unless the oncologist really pitches a fit. But my oncologist agrees - says now we know that the "natural history of my disease" does not involve frequent polyp formation, so waiting 3 years should be fine.

Take care,

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