The National Institute for Health & Care Excellence (NICE) guidelines state that patients with primary bowel cancer who have had treatment to cure their cancer should be offered regular follow-up tests which may include:
- at least two CT scans of the chest, abdomen and pelvis in the first three years
- regular CEA (blood) tests at least every six months in the first three years
- a follow-up colonoscopy at one year after initial treatment or sooner if you did not have one before surgery.
Your hospital team will follow local guidelines to ensure that you continue to be monitored in the most appropriate way for you. Hospital Trusts have introduced differing levels of follow-up. Increasingly, suitable patients will be given the chance to opt in to ‘self-managed’ or ‘remote’ follow-up. This means that for low risk patents there will be no face-to-face appointments unless problems arise; only patients with complex problems will be required to come back to see the hospital team.
If you have been diagnosed with advanced cancer, are having on-going treatment with intensive monitoring, or lots of problems with side-effects, you will find that you have more follow-up appointments with doctors, nurses and other healthcare professionals.
If problems do occur at any time, your team will want to know, so contact your colorectal nurse specialist or your consultant’s secretary, who can arrange for you to be seen if necessary.
Your GP will have been informed of your progress throughout treatment by letter from your surgeon and/or oncologist. Your GP is in charge of your care when you are not receiving active treatment from your surgeon, oncologist or palliative care team. Your GP is also required to carry out a cancer care review with you within six months of your diagnosis.
We know that the biggest fear for many bowel cancer patients is that your cancer may come back or spread to other parts of your body. Many people describe how they become anxious before follow-up appointments, and that going back for clinic appointments and waiting for test results can be very stressful. Even visiting the hospital again can create anxiety for some people. Your colorectal specialist team will help you to understand your own risk of the cancer coming back, based on your original diagnosis and the type and spread of the cancer at that time.
Our ‘Managing your follow-up’ factsheet gives suggestions for ways to help you cope with the emotions and anxieties that waiting for test results can stir up.