Appendix 1
FOLLOW-UP AFTER CURATIVE TREATMENT FOR COLORECTAL CANCER
Dear Patient:
You have now completed all treatment needed to offer you the best chance for cure of your colon/rectal cancer. We know how difficult this period of time has been for you, and we also acknowledge your concerns for the future. We hope the following guidelines will help you to understand how we are going to deal with problems in the future.
We plan to see you in the clinic at least every six months for the first three years, and then annually for another three years. During these visits we will ask about any significant symptoms you may have had, and will perform a physical examination, some blood tests, and x-rays. We will also arrange for a colonoscopy to be done now if you did not have one before the operation. The reason for this test is to be sure there are no polyps in the remaining bowel which may evolve into another cancer. If no polyps are found, the next colonoscopy would be in 3 to 5 years, which is the time a polyp may take to develop. If there are polyps, the colonoscopy would help to remove the polyps, and the test will be repeated in one year to check that no more polyps are present. There are some symptoms that may indicate the need for assessment between visits. These symptoms include:
- persistent changes in the bowel habit such as constipation or diarrhea;
- persistent changes in the form or shape of the stools;
- presence of blood in the stools;
- persistent abdominal or back pain;
- persistent weakness;
- lack of appetite, in particular if associated with weight loss;
- a lump in the neck, or elsewhere.
If any of these symptoms occur or you have other concerns, please contact your family physician or oncologist for advice.
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