Patient Presentation

A 68 y/o woman with a history of stage III rectal cancer presents diagnosed approximately 3 1/2 years ago after undergoing a colonoscopy for the evaluation of anemia. She comes to your clinic as a new patient for general medical care. Her treatment history includes previously undergoing neoadjuvant chemoradiation with 5-FU, followed by low anterior resection. She underwent a post-operative CT of the chest/abdomen/pelvis before undergoing four months of adjuvant chemotherapy with oxaliplatin, 5-FU and leucovorin. She ended her chemotherapy three years ago. Her last visit with the oncologist was 6 months ago. Records from this visit include the following tests: labs including CBC, chemistries, CEA, CT scans and colonoscopy which were normal. She has decided to no longer see her oncologist and requests to see you for all her follow-up care as part of her routine medical care.

History & Physical Exam

Patient History

Symptoms

Physical Exam

Patient History

Symptoms

Physical Exam

Radiologic and other diagnostic studies

Instructions: Based on her history and in accordance with NCCN and MDACC guidelines what radiologic studies should she have at this time?

  • CT chest

    CT chest

    5stars

    CT chest is recommended annually.

  • CT abdomen/pelvis

    CT abdomen/pelvis

    5stars

    CT or MRI abdomen/pelvis is recommended annually.

    mrithumb

  • MRI abdomen/pelvis

    MRI abdomen/pelvis

    5stars

    CT or MRI abdomen/pelvis is recommended annually.

    mrithumb

  • PET scan

    PET scan

    5stars

    PET scan is not routinely recommended and should not be used instead of a contrast enhanced CT.

    petthumb

  • Bone scan

    Bone scan

    5stars

    Bone scan is not indicated.

  • Colonoscopy

    Colonoscopy

    5stars

    Colonoscopy is recommended one year after first diagnosis, then at 3 years, then every 5 years.

Plan

If her evaluation, including all labs and diagnostic tests is unremarkable, when would you recommend her to return to clinic for her nxt CRC survivorship follow-up?