I have stage 2 colon cancer. What are the recurrence chances?

Question

Hello doctor,

I am a 50-year-old man recently diagnosed with stage II colon cancer. My oncologist recommended tumor genome profiling to check for actionable mutations.

How useful is genome testing in guiding treatment?
Does it actually change chemotherapy choices?

My CEA level was 6.3 ng/mL post-surgery, and I am worried about recurrence.

Please help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

I have gone through your questions.

Tumor genome testing in stage II colon cancer is useful mainly to decide whether chemotherapy is needed at all, not to choose between different chemotherapy drugs.

The most important result is MMR (mismatch repair) and MSI (microsatellite instability) status.

If the tumor is MSI-high, chemotherapy usually does not add benefit, while if it is MSI-stable and other high-risk features are present, a short course of chemotherapy may be recommended.

Most other mutations, such as KRAS (Kirsten rat sarcoma viral oncogene homolog), NRAS (Neuroblastoma RAS viral oncogene homolog), and BRAF (v-Raf murine sarcoma viral oncogene homolog B), usually do not change treatment right now, but they become important if the cancer ever comes back and targeted treatments are needed.

Your CEA (carcinoembryonic antigen) level is only mildly elevated after surgery and by itself does not mean recurrence, so the main focus should be regular follow-up with CEA tests, scans, and colonoscopy rather than escalating treatment immediately.

You should do the following:

CEA every three to six months initially.
CT (computed tomography) scans are advised (usually annually).
Colonoscopy within one year, then spaced out if normal.
Report new symptoms early (weight loss, pain, bowel changes).

I hope you find this helpful.

Thank you.