Diagnosed with Colorectal Cancer during COVID — how has treatment changed

Colorectal Cancer Treatment During and After COVID-19

I understand you were diagnosed with colorectal cancer during the pandemic—that's a particularly challenging time to navigate cancer care. Let me explain how treatment approaches have evolved and what may have changed since your diagnosis.

How COVID-19 Initially Impacted Cancer Treatment

During the early pandemic, oncologists had to make difficult decisions about balancing cancer treatment with infection risk. According to guidance from major cancer centers, doctors considered several factors:

Treatment Decisions:

• For patients on active chemotherapy, doctors evaluated whether continuing treatment or temporarily pausing was safer
• The decision depended on how effective the treatment was versus the risk of COVID-19 exposure
• Many centers reduced in-person visits by uncoupling telemedicine appointments from chemotherapy infusion days—meaning you'd arrive and go straight to the infusion area, minimizing time in waiting rooms

Monitoring and Follow-up:

• Routine check-ups were often cancelled or moved to phone/video visits
• Essential lab work and imaging continued but were sometimes done at local facilities to reduce travel
• Clinical trials continued with modifications to protect patient and staff safety

Current Colorectal Cancer Treatment Landscape

The good news is that colorectal cancer treatment has actually advanced significantly, with several important developments:

Blood-Based Screening & Monitoring Tests

According to recent FDA approvals and NCCN-recommended options, new blood tests are now available that can help with both early detection and monitoring:

Shield (Guardant Health) - FDA-approved July 2024

• Blood test detecting colorectal cancer with 83% sensitivity and 90% specificity
• Stage II sensitivity: 100% | Stage III sensitivity: 96%
• Now covered by Medicare and commercially available

Cologuard Plus (Exact Sciences) - FDA-approved October 2024

• Stool-based test with 94% sensitivity for Stage II and 97% for Stage III
• Launched commercially in March 2025
• Available through major health systems

ColoSense (Geneoscopy) - FDA-approved May 2024

• First FDA-approved RNA-based screening test
• 93% sensitivity, 88% specificity
• Launched late 2024/early 2025 via Labcorp

Molecular Residual Disease (MRD) Testing

For patients like you who've been treated, Guardant LUNAR and similar tests can detect remaining cancer cells in blood after treatment:

• Helps guide surveillance schedules
• Can identify molecular recurrence before symptoms appear
• Specificity of ~100% (very few false positives)

This is particularly valuable because it may help your doctor determine if additional treatment is needed before cancer returns clinically.

What This Means for Your Care

Questions to Ask Your Oncologist:

1. "Have I been tested for molecular residual disease (MRD) after my treatment? If not, would this test be appropriate for me?"

   • This can help predict if your cancer might return and guide surveillance intensity

2. "What biomarkers were identified in my tumor (MSI status, KRAS, BRAF, BRCA mutations)?"

   • These determine which targeted therapies or immunotherapies might work best if needed

3. "Are there any new clinical trials for colorectal cancer that might be appropriate for my stage and biomarker profile?"

   • Treatment options continue to expand, especially for advanced disease

4. "How often should I be monitored, and can some follow-up visits be done via telemedicine?"

   • Many centers now offer hybrid approaches that reduce unnecessary in-person visits

5. "If my cancer recurs, what treatment options are now available that weren't available at my initial diagnosis?"

   • The field has evolved significantly even in the past 2-3 years

Key Takeaway

While COVID-19 disrupted cancer care delivery, colorectal cancer treatment has actually improved with new screening tests, better monitoring tools, and expanded treatment options. The pandemic also normalized telemedicine, which many patients prefer for routine follow-ups.

Your care team can now use blood-based tests and molecular profiling to personalize your surveillance and treatment in ways that weren't available before. This is genuinely good news for colorectal cancer patients.

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This information is for educational purposes only. Always consult your healthcare team for personalized medical advice and decisions.