<s>[INST] I have a friend who is a 40 year old male who was diagnosed last year with Stage 3 Colon Cancer.  He had surgery to remove the cancerous tumor and is currently undergoing chemotherapy.  When his doctor removed the tumor he found 3 out of 16 lymph nodes testing positive.  For over three years he complained to his doctor about symptoms and wanted further testing done but his doctor kept telling him it was not necessary and it was due to having a fatty liver and being over weight.  He went with a different doctor last year and the doctor had a CT scan done which detected the cancer.  We just want some insight and to know if his cancer was detected three years ago would it have been at an earlier stage and not effecting his lymph nodes. [/INST] Hi, Thanks for writing in. Colon cancer even after treatment with surgery and chemotherapy, might spread to liver in half of the patients. This is confirmed by many studies and therefore a close follow-up is suggested in every patient with colon cancer even on treatment. Please get regular ultrasound scan abdomen done, and CT scan abdomen might also be done less frequently. It is possible that the cancer grew over they last 6 months before detection. To know the appearance of the cancer, it is important to know the CT scan report. Though it is less likely to be detectable on CT sand one 3 years back. If the cancer involves a large segment with obvious wall occlusion then a CT scan done earlier might have given a clue. Please do not worry. </s>