ASCO Templates for Use in Practice

Several versions of the colon cancer treatment plan and summary templates are provided below.

1. Colon Cancer Adjuvant Treatment Plan and Summary templates: these forms include a plan component, to be completed prior to chemotherapy treatment, and a summary to be completed following chemotherapy. The Colon Cancer Survivorship Plan can be added as a third page. Choose any of the following formats:

• Colon Cancer Adjuvant Treatment Plan and Summary (updated 11.09)- Modifiable Microsoft Word document: this version is best printed and filled in by hand.
  
• Colon Cancer Adjuvant Treatment Plan and Summary (updated 11.09)- Microsoft Word form: this form is best completed by typing in content electronically. The completed template can be saved and/or printed.
  
• Colon Cancer Adjuvant Treatment Plan and Summary (updated 11.09)- Microsoft Excel: spreadsheet with text fields and drop down menus, to be completed electronically. The completed template can be saved and/or printed.

 

2. Colon Cancer Adjuvant Treatment Summary only templates: this template includes all of the elements of the treatment plan and summary but is intended to be completed in total at the end of chemotherapy. The Colon Cancer Survivorship Plan can be added as a third page.

• Colon Cancer Adjuvant Treatment Summary (New 1207)- Modifiable Microsoft Word document: this version is best printed and filled in by hand.

 

3. Colon Cancer Survivorship Plan: a modifiable document that provides a customized plan for colon cancer survivorship care based on ASCO's guideline. The Plan can be added to a colon cancer treatment plan and summary template.

• Colon Cancer Survivorship Plan (updated 11.09)- Modifiable Microsoft Word document: this version is best printed and filled in by hand.
  
• Colon Cancer Survivorship Plan (updated 11.09)- Microsoft Word form: this form is best completed by typing in content electronically. The completed template can be saved and/or printed.

 

Related ASCO Resources

Colorectal Cancer Surveillance: 2005 Update of an American Society of Clinical Oncology Practice Guideline
This page includes the guideline abstract and links to the full text of the guideline and Colon Cancer and Rectal Cancer Surveillance Flow Sheets.

ASCO Patient Guide: Follow-Up Care for Colorectal Cancer
A patient guide based on ASCO's colorectal cancer surveillance guideline.

Information About Use of Treatment Plan and Summaries
The treatment summary is not intended to be, and should not be considered, a substitute for written or verbal communication, physical examination and history, or review of the complete medical record. Because the treatment summary will summarize parts of your patient’s medical record and treatment plan, it should be treated as confidential and used or disclosed only in accordance with federal and state privacy laws.

No single treatment plan or summary can be appropriate for all patients. Treating oncologists assume responsibility for tailoring the treatment summary to meet individual patient’s needs.

Use of the treatment summary is entirely voluntary. Use of this tool does not imply ASCO’s endorsement of any specific treatment or any product. ASCO is not responsible for any inaccurate or inappropriate use of the treatment summary.