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Information about all aspects of health care from choosing a doctor and treatment, staying safe in a hospital, to end of life care. Includes how to obtain, choose and maximize health insurance policies.
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Colorectal Cancer: Post Treatment 0 - 6 Months: Medical Care Stages II,III,IV

Summary

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FOR INFORMATION ABOUT EACH OF THE FOLLOWING SUBJECTS, SEE THE OTHER SECTIONS OF THIS DOCUMENT UNLESS NOTED OTHERWISE

Recovery

What happens during recovery from treatment depends on the treatment you received as well as your physical condition. Recovery takes time, probably more time than you would like. The recovery process typically includes periods of progress and periods where you will seem to get worse instead of better. There are also likely to be healing plateaus during which you don’t seem to be going backward or forward. Although setbacks and plateaus can be discouraging, they are normal and are not correlated with your prognosis. 

If results from an exam are negative, or if liver lesions or lung spots appear, keep in mind that only further testing or a biopsy is definitive. 

Save energy until you’re back to par. To learn how to save energy and time, click here

If you have a setback or reach a plateau and are concerned, contact your doctor and describe what is going on as well as you can or schedule an appointment with both your regular doctor and your oncologist. If you have been keeping a Symptoms Diary, take a copy with you. 

Continuing Side Effects

In general, the side effects you experienced during treatment should gradually fade away over the months following the end of treatment.  Some side effects may take longer – and some will possibly be permanent.

For an idea about which side effects to anticipate and their likely duration, see the section of this document about the type of treatment which you just completed. If symptoms are worse than anticipated, or unexpected symptoms appear, contact your oncologist without delay.

If side effects from treatment such as incontinence or erectile dysfunction become worse than anticipated or last longer than expected or if any of the symptoms listed in the section about when to call your doctor appear, do not wait until the next exam to contact both your oncologist and your primary care doctor. It is much better to err on the side of safety. This is your life we’re talking about. 

Drink at least eight glasses of pure water a day. (To learn about pure water, click here.) Water helps waste go through your system healthily. 

Save energy until you’re back to par. To learn how to save energy and time, click here

If you have an ostomy, learn how to keep it clean and how to live with it to minimize the effect on your life. Bottom line, there is nothing you cannot do because of an ostomy. To learn more, click here. 

Colorectal Cancer Follow-Up Plan 

  • Everyone should get a colorectal cancer follow-up plan. Such a plan should include a schedule of future medical appointments and tests, as well as symptoms to watch for. The timing of  doctor visits, as well as what should take place during those visits, varies depending on the treatment you had, your overall health, and other individual factors  The plan should also clearly state which of your doctors is going to follow you for your cancer follow-up care.
  • If you didn’t get a plan, ask your oncologist for one. You can find a suggested colorectal cancer follow up plan from the  American Society of Clinical Oncologists' (ASCO) by clicking here offsite link
  • Read the plan carefully to be sure you understand everything that it says. Ask your doctor or his/her nurse about any parts of the plan that are not clear to you.
  • Give a copy of the follow-up plan to your primary care doctor.
  • Report noted changes in your health to both your oncologist and primary care physician.
  • Health insurance is likely to cover services included in a follow-up plan. 

Keep all appointments noted in the follow-up plan even if you feel great with no symptoms, or you don't want to learn waht's going on because of fear of a recurrence.  There is a reason for each appointment.  If there is a recurrence, the sooner it is caught, the better.

Prepare for follow up visits with each of your doctors. For example:

  • Keep track of your symptoms, if any. Survivorship A to Z provides a Symptom Diary 
  • Keep an ongoing list of questions and concerns. Survivorship A to Z provides a Prioritizer to help you keep track. Add to your list a question about joining a clinical trial. Even if you are in complete remission, there may be clinical trials of agents that may prevent recurrence of colorectal cancer or help with residual side effects. Also ask your oncologist about the possiblity that your cancer will recur as long term survival rates. Keep in mind that the response will be about what happens statistically, not what happens to any particular individual – particularly you. Also keep in mind that a recurrence is not necessarily a death sentence. A recurrence can be treated. To learn more, click here). However, this information can be useful for planning purposes, particularly financial planning. To learn more about the meaning of statistics, click here
  • Check your health insurance to find out how much of each follow-up visit is covered and how much you will have to pay.
  • To learn more about preparing for doctor's appointments, click here.

Medications

  • Comply with all drug regimens. Don’t take a drug holiday without talking with your doctor first.
  • Save money when purchasing  your medication. Store and dispose of drugs safely.
  • Ask whether you should be taking supplements. If so, which brand does your doctor recommend?
  • Save money when purchasing medications. Store and dispose of drugs safely. For a primer about drugs, including purchasing and tips for complying with a drug regimen, click here

Doctors

  • Your primary care doctor is charged with overseeing your overall health, helping you keep your system in maximum disease fighting shape, and for being on the lookout for health conditions. It may be difficult to accept, but other life changing events can happen. As you learned with colorectal cancer, the earlier you catch medical problems, the better.
  • Make sure your oncologist and other doctors keep your primary care doctor up-to-date. For a list of information that should be in your medical file with your primary doctor, click here
  • Decide which of your doctors is in charge of your overall health. It could be your primary care doctor, a gastroenterologist or one of your oncologists. Be sure he or she agrees to the position. Remind each doctor you see after each visit to report notes about each appointment to your primary doctor. If you are keeping your own copy of your medical record (which we recommend that you do), a copy should be sent to you as well.
  • If your relationship with a doctor is not ideal, try to fix it. You will likely be dealing with your doctor for a long time.  If the relationship becomes difficult for you, consider looking for another doctor. To find out how to deal with difficulties, and how to switch doctors, click here and here respectively. 

Cancer Prevention Lifestyle

Use your experience as a wake-up call to do your best to help prevent your cancer from returning (recurrence). Adopt a cancer prevention lifestyle which includes the following:

  • Start eating a healthy diet.  For instance:
    • Increase the amount and variety of fruits and vegetables you eat each day.
    • Eat whole grain foods instead of white flour and sugars.
    • Limit meats that are high in fat. 
    • Eliminate processed meats such as hot dogs, bacon and bologna.
    • Be active. Exercise.
      • Exercise helps move waste along in your system and helps rebuild your immune system after treatment.[i]
      • After checking with your doctor, start slowly and build your exercise program. Exercise doesn’t have to be in a gym.To learn more about exercise, click here.
      • A physiatrist, a medical doctor who specializes in rehabilitation medicine, can be an important resource during the recovery period. Physiatrists are especially knowledgeable about the use of exercise to help with healing.  Ask your doctor for a referral or contact the American Academy of Physical Medicine and Rehabilitation: www.aapmr.org offsite link
    • Get rest by pacing yourself during the day and sleeping at night. (To learn about sleep, click here.
    • Relieve pain.  In addition to the unpleasant feeling, pain can keep you from exercising. (To learn how to relieve pain, click here.)
    • If you are overweight, lose the extra weight. Excess weight may be associated with cancer recurrence. For tips about how, click here. (If you lost weight, there are tips for coping with weight loss. Click here.) 
    • Take care of your mouth.  Infections in the mouth can easily spread throughout the body. (To learn about oral care, click here.)
    • Comply with drug regimens. Save money when purchasing drugs. Store and dispose of drugs safely. For a primer about drugs, including purchasing and tips for complying with a drug regimen, click here
    • If you smoke, stop. Smoking can increase the risk of developing colorectal cancer at the same or another site. You’ll also reduce your risk of heart disease and other smoking related illnesses. You now have a personal incentive to stop. The odds are in your favor if you want to stop badly enough. For information about how to stop, click here.
    • Avoid or limit consumption of alcohol. Alcohol is a risk factor for colorectal cancer as well as other cancers. For tips about limiting alcohol consumption, see WikiHow by clicking here offsite link
    • Reduce your exposure to carcinogens (substances that can cause cancer)
    • Subject to the approval of your doctor, consider:
      • Taking vitamins and/or supplements to make up for any nutritional deficiencies.
      •  Using complementary therapies such as massage therapy to ease stress.  
    • Do not try to change everything overnight, or expect that you could. Change takes time - especially when habits build up over a lifetime. Start slowly, perhaps in one area at a time. Do small steps you can accomplish. Then build on them, one at a time.

Take care of yourself

  • Connect with other people – both people you love and who enhance your life and other people with the same health situation.  You can connect with other people one-on-one (generally referred to as a cancer buddy[) and/or in a support group. You're likely to learn helpful practical tips, as well as receive support. 
  • Develop and nourish a spiritual life – it doesn’t have to be religious.
  • Consider getting a pet.  In addition to helping you feel good, a pet may help prolong your life. To learn about choosing a pet, how to keep from getting infected by your pet etc, click here. 
  • Bring humor into your life.
    • "A laugh a day keeps the doctor away" -- or at least makes you feel better. 
    • For tips about bringing humor into your life, click here.
  • Don’t give up on hope.
  • Do your best. Don’t feel guilty when you don’t do something perfectly. 

Other life changing events can happen. Get other screening tests. 

American Cancer Society recommends:

  • Women
    • All women should get an annual Pap test or every two years using the liquid-based pap test.
    • Women age 20 - 39: get a clinical breast exam.
    • Women starting age 40: get a yearly mammogram
  • Men
    • Starting at age 40, get a rectal prostate exam.
    • Starting at age 50, discuss with your doctor whether to be tested for prostate cancer. Research has not yet proven that the potential benefits of testing outweigh the harms of testing and treatment.
    • If you are African American or have a father or brother who had prostate cancer before age 65, you should have this talk with your doctor starting at age 45.

And

  • Now that you’ve been dealing with the medical system and hopefully recognize how helpful knowledge is to getting what you need, take a few moments to think about what to do if there is a medical emergency, or how to continue medical care if there is a disaster. 
  • If you have left over drugs or supplies that you no longer need such as wig, consider donating them or at least disposing of drugs properly. (For information, click here)
  • Talk with your doctor about whether you could have a gene that makes you a likely candidate for colorectal cancer. If you have the gene, ask about having your children tested. Inform your brothers and sisters. Existing sites help educate people about the risks involved, and what to do about them. For a list, click here offsite link.
  • Don’t let a fear of recurrence keep you from taking the steps described in this article. (For information about dealing with emotions, click here.)
  • If you haven’t already, now is the time to assure that you keep control of your medical care even if something happens and you become unable to speak for yourself. The documents you’ll need to think about are called Advance Healthcare Directives and Advance Mental Health Directives. They are free and easy to execute. For more information, see the articles in “To Learn More.” While you’re at it, also think about what to do if there is an emergency or a disaster. Our articles in “To Learn More” provide guidance. Also write a Will if you don’t have one, or check your existing will to be sure it is up-to-date. For basic information about wills, click here.
  • Medical expenses may linger or new ones may be incurred. See: How to Maximize Use Of Your Health Insurance and Colorectal Cancer Finances
  • For planning purposes, particularly financial planning. it is useful to ask your oncologist about  the statistical odds that your cancer will recur as well as long term survival rates. (If you don’t want to know, don’t ask). Keep in mind that the response will be about what happens statistically, not what happens to any particular individual – particularly you. Also keep in mind that a recurrence is not necessarily a death sentence. A recurrence can be treated. (To learn more, click here). For information about the meaning of statistics, click here

NOTE: Call your doctor right away if you have symptoms listed in “If These Symptoms Appear, Call Your Doctor.”  


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