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Colorectal Cancer: Post Treatment 0 - 6 Months: Medical Care Stages II,III,IV

What To Expect And What To Do After Radiation Treatment

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Follow Up Exams and Tests

Your follow-up plan will tell you when follow-up appointments will be scheduled.

The first tests and imaging studies such as a CT scan, an MRI test or a PET scan are usually delayed for a few months after the end of treatment because the radiotherapy continues to have a cell killing effect for several months. Tests and imaging studies will then be repeated.

To learn about what to expect at follow-up visits, click here

Side Effects

During the first 6 months after the end of radiation treatment, the following are common continuing side effects.

  • Allergies: If you had food allergies prior to treatment, they may become better or worse. If you didn’t have food allergies, some may appear. 
  • Blood counts: Both white and red blood cells may remain low or below normal for months or years.
  • Bowel cramping and intestinal blockages recede or diminish for most people. For some people this symptom continues for a long period of time. For some people, it is permanent.
  • Diarrhea: Persistent diarrhea after surgery is common. If you had the entire colon removed, there is no cure for diarrhea but changes in diet may lessen the frequency or looseness of your stool. For everyone else, click here to learn how to cope with diarrhea
  • Eyes:  
    • Dry or watery eyes may continue for months.
    • If you previously had herpes or shingles (varicella zoster) you may have a reactivation which can result in a permanent change in eyesight. Call your doctor right away if you experience eye pain or impaired vision with a rash on your face or scalp. Antiviral drugs can help.
  • Fatigue: May continue for years after treatment.
    • Fatigue generally continues for at least as long as the time between diagnosis and end of treatment.
    • There are tips for coping with fatigue (See the document in "To Learn More.") 
  • Fertility: May improve over months or years following treatment, or it may never recover.
  • Hair: The hair on your head will not be affected by radiation for colorectal cancer. However, with radiation treatment to the pelvis, there may be a thinning out of the hair on your lower abdomen or pubic area or you may lose hair entirely. If you do lose hair, it will generally not grow back. If it does, it may be a different color or texture.
  • Incontinence: is not usually a major side effect of external radiation. Incontinence is treated by wearing a pad or a diaper. If incontinence continues or becomes unbearable, there are medical steps to take. If this occurs, speak with your doctor. For practical ways to deal with incontinence, click here.
  • Neuropathy (pain, burning, weakness or numbness in the hands or feet): may continue for weeks or months. If you had platinum based therapy (for example, oxaliplatin) neuropathy may be permanent in some people.
  • Rectal soreness or bleeding:
    • It is not unusual to have rectal bleeding for a while after radiation treatment due to the ulceration of the rectal wall where the radiation dosage is concentrated. Rectal bleeding can usually be treated with enemas containing steroids or by laser.
    • There may be rectal soreness.  A diet which is low in fibrous foods often will help to allow healing. Symptoms may be lessened with steroid enemas or suppositories.
  • Urinating difficulty may be a short term effect of radiation treatment.

Men

  • Erectile function: If you experience erectile dysfunction during treatment, it may continue. Erectile dysfunction can go on for 2 – 5 years. For a small percentage of men, it may become permanent. To learn more about erectile dysfunction and what can be done about it temporarily or permanently, click here.  
  • Orgasms:  After radiation therapy, there may be a change in the sensation Of the ejaculate.
    • The ejaculation is often described as different than that was encountered prior to the treatment.
    • There will be ejaculation of seminal fluid.  However, there will be a permanent decrease in semen volume.

Contact your cancer doctor if:

  • You experience any of the above conditions and the tips provided in related documents don’t help.
  • If any of the conditions are so severe that they interfere with your daily living.
  • Unexpected symptoms appear. Also let your primary care doctor know about these symptoms in case they do not relate to colorectal cancer.

You experience any of the symptoms listed in the section: “If These Symptoms Appear, Contact Your Doctor” 

For possible long term effects of radiation treatment, see: Colorectal Cancer: Post Treatment 6 Months Plus 


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