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

Overview

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Even if your oncologist tells you that you are “cured,” there is always the possibility of a recurrence or that another cancer will appear. Although a recurrence or a new cancer are treatable, it is best to avoid them if possible.  Use your experience as a spur to do your best to help prevent your colon from developing another polyp or cancer. It may take thought and work in the beginning, but it gets easier as time goes on.

If there is no evidence of disease: Even if your oncologist tells you that you are “cured,” there is always the possibility of a recurrence or that another cancer will appear. As stated by Dr. Mark Pochapin, the noted colorectal specialist:

“Cure" is a tough word when we're talking about cancer. No one knows if cancer is ever really cured. But it is sometimes pushed back so far it never grows again. We call that "remission" or "long term survival." Your chances of surviving for a long time depend on the stage of your cancer and how successful the treatments are. Obviously, the lower the stage and the less the cancer has grown, the better the odds. Still, no one can confidently predict any of those things. Your best bet is to fight as hard as you can and live every minute to the fullest. 

It may take thought and work in the beginning, but it gets easier as time goes on.

To learn about what to expect and what to do about it, see:

Follow Up Visits and Tests

When treatment was finished, you should have received a colorectal cancer follow-up plan If you didn’t get a plan, it is never too late to ask your cancer doctor for one or to get one from a nearby Survivor clinic at an NCI certified cancer cente offsite linkr. Your insurance is likely to cover these services.

A follow-up plan includes dates for follow-up appointments with your oncologist(s), tests you should take, and symptoms to watch for. The timing of  doctor visits, as well as what happens during those visits, varies depending on the treatment you had, your particular health situation, and other individual factors.

Prepare for follow up visits with your doctors. 

  • Keep track of follow-up appointments in whatever way works for you. People have been known to keep track in a diary, on a wall calender, on a computer or on a smart phone.
  • 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 getting a cutting edge treatment by 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. If you are in partial remission, there may be trials which are aimed at preventing cancer growth. Also ask your oncologist for the statistical odds 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. For information about understanding your policy, and how to maxmiize use of it, click here
  • Know what doctors mean when they say where you are with respect to cancer. For tips, click here.

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. 

If side effects become worse than anticipated or last longer than expected or if any of the symptoms listed in the section of this article about when to call your doctor appear, do not wait until the next exam to contact both your oncologist and your primary care doctor. Don’t worry about being called a “worry wort” or some such. It is much better to err on the side of safety. This is your life we’re talking about.

If you have more than one doctor

  • Continue to see your primary care doctor and other specialists. Your primary care doctor is charged with overseeing your entire medical condition, 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 things can happen. As you learned with colorectal cancer, the earlier you catch a medical condition, the better.
  • Make sure your oncologist and other medical specialists 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. 
  • If you haven’t already, 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.

Get screening tests recommended by the American Cancer Society. They are described in a section below.

Drugs

  • Comply with drug regimens. Do not take a drug holiday without talking with your doctor first.
  • Save money when purchasing drugs. Store and dispose of drugs safely.
  • Ask whether you should be taking vitamins and supplements such as the ones described in the vitamins section of this article.  If so, which brand does your doctor recommend? 
  • For a primer about drugs, including purchasing and tips for complying with a drug regimen, click here.

Protect the future

While it’s not pleasant to think about, there is no guarantee that your colon or rectal cancer will not return or that another cancer will not appear or that something else will not happen. You can help to heal optimally, help prevent another cancer occurrence, maximize your body's fighting ability, and help feel in control on a daily basis by living an expanded cancer prevention lifestyle. A cancer prevention lifestyle doesn’t take the place of medical treatment. Such a lifestyle does make treatments more effective and help prevent recurrences.

Examples of a cancer prevention lifestyle include the following: To learn practical information about each of these tips, click on the tip.

  • A healthy diet. (To laern about a cancer prevention diet, click here.)
  • Get rest by pacing yourself during the day and sleeping at night.
  • Regular exercise  
  • Relieve pain.
  • Avoiding smoke – both smoking and second hand smoke.
  • Reduce exposure to carcinogens (substances that can cause cancer)
  • Maintain proper weight
  • Being alert for symptoms that COULD indicate a return of your cancer
  • Don’t give up on hope.

We strongly recommend that you look at the rest of the factors that are part of a cancer prevention diet and lifestyle. Some of the tips are likely to surprise you. Please click here

And…

  • 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, inform your brothers and sisters and ask about having your children tested.  Existing sites help educate people about the risks involved, and what to do about them. For a list, click here. offsite link
  • 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 natural disaster. In case you need it in the future, keep in mind that Survivorship A to Z provides information about how to maximize time in a hospital, including staying safe.
  • 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)
  • 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. While you’re at it, write a Will if you don’t have one, or check your existing will to be sure it is up-to-date. For information, see the documents in To Learn More.
  • While treatment may be long over, medical expenses may still linger or new ones may be incurred. See: How to Maximize Use Of Your Health Insurance, Colorectal Cancer Finances)  and How To Deal With A Financial Crunch. While you’re at it, write a Will if you don’t have one, or check your existing will to be sure it is up-to-date. For information about wills, 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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