For many individuals diagnosed with colorectal cancer, completing treatment is a significant milestone. While it brings relief, it can also bring uncertainty about the future and concern over the possibility of recurrence. Others may find themselves managing cancer as a chronic condition, requiring ongoing treatment. No matter where you are in your journey, survivorship comes with unique challenges—and opportunities to take charge of your health.
Creating a Survivorship Care Plan
A survivorship care plan is a crucial tool for post-treatment life. Work with your doctor to develop a plan that includes:
- A schedule for follow-up exams and tests
- Awareness of potential long-term side effects and when to seek medical attention
- Recommendations for maintaining overall health, such as nutrition and exercise
- Guidelines for cancer screening and preventative care
Staying engaged in your follow-up care can help you feel more in control of your health and detect any issues early.
The Importance of Follow-Up Care
Regular follow-ups are essential to monitor for recurrence, new cancers, or late effects of treatment. Depending on your cancer stage and treatment history, your doctor may recommend:
- Colonoscopy: Typically done one year after surgery, then every three to five years if results are normal
- Proctoscopy: For rectal cancer patients who had transanal surgery, this may be recommended every 3-6 months for the first two years
- Imaging tests: CT scans may be conducted every 6-12 months for those at higher risk of recurrence
- Blood tests: CEA is a tumor marker used to monitor colorectal cancer. If initially high, doctors track its levels every 3-6 months through blood tests for a few years after treatment. A decrease to normal suggests successful treatment, while a rise may indicate recurrence, prompting further tests. (Note: If CEA was normal at diagnosis, it’s usually not useful for detecting recurrence.)
Managing Long-Term Side Effects
While most colon cancer survivors won’t need a colostomy, some experience lingering effects of treatment. Understanding and managing these side effects can improve quality of life and overall well-being. Here’s what to expect and how to cope with common post-treatment challenges.
1. Bowel Changes
Since colon cancer treatments often affect the digestive system, many survivors experience bowel irregularities, including:
- Diarrhea: Frequent, loose stools can occur due to the removal of part of the colon or the impact of chemotherapy and radiation.
- Constipation: Some treatments slow down digestion, leading to difficulty passing stools.
- Fecal incontinence: Loss of bowel control can be due to nerve or muscle damage during surgery.
Management Strategies:
- Eat a balanced diet with fiber-rich foods to regulate digestion.
- Stay hydrated to prevent constipation.
- Use anti-diarrheal or stool-softening medications as recommended by your doctor.
- Practice bowel retraining techniques, such as scheduled bathroom visits and pelvic floor exercises.
2. Neuropathy (Nerve Damage)
Some chemotherapy drugs can cause peripheral neuropathy, leading to numbness, tingling, or pain in the hands and feet. This may persist for months or even years.
Management Strategies:
- Keep extremities warm and avoid cold temperatures, which can worsen symptoms.
- Use medications for neuropathy, if prescribed.
- Try physical therapy or acupuncture for relief.
- Be cautious with sharp objects and hot surfaces to prevent injuries from numbness.
3. Fatigue
Cancer-related fatigue may last a few weeks, months, or longer. It can stem from chemotherapy, radiation, surgery, anemia, or emotional distress.
Management Strategies:
- Prioritize rest and listen to your body’s signals.
- Engage in light physical activity, such as walking or yoga, to boost energy levels.
- Maintain a nutritious diet with enough protein and vitamins to support recovery.
- Seek support for emotional well-being, as depression and anxiety can worsen fatigue.
4. Changes in Bladder Function
Colon cancer surgery or radiation can sometimes impact bladder control, leading to:
- Increased urgency (needing to urinate more often).
- Incontinence (leakage of urine).
- Difficulty emptying the bladder completely.
Management Strategies:
- Pelvic floor exercises (Kegels) can strengthen bladder control.
- Avoid caffeine and alcohol, which can irritate the bladder.
- Schedule bathroom breaks to prevent urgency issues.
5. Sexual Dysfunction
Both men and women may experience sexual health changes after colon cancer treatment due to nerve damage, hormonal shifts, or emotional distress. Men might have difficulty achieving or maintaining an erection, while women may experience vaginal dryness or discomfort during intercourse. Body image issues can play a role, especially if you are dealing with an ostomy.
Management Strategies:
- Communicate openly with your partner about changes and concerns.
- Talk to a doctor about medications or therapy options for sexual dysfunction.
- Seek counseling or a support group for emotional support.
6. Ostomy-Related Challenges
For those who have undergone a colostomy, adjusting to an ostomy bag can be a major lifestyle change. Skin irritation, leakage, and emotional distress are common concerns.
Management Strategies:
- Work with an ostomy nurse to ensure a proper fit and reduce skin irritation.
- Use barrier creams or powders to protect the skin around the stoma.
- Find comfortable, supportive clothing designed for ostomy wearers.
- Seek out ostomy support groups for tips and encouragement.
Reducing Your Risk of Recurrence
While there’s no guaranteed way to prevent cancer from returning, adopting a healthy lifestyle may lower your risk. Consider these steps:
- Maintain a healthy weight: Obesity has been linked to an increased risk of colorectal cancer
- Stay physically active: Regular movement can improve overall health and may reduce the risk of recurrence
- Eat a balanced diet: Prioritize fruits, vegetables, whole grains, lean proteins, and healthy fats while minimizing processed and red meats
- Limit alcohol consumption: Excessive drinking may be linked to an increased risk of colorectal cancer
- Avoid smoking: Research shows that smoking is associated with a higher risk of cancer recurrence
Emotional Well-Being and Support
Survivorship is not just about physical health—it’s also about emotional resilience. Many survivors experience anxiety, depression, or fear of recurrence. Seeking support from loved ones, therapists, or survivorship programs can help you cope with these feelings and maintain a positive outlook.
At Arizona Oncology, we understand the complexities of life after cancer. Whether you’re adjusting to new health routines, managing side effects, or seeking emotional support, our team is here to help you not just survive, but thrive.