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

Recovery

Immediately after surgery there will be a period during which the incision and internal organs heal. The length of time the healing process takes depends on the surgery that was performed, the condition of your body and your health history. If there is evidence of infection, or if you are undergoing additional cancer treatments such as chemotherapy, there may be a delay in the healing of the incision and  It may take longer for you to recover

Your surgeon should be able to give you a ballpark estimate of how long your recovery period will be. Most people can return to full activities after 10-14 days if the surgery is laproscopic and 4-6 weeks with a traditional incision or open surgery.

It is generally recommended that you do not drive while you are recovering from abdominal surgery.

Your doctor will advise you when you can resume work, and exercise. If you have an ostomy you should be able to resume normal activities as tolerated. .

Follow Up Exams and Tests

Your follow-up plan will tell you when follow-up appointments will be scheduled. To learn about what to expect at follow-up visits, click here. (Link to the new section above: Follow up visits and tests for colon and rectal cancer)

After surgery, the first tests and imaging studies such as a CT scan, an MRI test or a PET scan will vary depending on the stage of your cancer and your treatment plan. 

Additional Treatments

If the cancer has spread beyond the colon or rectum, radiation and/or chemotherapy may be recommended.

• Ask your doctor how long you can reasonably wait to make a decision about additional treatment.
• Use the time to get a second opinion and to be sure you make the best choice of a specialist to provide the treatment before proceeding. Second opinions are generally covered by health insurance. (To learn more about a second opinion, click here). 

If there was no spread outside the colon, consider consulting with a medical oncologist and a radiation oncologist to find out if they would recommend additional treatment based on the results of your surgery and any additional diagnostic tests you may have had.. This is known as a second opinion. Second opinions are generally covered by health insurance. (To learn more about a second opinion, click here).

Side Effects

Following is a list of side effects that are not uncommon in the first 6 months following surgery. Contact your doctor immediately if something unexpected occurs or if a side effect unduly affects your life.

• Abdominal pain and cramping. Abdominal or pelvic supportive tissues can be stretched, constricted or weakened.
• Bowel movements can be difficult or painful .
• Damage to nerves can cause pain or bowel, sexual and urinary dysfunction.
• 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.
• Erectile dysfunction. If you had nerve-sparing surgery, it may take 6 to 12 months or even 24 months before you will be able to achieve an erection. However, sexual activity can usually be resumed within 6 weeks following surgery. (There are techniques to give you an erection. Click here). Keep in mind that intercourse is not the only way to achieve intimacy. Click here for information. 
• Fistulae: A fistulae is an abnormal connection which can form between two organs during healing following surgery. This condition can be corrected by surgery. Contact your surgeon if you notice urine leakage from the vagina or rectum or feces or fecal odor in the vagina or in urine.
• Fluid retention: The build-up of fluid in the legs and elsewhere in the body may signal lymphedema  - swelling of a body part due to lymphatic fluid that cannot move. Less commonly, a build-up of fluid could also signal heart, liver or kidney failure. The build-up of fluid in the abdomen or chest may signal a recurrence of disease. If your doctor gave you instructions to follow for reducing the possibility of lymphedema, follow those instructions for the period indicated. To learn about lymphedema, click here.
• Hernia: A hernia is a bulging of tissue beneath a section of skin on the abdomen or near an incision. A hernia can become life threatening if a segment of bowel ruptures. If you feel or see a bulge, contact your surgeon without delay. Hernias can be fixed.
• Fecal Incontinence 
  • Fecal incontinence may occur after a colectomy. It generally lessens as you heal – gradually improving for up to 6 to 12 months after surgery. 
  • Incontinence after other surgeries should resolve soon after surgery. Incontinence is treated by wearing a pad or a diaper or other device.
• Urinary incontinence may occur after colon or rectal surgery but it should improve as you heal.  If incontinence becomes permanent, there are surgical techniques to consider. To learn about exercises you can do to help,  click here and here.
• Kidney or Liver Damage: 
  • Kidney or liver damage may occur from some surgeries.
  • Symptoms which may indicate kidney or liver damage include changes in urination, fever, nausea or your skin or eyes seem jaundiced (yellow or suntanned.) 
  • Kidney or liver damage is treatable.

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

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