Colorectal Cancer: Post Treatment 6 Months Plus: Day to Day Living: Stages II,III,IV
To help you feel in control on a daily basis, and to maximize your body's disease fighting abilities, consider the following:
- If you learned life lessons during treatment and haven’t started putting them into practice, now is the time. Otherwise they may be lost until the day you wake up and wonder what happened.
Educate Family and Friends
With most illnesses, when treatment is over, life for everyone returns to normal. An immediate return to life the way it was before your diagnosis is likely what your friends expect.
If this is not the case with you because you have ongoing side effects such as diarrhea, constipation or an ostomy, the people around you need to be educated in a manner they understand about your ongoing needs.
Explain which physical symptoms continue as well as unusual emotions.
Explain that while you are optimistic, colorectal cancer may recur and that this sometimes weighs on you.
Talk about the changes you are going through and your needs.
Consider letting friends know you are likely to be anxious before going to medical appointments so they can be supportive during those periods of time.
Ask for any help you still need.
Relationships May Need To Be Reexamined
- Family roles likely shifted during treatment and the recovery period, with other family members taking on more of the chores and responsibility.
- Take the time to look at how things have changed and whether they should remain that way --or whether you should suggest another change. Perhaps the change is to the way things were before your diagnosis. Or perhaps to yet a different way.
- Your relationship with friends may also have shifted during your treatment. Reexamine those as well.
- Relationships are mutual. Pay particular attention to their stories and needs if you haven't been.
- If the diagnosis or treatment has changed the way you see things and you now see things differently than certain friends, be honest with yourself and think about whether the relationship is worth continuing.
- Relationship Tips Here are some ideas that have helped other people recovering from colorectal cancer treatment deal with relationship concerns:
- Ask for help when you need it. Include your underage children. It will help children feel as if they are assisting if they have age appropriate chores to do.
- Accept help. When friends or family offer to help, say yes. Let them know things that they could do to make your life easier. In this way, you will get the support you need and your loved ones will feel helpful.
- Talk about your needs. Ask each family member to talk about their needs and concerns. Don't let colorectal cancer be the 800 pound gorilla in the room that everyone knows is there, but no one talks about
- Spouses and Significant Others
- Your spouse or partner is likely to be anxious to regain balance. He or she has likely experienced the same fears you have. However, a spouse or partner may be reluctant to talk about them.
- It may help to know that the incidence of separation and divorce is no higher for people with cancer than the general population.
- Don't be surprised if issues and tensions that existed before the diagnosis resurface.
- Things to do:
- Talk about each of your feelings and your needs. The two of you have been through a stressful ordeal. Don't think that one conversation will be enough. It will take time to adjust to the emotions that are likely to stay around for a while.
- Look for time alone together.
- Work toward a balance that takes into account both of your needs.
- Perhaps start intimacy with other methods such as cuddling, or massaging each others' backs. (For tips about sex and intimacy, click here.
- If the situation with your spouse or partner is difficult to handle, consider speaking with a counselor or therapist, especially one who has experience in working with couples who are dealing with a situation similar to yours.
- If it appears that things won't work out between you, wait until at least the nine month mark and preferably the twelve month mark before making and acting on a decision.
- For more information, see: Couples
- What To Do If You Have Children
- Children don’t have any idea what to expect during post treatment. They likely expect that everything will return to the way it was right away.
- Tell Children
- Tell them about your situation and ongoing needs in an age appropriate manner.
- Let your children know that you were scared too. Remind them you are fine now. You see the doctors to keep it that way.
- Tell them that you will always be honest with them.
- Under age children do not need to know about your worries about the future, or what could happen.
- If you err on either side, do it on the side of caring too much.
- Watch for reactions.
- Reactions that may seem overboard for the immediate cause may be a substitute for fear that you may die.
- Adolescent children may appear to be indifferent. Self absorption during adolescent years is a normal development. Each child will deal with fears about your health in his or her own way.
- Helping children cope
- Spend one-on-one time with each child.
- Encourage each child to talk about how they feel now.
- Ask teachers to watch for behavioral problems.
- Prepare to answer the question: “Are you cured?” Be honest. For example, you can say something like: “I am okay now. I’m hopeful that I will stay that way.”
- For more information, see: Children 101, Children: How To Help Children Cope; Common Behavioral Reactions Of Children And What To Do About Them
Be Active. Exercise
- The Importance Of Overall Exercise
- It is often said that exercise is one of the least risky and most beneficial treatment options doctors have to offer cancer survivors.
- Exercise may also help prevent recurrence and possibly recurrence. Recent studies show that lack of physical activity increases the risk of developing colon cancer. This is in line with other studies which show that people who exercise regularly have about a 30-40 percent reduction in their risk of contracting colon cancer. Physical activity improves quality of life and diminishes emotional swings.
- If your weight changed since your diagnosis, exercise will help you normalize it as well.
- Exercise also has a large number of other benefits such as helping to prevent other chronic diseases, and reduce risk of cardiovascular and metabolic disease.
- There does not seem to be any downside to exercise unless you have a serious heart or lung problem.
- You can even exercise with an ostomy. (For more information, click here.)
- You do not have to join a gym to get benefit from exercise.
- Exercise And Incontinence
- Incontinence is common after all types of colorectal cancer treatment.
- There are exercises known as Kegel exercises which can help the bladder to hold urine. To learn more, click here.
- MET Hours
- In general, studies show that the more vigorous the exercise, the greater the benefits.
- Consider the following which relates to colorectal cancer. There does not appear to be any harm in applying the concept of metabolic equivalent task (MET) hours to your exercise. One MET hour is the equivalent of the energy expended by the body during one hour of rest. You can use several MET hours of exercise during one real time hour. For example, one hour of doubles tennis is equal to 5 MET hours.
- A study published in the Journal of the American Medical Association followed 2,987 women with colorectal cancer. Women who exercised more than three MET hours a week after diagnosis were less likely to die of their cancer.
- To see a list of activities and the MET hours each generates, see: http://prevention.sph.sc.edu/tools/docs/documents_compendium.pdf
- Exercise Programs For People With Cancer
- If you have special needs, there are exercise programs designed for people with cancer throughout the country.
- The American College of Sports Medicine has a certification program for health and fitness instructors who work with cancer patients. To find a trainer in your area, go to www.acsm.org, Click on "Certification." Then click on "Find An ACSM Certified Trainer." On the next page, scroll down to "ACSM/ACS Certified Cancer Exercise Trainer". (The program was developed with the American Cancer Society).
- Other professionals who can help develop exercise programs for your specific needs and situation are physical therapists, occupational therapists and exercise physiologists.
- For other programs, check with your local gyms, disease specific non-profit organizations, and your oncologist.
- How To Sustain Exercise
- Exercise can be difficult to sustain over time. Think about techniques to help keep you motivated. For instance:
- Set up a system that reminds you periodically of why you exercise. For example, a posting on your refrigerator, or an alert that pops up on your computer every few weeks.
- Find a buddy to exercise with. (One of the advantages of classes or gyms for people with cancer is the company and support of people in a similar situation). Note that an exercise buddy is not necessarily the same as a cancer buddy (link to article 1512).
- Exercise can be difficult to sustain over time. Think about techniques to help keep you motivated. For instance:
- For more information about exercise, see Exercise For Survivors.
NOTE: Check with your doctor before starting new exercise or increasing current exercise levels.
Do What You Can To Prevent Unnecessary Infections
- Infections lower your disease fighting immune system’s ability to fight disease.
- A few techniques have been shown to greatly reduce the risk of infection. For instance:
- Keep your hands away from your face - particularly around your mouth, nose and eyes.
- Wash your hands regularly. When you wash your hands, use soap and water for the amount of time it takes you to sing Happy Birthday.
- Wash your hands before leaving the gym and after being in other highly trafficked areas.
- Eat a healthy diet - such as the cancer prevention diet
- Store, cook and handle food safely.
- For more, see:
Body Changes Can Be Managed
- Our medical section describes the various bodily changes that may become permanent. Our document about ostomies describes how to manage living with an ostomy. (As you will see, there is nothing you cannot do with an ostomy).
- For day-to-day living purposes, keep in mind that whatever the change, it can be managed. You are likely over the learning curve involved in anything new.
- As a practical matter, physical changes from colorectal cancer should not keep you from doing the work you want to do (unless you have an ostomy and your work involves heavy lifting), from engaging in all life activities you enjoy, including sex, or even from travel. Activities may take more thought and preparation than previously, but that is a small price to pay for this amazing thing we call life.
- If there are physical aspects that are affecting your ability to do the things you want to do, speak with people who have had experience with the situation to learn about how they have managed. For example, a cancer buddy or another person in a support group or self help group. If you have an ostomy, contact the United Ostomy Association tel.800.826.0826.
Consider Getting A Pet
- While pets are mentioned in other documents in this guide, they are mentioned here because there are numerous physical and emotional reasons to live with a pet. For instance, pets motivate people to exercise, help fight depression, loneliness and stress, reduce blood pressure, and even help prevent heart disease. Pets can reduce pain. Some studies indicate pets increase longevity.
- While dogs and cats may be the first pets to come to mind, there are all kinds of pets with different characteristics to suit your physical, emotional and financial needs and lifestyle. If you don't have a pet, consider getting one. Many doctors now even prescribe having a pet as part of medical care.
- To learn about pets, including which to choose, how to avoid getting infected from a pet, and how to travel with a pet, click here.
Keep in mind that You Are Not Your Disease
NOTE: If You Had Chemotherapy Or Radiation And Want To Have Children: For information, click here