FOR INFORMATION ABOUT EACH OF THE FOLLOWING SUBJECTS, SEE THE OTHER SECTIONS OF THIS ARTICLE UNLESS NOTED OTHERWISE

NOTE: IF YOU READ OUR INFORMATION ABOUT POST TREATMENT 0 – 6 MONTHS, you already read much of the following information. We still suggest reading this document because you are likely to learn something that will be useful to you now that you may not have paid attention to before.

While you were lucky to find and eliminate colorectal cancer early, you have a high risk of having it returning in the future in the colon or in another organ (recurrence). Most recurrences occur within the first 2 years after the end of treatment. Even after the 2 year period, you are still at an increased risk of recurrence or another cancer appearing. While a recurrence or 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 this happening. It gets easier as time goes on.

• Review your 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 center .  Your insurance is likely to cover these services. A follow-up plan should include a schedule of future medical appointments and tests, as well as symptoms to watch for.
  • Prepare for follow up visits with each of your doctors. It helps make you a better participant in your health care if you:
    • Keep track of your symptoms, if any, so you can make an accurate report at each doctor visit. 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. 
    • Keep track of follow-up appointments in whatever way is easiest for you. Some people use paper calendars. Some people use their computer, others their smart phone.
  • Learn how to save money when purchasing drugs and how to obtain drugs when money is a problem. Store and dispose of drugs safely.
  • Get other screening tests recommended by the American Cancer Society. See below.
• If you haven’t already, talk with your doctor about whether you 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.  
  • Read the plan carefully to be sure you understand what it says. Ask your doctor or his/her nurse about any parts of the plan that are not clear to you.
  • Give a copy of the follow-up plan to your primary care doctor.
  • Report noted changes in your health to both your oncologist and primary care physician.
  • Keep all appointments noted in the follow-up plan even if you feel great with no symptoms or you fear a recurrence.  There is a reason for each appointment.  If there is a recurrence, the sooner it is caught, the better.
  • Keep in mind how much you will have to pay. For instance, check your health insurance to find out how much of each follow-up visit is covered and how much you will have to pay. If you don’t have health insurance, and money is difficult, perhaps your doctor will negotiate his or her fee.
• With respect to drugs:
  • Comply with drug regimens. Don’t take a drug holiday without talking with your doctor first.
  • Ask whether you should be taking supplements. If so, what supplements, in what quantity, and which brand does your doctor recommend?
• Take care of your mouth.  (To learn how, click here.) Infections in the mouth can spread. Infections in the mouth can easily spread throughout the body. 
• Think about your relationship with your doctor:  If your relationship with a doctor is not ideal, try to fix it. You will likely be dealing with your doctor for a long time.  If the relationship becomes difficult for you, consider looking for another doctor. To find out how to deal with difficulties, and how to switch doctors, click here and here respectively. 
• Drink at least eight glasses of pure water a day. (To learn about water, click here.)  Water helps waste go through your system.
• Do what you can to help beat cancer. For instance, adopt a cancer prevention lifestyle.Start shifting your food intake to a healthy, cancer prevention, diet.  For instance:
  • Increase the amount and variety of fruits and vegetables you eat each day.
  • Eat whole grain foods instead of white flour and sugars.
  • Limit meats that are high in fact. Eliminate processed meats such as hot dogs, bacon and bologna. For more information, click here. 
• Be active. Exercise.
  • Exercise helps move waste along in your system and helps bolster your disease-fighting immune system.
  • After checking with your doctor, start slowly and build your exercise program. Exercise doesn’t have to be in a gym. To learn more about exercise, click here.
• If you are overweight, lose the extra weight. Excess weight is linked to cancer recurrence. For tips, click here. 
• If you smoke quit. 
  •  Smoking can increase the risk of developing colorectal cancer at the same or another site. 
  •  You’ll also reduce your risk of heart disease and other smoking related illnesses. 
  • Your health history provides a personal incentive to stop. The odds are in your favor if you want to badly enough. It’s all about will power. 
  • For information about how to stop smoking, click here. 
• Avoid or limit consumption of alcohol. Alcohol is a risk factor for colorectal cancer as well as other cancers.] For tips about limiting alcohol consumption, click here . 
• Reduce your exposure to carcinogens (substances that can cause cancer)
• Subject to the approval of your doctor, consider taking vitamins and/or supplements to make up for any nutritional deficiencies and 1 aspirin pill daily. Studies show that aspirin users have less colorectal cancer. See the vitamins section of this document. 
• Do not try to change everything overnight, or expect that you can. Change takes time - especially when habits build up over a lifetime. Start slowly, perhaps in one area at a time. Do small steps you can accomplish. Then build on them, one at a time.

• 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 life changing events can happen. As you learned with colorectal cancer, the earlier you catch medical conditions, the better.
  • Make sure your oncologist and other doctors 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. 
• Consider getting a pet.  In addition to helping you feel good, a pet may help prolong your life. To learn about choosing a pet, how to keep from getting infected by your pet etc, click here.
• Bring humor into your life.
  • "A laugh a day keeps the doctor away" -- or at least makes you feel better.
  • For tips about bringing humor into your life, click here. 
• Don’t let a fear of recurrence keep you from taking the steps described in this document.  (For information about dealing with emotions, click here. 
• Consider advance directives.
  • 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 about wills, click here).
  • For more information, see the documents in “To Learn More.”
  • Last, but not least, also think about what to do if there is an emergency or a disaster. Our documents in “To Learn More” provide guidance.
• Medical expenses may linger or new ones may be incurred. Maximize your financial resources. See: How to Maximize Use Of Your Health Insurance and Colorectal Cancer Finances)

NOTE: Call your doctor right away if you have symptoms listed in “If These Symptoms Appear, Call Your Doctor.”  

The following supplements and vitamins have proved to be useful in reducing the likelihood of a recurrence of colorectal cancer. Ask your oncologist and primary care doctor about taking them before taking any vitamins or supplements (or over-the-counter drugs).

• For women: at least 1,200 milligrams a day of calcium may reduce the likelihood of a recurrence and minimize the number of polyps if it does return. (Calcium is not recommended for men because it can increase the risk of prostate cancer).
• 400 micrograms of folic acid when not taking cancer treatment.
• Up to 800 IUs daily of Vitamin D if you do not get exposure to sunlight or enough Vitamin D from your diet.

Also consider taking an aspirin each day. Research shows that aspirin helps to prevent colorectal cancer. Keep in mind that aspirin can result in gastrointestinal bleeding which can be serious.

NOTE: Also consider using complementary therapies such as massage to ease stress. 

More information about this subject is contained in the Main Article in "To Learn More."