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Colorectal Cancer: Post Treatment 0-6 Months: Managing Your Medical Care: Stages 0,I

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Recovery from treatment

 Treatment for Stage 0 and Stage I colorectal cancer is usually surgery.  

  • The majority of the time the surgery is performed through a colonoscopy procedure. Therefore the recovery is the same as it would be after having a colonoscopy: : 
    • For the vast majority of people, recovery time from the removal of polyps or other abnormal conditions will require a minimal amount of time, often only several hours as you recvover from anesthesia.
    • For a few days you may have diarrhea and possibly a few painful twinges. If diarrhea cannot be controlled provided in our document about diarrhea, then contact your doctor immediately.
  • In some cases laproscopic or open surgery may be required although these instances are rare. (For information about surgery for colon or rectal cancer, click here)

Understand the ongoing risks 

While you were fortunate to have had your cancer found and removed early, you have a higher risk than the average population of having the cancer come back or show up in a different organ in the future. Your doctor should be able to give you more specific information about risk based on your particular situation.

Get A Colorectal Cancer Follow-Up Plan 

  • Everyone should get a colorectal cancer follow-up plan. Such a plan should include a schedule of future medical appointments and tests, as well as symptoms to watch for.  It should also clearly state which of your doctors is going to follow you for your cancer follow-up care.
  • If you didn’t get a plan, ask your oncologist for one. You can find a suggested colorectal cancer follow up plan from the  American Society of Clinical Oncologists' (ASCO) by clicking here offsite link
  • Read the plan carefully to be sure you understand everything that 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.
  • Health insurance is likely to cover services included in a follow-up plan. 
  • Keep track of follow-up appointments in a way that you will remember.  For some people this is as simple as using a large calendar. Other people prefer day planners. Still others use electronic calendars found on their computer or smart phone.  Whatever method you use, remaiin consistent.

Keep all appointments noted in the follow-up plan even if you feel great with no symptoms, or you don't want to learn what's going on because of fear of a recurrence.  There is a reason for each appointment.  If there is a recurrence, the sooner it is caught, the better.

Go to all follow-up visits and take the suggested tests.

  • The Visits And Tests
    • There will be follow-up visits with your oncologist after treatment. The timing of  those visits, as well as what happens during those visits, varies depending on the treatment, your particular health condition and other individual factors. At the least, a follow-up visit usually involves:
      • A review of your medical history
      • A thorough physical examination.
      • A discussion about your health and any problems since your last visit (our Symptoms Diary can help keep track of symptoms from visit to visit. The push of a button turns the information into an easy to read graph. Click here 
      • Taking blood for blood tests such as the CEA . 
      • The doctor will order some follow-up tests. Common follow-up tests include:
        • Colonoscopy. The timing of a colonoscopy depends on plan recommendations.
        • Barium enema (a series of x rays of the colon or rectum that are taken after the patient is given an enema containing a contrast medium (usually barium sulfate). The contrast medium generally is described as tasting like chalk. Air can be instilled into the colon along with the barium contrast medium to further define structures of the large bowel and rectum.  
        • Chest x-rays 
        • CT scanMRI, or Ultrasound   
      • Time for you and your doctor to discuss:
        • Your progress
        • your questions and concerns. (We provide a prioritizer to help you keep track of questions and concerns. A button reorders your entries before the appointment according to your priorities.) For information about how to effectively work with a doctor, click here.
          • Any concerns the doctor may have.
      • NOTE: 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.
  • Prepare for follow up visits with each of your doctors. For example:
    • 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.
    • Keep in mind the cost of your follow-up visits and care.  Understand what your health insurance covers and does not cover and how much of a co-pay you may be expected to give.  Discuss with your physician if you will have difficulty paying these costs.  The doctor may be able to reduce his or her fee or there may be financial assistance programs that you qualify for. (To learn how to negotiate a doctor's bill, click here.)
    • To learn more about preparing for doctor's appointments, click here.

Vitamins And Supplements To Talk With Your Doctor About Taking

  • The following supplements and vitamins are considered  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).'
    • 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.
    • 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).
    • Also consider taking an aspirin each day. Keep in mind that aspirin can result in gastrointestinal bleeding which can be serious.

If any of the following symptoms appear, or if symptoms occur that are not on the list, but you are concerned anyhow, contact your doctor without delay. Let your doctor or his or her staff decide whether a symptom is important. (If needed, How to Get An Appointment With A Doctor Sooner)

  • Back pain for two days.
  • Bleeding from the rectum (either dark or bright red blood).
  • Continuous abdominal pain, bloating or fullness.
  • Bowel movements as follows: Constant urge to have a bowel movement, even after you just had one
  • Stool quality or color changes
  • Excess mucus secretions that accompany a bowel movement
  • Constipation that is ongoing that does not respond to laxatives or other remedies described in our articlew about constipation.
  • Coughing
    • Coughing that doesn’t go away after three days.
    • Any coughing that produces green or yellow sputum.
  • Diarrhea that is ongoing despite management tips which you can find by clicking here.
  • Dizziness
  • Eyes or skin seem yellow or suntanned
  • Fever more than 100.5 degrees , or shaking chills.
  • General malaise or fatigue or lack of appetite for more than a few days.
  • Headache.
  • Nausea or vomiting that is ongoing. (To learn management techniques, click here)
  • Neck stiffness
  • Night sweats
  • Pelvic pain
  • Severe chills
  • Trouble breathing: call 911.
  • Urine
    • Blood in the urine
    • Decreased urine flow
    • Difficulty urinating
    • Burning or pain while urinating
  • Weight loss that is unexplained


  • Report all unanticipated changes in your health to primary care physician as well as to your oncologist. The symptoms could relate to your cancer or to something else entirely.  An update by fax or email will do.   
  • If you experience fatigue, work with your doctor to try to determine the cause. For example, fatigue could be a symptom of:
    • Depression: A psychologist can help improve functioning, especially one knowledgeable about the impact of cancer. Psychotropic medication may also help.
    • Hypothyroidism: Thyroid tests usually done routinely may not be specific enough for people with cancer treatment in their medical history. If thyroid problems are suspected, a specialist known as an endocrinologist will be able to accurately diagnose and treat them.
    • Anemia: A simple blood test can determine iron deficiency anemia. Some people may need iron supplementation. A change in eating habits may help.
    • Heart problems.
    • For tips about dealing with fatigue, click here.
  • No matter how long you have been involved with the medical system, it is worth reading: Doctors: How To Work Effectively With

Medications and Supplements

  • Comply with medication instructions.  
  • Never stop taking a medication or take a “break” from your medication without first speaking with your doctor.  
  • Don’t take a drug holiday without talking with your doctor first.
  • Learn how to save money when purchasing drugs.  Store and dispose of drugs safely
  • Never take supplements without discussing them first with your doctor. When discussing supplements, ask: what supplements, in what quantity, and which brand does your doctor recommend?
  • To learn more about living with drugs and supplements, click here.


  • Your primary care doctor is charged with overseeing your overall health, 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 problems, the better.
  • Make sure your oncologist and other doctors  keep your primary care doctor up-to-date. 
    • One way to be sure that your primary care doctor up-to-date is to remind specialists every time you see them to please be sure to 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
  • 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.
  • 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. 

Cancer Prevention Lifestyle

  • While it is good that you found and eliminated your polyps or cancer early, the possibility of a recurrence is much higher for you than for someone who has never had polyps or cancer.  Use this experience to encourage you to take charge of your colon health and make changes that will help decrease the possibility of a recurrence. 
  • Do not try to change everything overnight, or expect that you could. 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. 
  • A cancer prevention lifestyle includes the following:
    • A healthy diet.  For instance:
      • Eat a variety of fruits and vegetables 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.
      • Be active. Exercise.
        • Exercise helps move waste along in your system and helps rebuild your immune system after treatment.
        • 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.
        • A physiatrist, a medical doctor who specializes in rehabilitation medicine, can be an important resource during the recovery period. Physiatrists are especially knowledgeable about the use of exercise to help with healing.  Ask your doctor for a referral or contact the American Academy of Physical Medicine and Rehabilitation: offsite link
      • Get rest by pacing yourself during the day and sleeping at night.(To learn about sleep, click here.
      • Relieve pain.  In addition to the unpleasant feeling, pain can keep you from exercising.
      • If you are overweight, lose the extra weight. Excess weight may be associated with cancer recurrence. For tips about how, click here. (If you lost weight, there are tips for coping with weight loss. Click here.) 
      • Take care of your mouth.  
        • Infections in the mouth can easily spread throughout the body. 
        • Schedule regular visits to your dentist to ensure that any infections are taken care of as soon as possible.
        • To learn about oral care, click here.
      • Comply with drug regimens. Save money when purchasing drugs. Store and dispose of drugs safely. For a primer about drugs, including purchasing and tips for complying with a drug regimen, click here
      • If you smoke, stop. 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. You now have a personal incentive to stop. The odds are in your favor if you want to stop badly enough. For information about how to stop, 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, see WikiHow by clicking here offsite link
      • Reduce your exposure to carcinogens (substances that can cause cancer). For example, second hand smoke. Unprotected exposure to toxic chemicals.
      • After talking with your doctor, consider:
        • Taking vitamins and/or supplements to make up for any nutritional deficiencies.
        •  Using complementary therapies such as massage therapy to ease stress.  

Get other screening tests. American Cancer Society recommends the following screening tests:


  • All women should get an annual Pap test or every two years using the liquid-based pap test.
  • Women age 20 - 39: get a clinical breast exam.
  • Women starting age 40: get a yearly mammogram


  • Starting at age 40, get a rectal prostate exam.
  • Starting at age 50, discuss with your doctor whether to be tested for prostate cancer. Research has not yet proven that the potential benefits of testing outweigh the harms of testing and treatment.
  • If you are African American or have a father or brother who had prostate cancer before age 65, you should have this talk with your doctor starting at age 45.


  • 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
  • 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, ask about having your children tested. Inform your brothers and sisters. Existing sites help educate people about the risks involved, and what to do about them. For a list, click here offsite link.
  • 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.
  • 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)
  • 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 disaster. 
  • 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. For more information, see the documents in “To Learn More.” While you’re at it, 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. See: How to Maximize Use Of Your Health Insurance and Colorectal Cancer Finances
  • Write a Will if you don’t have one, or check your existing will to be sure it is up-to-date. For basic information about wills, click here.

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

For additional information, see:

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