After the diagnosis and successful treatment of colon cancer, it is completely normal to be bombarded with thoughts of recurrence (a return of the cancer). A twinge here, a pain there -– surely these are signs that the cancer has come back?
Your risk of recurrence is dependent on many factors, such as the stage and grade of your colon cancer and what treatment you received. Thinking about colon cancer recurrence and obsessing over it are two different things. Make sure your conscientious behavior doesn’t enter obsessive territory by learning the facts about recurrence.
Types of Recurrence
Although your doctor may say the magic words "you’re cured of cancer," there are no guarantees. When your tests show a complete absence of cancer after treatment, you are in remission. Remission is a term used to describe an absence of detectable cancer cells in your body, which some doctors give the label of "cured."
Scientists say that when cancer recurs, there is a chance it was never completely removed or it had already spread to distant sites, which were undetected on screening tests (PET scan, for instance). Colon cancer recurrences are identified as:
- Local -– in the colon where the initial cancer was located
- Regional -- found in lymph nodes close to the original site
- Distant -- also considered metastatic, as the cancer has traveled through the body to a distant site
What the Statistics Say
Here's the thing to remember about statistics, cancer, and survival: Most of the numbers do not take any individual factors into account, such as other diseases the survivor may have, treatment modalities, or the stage of cancer -– all of which impact your survival rate. A 2008 study at the Sloan-Kettering Cancer Center aimed to improve the data collection and statistics about colon cancer recurrence. This study included 1,320 patients without metastatic disease. By the end of the study, 243 of those patients suffered recurrence –- or about 18 percent of the patients.
Survival by Stage
The five-year survival rates by the stage of colon cancer are, at the very least, five years behind current trends and treatments in oncology. The data is collected over time –- the people included in those statistics finished their colon cancer treatment over five years ago (many medical advances occur within five years). Take survival statistics with a grain of salt. You are an individual who will not fit neatly into a statistical package. According to the American Cancer Society, the five-year survival rates for colon cancer are as follows:
- Stage I – 74 percent
- Stage IIA – 67 percent
- Stage IIB – 59 percent
- Stage IIC – 37 percent
- Stage IIIA – 73 percent
- Stage IIIB – 46 percent
- Stage IIIC – 28 percent
- Stage IV – 6 percent
Signs and Symptoms of Recurrence
Following your cancer treatment, your doctor will suggest frequent screening tests to prevent a recurrence. Your follow-up appointments may be as frequent as every three months -– it’s worth the time spent. The majority of recurrent cancers develop within two to three years after the primary cancer, according to the American Cancer Society.
You know your body better than anyone. If you notice something is "off," talk to your doctor about that symptom. Some signs to watch for include:
- A constant urge to move your bowels
- Blood in the stool
- Change in stool size (ribbon or thin stools)
- Bowel frequency changes
- Stomach pain, bloating or excessive gas
- Decreased appetite
- Weakness or lethargy
- Weight loss
- Cough that does not go away
- Yellow eyes or skin
Recurrence Treatment Options
The treatment options available depend on the type of recurrence (local, regional, or distant). If the cancer recurrence is localized, the doctor may suggest a surgical resection, which includes removing the portion of bowel that contains the cancer. If the cancer is distant or metastatic, the doctor may suggest surgery to the metastatic sites (ablation of liver tumors, surgical removal of ovarian or lung tumors) along with radiation therapy and chemotherapy. Your surgeon and oncologist will work with you to present the best treatment option for your scenario.
Keeping the Fear in Check
Fear of recurrence is a strong motivator for many colon cancer survivors. It can stimulate lifestyle and diet changes, healthy choices, and regular screening tests, such as a colonoscopy or virtual colonoscopy. However, this fear can become paralytic and control your every thought -– if you let it. Consider these methods to help you control the fear:
- Talk to loved ones about it
- Schedule routine screening exams -– stick it on the calendar and forget it
- Get support from survivors like yourself
- Ask your doctor to explain your prognosis
- Consider seeing a counselor if fear encompasses your thoughts
- Keep abreast of new studies and colon cancer treatment options
- Make positive choices for your health and well-being
- Take life one day at a time
Now is the time to embrace to your health and well-being. You cannot predict or control the chances that your colon cancer will come back. You can, however, control your diet, exercise frequency, and check-ups.
American Cancer Society. (2006). American Cancer Society’s Complete Guide to Colorectal Cancer. Clifton Fields, NE: American Cancer Society.
American Cancer Society. (n.d.). What are the Key Statistics About Colorectal Cancer? Accessed February 6, 2012.
American Cancer Society. (n.d.). What are the Survival Rates for Colorectal Cancer by Stage? Accessed February 7, 2012.
Weiser, M.R., Landmann, R.G., Kattan, M.W., et al. (January 2008). Individualized Prediction of Colon Cancer Recurrence Using a Nomogram. Journal of Clinical Oncology, 26: 3. Accessed February 8, 2012.
National Cancer Institute. (n.d.). Stage IV and Recurrent Colon Cancer. Accessed February 8, 2012.