Colorectal Cancer: What To Expect After
What follow up is needed after colorectal cancer treatment?
Once your treatment for colorectal cancer finishes, it's important to continue to follow up, to continue to get surveillance so that if there's a relapse of colorectal cancer it's caught early. Colorectal cancer, because of the way that it starts as a polyp which then develops into a cancer over time, once somebody has one cancer they're at risk for developing a second cancer, even though it's not a relapse of the first one. So it's important to continue to see your doctors and to get screened after you've been treated for colorectal cancer. For an individual who has had colorectal cancer, usually that means seeing their physician every three months and getting blood tests, and sometimes getting CT scans. It's also important to get continued colonoscopic surveillance after treatment for colorectal cancer, to evaluate the anastomosis to make sure that everything is healthy there, that there's no local recurrence of the cancer, and again also to check to make sure that there are no other polyps or any new colorectal cancer that's developing.
How common is recurrence with colorectal cancer?
Like with any type of cancer, colorectal cancer can recur. That's why it's important to continue to follow up with your physicians to get routine surveillance and make sure that your colorectal cancer does not relapse. It is also important to check that a new cancer has not developed because once somebody has developed a cancer they are at greater risk for developing a second cancer. More polyps can turn into cancers later down the line, so it's important to catch those early, even after you've had colorectal cancer already. The earlier cancer is found, the greater the chances are that you can be cured from it. Even if colorectal cancer recurs, if it's a local relapse or one metastatic site that can be removed, it can still be cured. Therefore it's really important to follow up.
Do I need to consider my fertility if I am diagnosed with colorectal cancer?
In general, fertility is not usually an issue with colorectal cancer. The reason for this is that most individuals who develop colorectal cancer are older individuals; women with colorectal cancer have usually already gone through menopause. People can develop colorectal cancer earlier in life, however, when fertility is still an issue. In general, though, the chemotherapies used for colorectal cancer do not induce permanent amenorrhea - they do not induce cessation of ovarian function. Women usually will develop a return of their menstruation after their treatment of their colorectal cancer, and they usually will be able to become pregnant.
Will chemotherapy cause birth defects?
Once somebody's had cancer, once somebody's had chemotherapy, it does not increase the chances of birth defects if somebody becomes pregnant later down the line. However, if somebody receives chemotherapy while they're pregnant, it can increase the risk of birth defects depending upon what chemotherapy is given and at what time during pregnancy. It's important to talk with your physician closely about the risk of birth defects which accompany cancer if you're pregnant or you think you're pregnant, when you're diagnosed with cancer, or if you think you're getting pregnant after cancer. Just make sure you get the input of your physician and healthcare team.
How long will it take me to recover from colorectal surgery?
After colorectal surgery most people recover in the hospital for about three to five days, depending upon how long it takes their bowel function to return after colorectal surgery, until they're able to eat and drink, pass gas, and have normal bowel movements, all indicators of recovery. They also have to have their pain controlled after the colorectal surgery and they have to be able to get up and walk around, but this recovery usually takes about three to five days. Once they're home the healing process continues to occur, and it can take up to two to three months for somebody to recover, be completely healed up, after colorectal surgery. The difficult thing is that if somebody is getting chemotherapy and other treatments after their colorectal surgery, this can prolong the healing process. And some of the side effects of chemotherapy can mimic difficulties with healing causing diarrhoea, nausea, abdominal discomfort. Sorecovery time after colorectal surgery can be hard to gauge, but usually without anything else, by about two months, usually by three months people are fully healed after their colorectalsurgery.
What are the side effects of colorectal surgery?
After surgery people usually develop some abdominal pain related to the surgical incision. They can have some effects from anaesthesia, so some nausea, some vomiting, and some upset stomach. It can take a couple days for their bowel function to return and for them to be able to eat and drink, and usually they are going to have to start on liquids before they slowly advance their diet to a regular diet. They can have change in their bowel habits with some diarrhoea, some constipation again because they are not eating normally like they were before, and then the anaesthesia and the pain medications can cause constipation and can cause problems there. With the surgical incision there can be risks of infection and risks of bleeding, but usually that's in a minority of the cases. With good local washing and control of the wound site people heal up well without any complications there.
What are the rare side effects of colorectal surgery?
Some other complications that can happen from colorectal surgery are the anastomosis, where the two parts of the colon that were reattached after the cancer was taken out, rarely, this can break open and people can have a perforation. This will need to be treated surgically. They'll need to go back to the operating room to have that repaired. This happens rarely, but it can happen. In addition, over time, as that heals, there can be scar tissue in the abdomen that later down the line, many years, even, after the surgery, people can develop obstructions secondary to adhesions, or the scar tissue in the abdomen. Obstructions are where the colonic material does not move through normally and it gets backed up and people will develop pain, nausea and vomiting. Usually, they need to be hospitalizeda and they need to be kept NPO – or nothing by mouth. Sometimes bowel rest alone is enough for this complication to resolve and sometimes people need to go to surgery to have the adhesions lysed and to have their colon or small bowel, whichever is obstructed, fixed.
Will I be able to have sex after colorectal surgery?
You will be able to have sex after colorectal surgery. For colorectal surgery, the nerves that are important for sexual functioning are not touched. Men are able to get and maintain erections, and women are able to achieve the normal arousal state - this is not affected by the surgery.
What sexual problems are associated with colorectal cancer treatment?
As far as physiological problems for sexual functioning, surgery does not usually contribute to these problems. Radiation for rectal cancer, particularly in men, can sometimes cause problems. Because the nerves which are important for both erection and ejaculation can sustain some damage from the radiation or the healing after radiation. Fibrosis can trap these nerves and the nerve production can decrease, then men can have difficult problems with erection and ejaculation. In addition, there can also be psychological problems afterwards, and emotional problems because having the diagnosis for cancer and going through the treatment for cancer can be very difficult on some people. They can then have some problems which affect their sexual functioning afterwards. But so far a physiological problems with colorectal cancer, they really are minimal.