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COLORECTAL CANCER

Managing colorectal cancer side effects

The first thing many colorectal cancer patients want to know is, how can I fight the disease? Treating cancer is, of course, a major step in getting better. But patients often find themselves asking another important question: How can I feel better—before, during and after treatment? For colorectal cancer patients, the answer lies first in understanding how the disease, and its treatment, may change the way they feel and function, then learning about the tools and therapies that can help. Because colorectal cancer affects the digestive track, for example, a balanced diet packed with nutrients and easily tolerated foods is one important ally.

For Mike Fincham, coping with a stage IV colon cancer diagnosis meant not just the surgery and chemotherapy he would need to treat the disease. It also meant dealing with the weakness and loss of appetite he experienced during treatment. A dietitian on Fincham's care team at Cancer Treatment Centers of America® (CTCA) designed a diet that calmed his stomach and helped him regain his strength. Likewise, Beth Gomez struggled with chemotherapy-related nausea and fatigue, so much so that she wondered how she would stay strong enough to stick with her treatment plan for stage III colon cancer. A naturopathic provider on her CTCA® care team recommended vitamins and natural supplements, and a dietitian, Gomez says, "had lots of great ideas on how to get foods and liquids down."

Every patient, like every cancer, is different, and not everyone will respond to treatments or supportive therapies in the same fashion. No case is typical. That's why it's important that every colorectal patient talk to his or her health care provider about whether and how evidence-informed, supportive therapies like nutrition therapy, mind-body medicine and naturopathic medicine can help. It's also important to understand how the disease itself forms and affects the body.

Colorectal cancer is the third most common non-skin cancer among both men and women in the United States. It starts in the inner lining of the colon and/or rectum, which are in the lower portion of the digestive track. Both organs play critical roles in digesting food. The colon, which is the first five feet of the large intestine, absorbs food and water and stores waste. That waste is then dispensed from the body by the rectum, comprising the last several inches of the large intestine. The close relationship between food and the organs that process it reinforces why diet plays such a critical role in colorectal cancer risk, and side effect management.

"It's about putting the right foods in your body," says Mary Englert, Clinical Oncology Dietitian at CTCA near Chicago. Colorectal cancer limits the body's ability to absorb nutrients and digest food, often leading to malnutrition. Treatment can also cause additional side effects, like weight loss, fatigue, bloating, nausea, diarrhea and constipation. The first course of action for the nutrition therapy team is to address the patient's symptoms and restore digestive health. Then, a balanced nutritional regimen can help the patient better tolerate treatment, prevent malnutrition and improve quality of life. What that regimen looks like varies from person to person.

"We treat all patients individually," Englert says. "Each patient's lifestyle is considered before a treatment plan is crafted—their likes and dislikes, their functional implications, their physical well-being. It really is very personal."

Digestive issues and nutrition-related challenges are not the only side effects colorectal cancer patients may experience. Here are some others, and the evidence-based therapies that may help:

Fatigue: Colorectal cancer, and its treatment, often causes constipation, which can lead to iron deficiencies and, ultimately, fatigue, among other complications. Managing fatigue can be critical to keeping patients on their treatment regimen. Naturopathic options include dietary supplements such as vitamins, minerals and amino acids, or natural remedies such as panax ginseng, golden root, Acetyle L-carnitine and essential oils. A dietitian may also recommend liquid nutrition, which requires less energy than chewing, or quick and easy meals that can boost the patient's energy levels.

Memory/Cognition Issues: Colorectal cancer patients undergoing chemotherapy treatments may experience memory and cognition deficits, sometimes called "chemobrain." Prescription stimulants, anti-depressants or other medications may help improve brain function. Occupational and speech therapists may also help patients strengthen speech, recall and cognitive processes.

Peripheral Neuropathy: Marked by numbness, pain and muscle weakness, peripheral neuropathy is a common side effect of chemotherapy, affecting an estimated 30 to 40 percent of chemo patients, according to the National Comprehensive Cancer Network. L-glutamine, an amino acid and protein building block, may help offset nerve damage. And physical and occupational therapy exercises that work to improve mobility, stability and range of motion, may improve patients' ability to perform everyday tasks.

Sexual Side Effects: Some colorectal cancer treatments include radiation to the pelvic region, which can cause sexual side effects in both men and women. Physical and occupational therapists can help with sexual functionality issues, through tissue massage, vaginal dilation, strengthening and techniques. Mind-body therapists may help couples or patients work through sexual performance, painful intercourse and other intimacy issues.
No case is typical. You should not expect to experience these results.

Learn more about colorectal cancer symptoms, incidence and how it develops.

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