Every person is different and responds differently to colorectal cancer treatment. With quick and accurate treatment, there’s good reason to be hopeful about your future.
You may need several treatments or a combination that includes surgery, chemotherapy, radiation, targeted therapy, and immunotherapy to have the best results.
Two key things that matter are the extent of the cancer when you were diagnosed and how much treatment helped.
Could It Come Back?
For most people, colorectal cancer doesn’t come back, or “recur.” But in about 35% to 40% of people who get surgery with or without chemotherapy, the cancer may come back within 3 to 5 years of treatment. If this happens, it could be in the colon or rectum, or in another part of the body, such as the liver and lungs.
What Affects the Odds of Recurrence?
Some of the things that matter include:
Depth of penetration. How far the original tumor went into your tissue affects whether it will return. The deeper the tumor, the higher the chance of recurrence.
Number of lymph nodes involved. The more lymph glands affected by the cancer, the more likely your cancer will return.
Spread to other organs. If the cancer was also in other organs, such as the liver or lungs, it’s more likely to come back.
Quality of the surgery. This is most important for rectal cancers, where surgery can be difficult.
What Happens if Colorectal Cancer Comes Back?
If it recurs in only one part of your body, you may need surgery to remove it. If it has spread to several parts of the body, you may need chemotherapy with or without radiation. Targeted therapy and immunotherapy may also be part of your treatment.
What if Treatment Doesn’t Work?
Sometimes, the first or second treatment for advanced colon cancer doesn’t work. But for other people, no treatments are effective. Other options include:
Clinical trials
When regular treatments stop working, experimental ones can hold promise. Researchers test them through clinical trials. They usually aren’t available to people who aren’t part of the trial. There’s no guarantee that these treatments will help, but many people feel it’s worth a try.
Experimental treatments can have side effects, including ones that researchers don’t expect.
To enroll in a clinical trial, talk to your doctor. If you’re selected for a trial, ask about risks and side effects so you can decide if you want to move forward.
Palliative care
If you have pain, nausea, or other side effects from your colon cancer or treatments for it, ask your doctor about this option. You can get palliative care whether you get cancer treatments or not. Its goal is to improve how you feel and your quality of life.
You’ll be assigned a team of caregivers, including doctors and nurses. They’ll ask about your goals for palliative care and create a plan to meet your needs.
With palliative care, you’ll feel better than if you didn’t have the additional support, which can greatly affect your health. Some people who get cancer treatments along with palliative care live longer, probably because their improved quality of life helps them fare better.
Stopping treatment
Many cancer treatments are tough to endure. They can make you feel exhausted, nauseated, or sick in other ways. If you’ve dealt with side effects through several treatments but haven’t improved, you may decide that it isn’t worth trying other treatments that show even less promise.
There may come a point when dealing with side effects that affect your quality of life may not make things better and therefore may not be worth going through. It’s a personal choice that may not be right for everyone.
Hospice care
If you decide to stop cancer treatment, your doctor may talk to you about hospice care. This service might be offered to people who are expected to live 6 months or less. Hospice care offers dignity and helps make your final weeks or months as comfortable as possible. You can get hospice care in your home, the hospital, a nursing home, or a hospice center.
You’ll be assigned a team of caregivers, including doctors, nurses, social workers, and chaplains. They’ll help manage your pain, nausea, and other physical symptoms, and they’ll involve your family members in the decision-making process as much as you’d like.
Your hospice team will also focus on your emotional and spiritual needs, to help you get the most out of your time. They may help you have important conversations with loved ones to tell them how much they mean to you or to say goodbye. And they can offer counseling for depression or other issues as you process your emotions during the end-of-life period.
It’s important to note that while hospice care stops things like chemo and radiation, it doesn’t have to end treatments for other conditions caused by your cancer. For example, you’d still want oxygen or an inhaler for lung cancer so that your breathing can be as solid as possible.