Colorectal Cancer Recurrence
When colon or rectal cancer comes back after treatment, it’s referred to as recurrent cancer. It can be months or even years after treatment has finished. The likelihood of colorectal cancer recurring varies based on the cancer's stage at the time of the initial diagnosis and the treatments that were used.
If you were previously diagnosed with colon or rectal cancer, it’s important to see an oncologist for follow-up appointments, even if it’s not the same team you worked with for your initial treatment. The specialists at Cancer Care Centers of Brevard are there to provide care for newly diagnosed patients and those with recurrent cancer.
Types of Colorectal Cancer Recurrence
The recommended next steps for recurrent patients will depend on several factors, including where the cancer reappeared.
Local recurrence: The cancer has returned to the same area where the original tumor was removed. This is usually the easiest to treat because it has not affected other areas of the body.
Regional recurrence: The cancer has spread to nearby lymph nodes but has not reached other areas of the body.
Distant (metastatic) recurrence: The cancer has metastasized beyond the original site to other areas such as the liver, lungs, brain, or distant lymph nodes. While this is more challenging to treat, there may be treatments available for distant recurrence that were not available to you during initial treatment.
What are the Risk Factors for Recurrent Colorectal Cancer?
Generally, the risk of recurrence is lower if the initial cancer was detected and treated at an early stage. However, it's important to be aware of factors that may increase the risk of colorectal cancer returning. Risk factors of colorectal cancer returning include:
Detection of the original cancer at a later stage and higher grade
Cancer cells remaining at the edges of the removed tissue (incomplete surgical margins)
Genetic factors, such as hereditary syndromes, including Lynch syndrome and familial adenomatous polyposis
Unhealthy lifestyle choices, such as a lack of exercise, a poor diet, smoking, and excessive alcohol consumption
Common Signs of Colorectal Cancer Recurrence
The symptoms of recurrent colorectal cancer are about the same as those reported by many patients before an initial diagnosis. Some individuals may not experience any symptoms at all, which is why colorectal cancer survivors should attend all regular follow-up colonoscopies. Detecting recurrent colorectal cancer early can result in better outcomes.
If you notice any of the following symptoms, discuss them with your cancer care team:
Blood in stools
Rectal bleeding
Abdominal pain or discomfort
Unexplained weight loss
Fatigue
Change in bowel habits, such as constipation or diarrhea
A persistent feeling of needing to have a bowel movement even after finishing
How Is a Colorectal Cancer Recurrence Diagnosed?
After initial treatment, you will be monitored closely with appointments every three to six months for the first two to three years. If you remain cancer-free, your follow-up appointments may be spread out to every six months until you reach the five-year mark. Follow-up appointments typically include blood tests to look for signs of cancer, imaging scans, and some colonoscopies to check for signs of colorectal cancer recurrence.
Staying committed to follow-up appointments allows for earlier detection and diagnosis of recurrence, which increases the chances of successful treatment and improved survival outcomes.
Treatment Options for Recurrent Colorectal Cancer
When facing recurrent colorectal cancer, you will receive a personalized treatment plan. Some treatments may differ from those you received after your initial diagnosis.
Treating Local and Regional Colorectal Cancer Recurrence
For local or regional recurrence, treatment usually involves a combination of surgery, if possible, and chemotherapy. Chemo may be administered before surgery to shrink the tumor, or it might be given after surgery to eliminate any remaining cancer cells.
Some patients may also receive radiation therapy either during the surgery (intraoperative radiotherapy) or afterward, particularly if the cancer has returned to the rectal area.
Treating a Distant Recurrence of Colorectal Cancer
Distant recurrent colorectal cancer is more challenging to treat due to the spread of cancer to other areas of the body. Treatment options will largely depend on whether the tumor can be surgically removed.
If surgery is not an option, treatment typically involves a combination of medications, such as chemotherapy, immunotherapy, and targeted therapies selected based on biomarker test results. Learn about the genetics of colon and rectal cancers.
The selection of drugs will depend on your overall health and the treatments you have received previously. If the cancer does not respond to the initial medication combination, your doctor may recommend trying a different combination approach.
Radiation may also be used to help manage symptoms caused by colorectal cancer recurrence. The use of radiation therapy during this time depends on whether radiation was part of the initial treatment plan and how much radiation you received.
Clinical Trials for Recurrent Colorectal Cancer
Cancer Care Centers of Brevard offers access to colorectal cancer clinical trials that provide innovative therapies not yet widely available for certain types of advanced or recurrent colon and rectal cancers. Some of these trials may include testing for biomarkers to determine if you are eligible for certain targeted therapy or immunotherapy clinical trials. Your oncologist will discuss these options with you.
Learn more about colorectal cancer research and clinical trials in Brevard County.
Colorectal Cancer Care in Brevard County
The colorectal cancer doctors at Cancer Care Centers of Brevard provide the latest cancer treatments, including clinical trials, to develop personalized treatment plans. If you or a loved one was diagnosed with recurrent colorectal cancer, our specialists in Melbourne, Merritt Island, Palm Bay, and Rockledge, Florida, are ready to assist you in finding the best treatment plan. Even if you didn’t receive your initial care at our cancer center, our team will meet with you to recommend next steps.