Colorectal cancer survivorship in older adults

Overview

Survivorship means living with and beyond a cancer diagnosis. For older adults, this includes recovery, follow-up care, and managing the effects of treatment while maintaining quality of life.

Colorectal cancer is one of the most common cancers in older adults. Thanks to better treatments, many older adults live for years after their diagnosis.

It affects adults over 65 who have been treated for colorectal cancer. Survivorship is a personal journey that varies from person to person.

Symptoms

Common symptoms

• Changes in bowel habits, such as more frequent stools or feeling the need to go often
• Fatigue that lasts a long time
• Abdominal discomfort or bloating
• Reduced appetite or weight changes
• Tingling or numbness in the hands or feet after certain treatments

Causes

Main causes

• Survivorship issues are not a disease. They come from the cancer itself and the treatments used to fight it.
• Long-term effects can include changes to the bowel, bladder, nerves, or energy levels.
• These effects may take months or years to appear.

Risk factors

• Older age
• Having advanced cancer at diagnosis
• Certain treatments like radiation therapy or chemotherapy
• Existing health problems such as heart disease or diabetes

When to see a doctor

See a doctor urgently if:

• New bleeding from the bottom
• Severe stomach pain
• Persistent fever
• Vomiting with no ability to keep fluids down

Book a routine appointment if:

• Attend all scheduled follow-up appointments
• Undergo any recommended tests, such as colonoscopy or scans
• Stay in touch with your cancer care team between visits

Diagnosis

Survivorship is not a diagnosis. Instead, doctors monitor for signs of recurrence and manage ongoing effects through regular check-ups and tests.

Tests that may be done

• Colonoscopy
• CT scans of the abdomen and chest
• Blood tests, including a test for a protein called carcinoembryonic antigen (CEA)
• Routine physical exams

What to expect at your appointment

You will have a follow-up plan based on your cancer stage and treatment. You may see your doctor every few months at first, then less often over time. Ask what your personal plan includes.

Treatment

Treatment during survivorship focuses on managing side effects, preventing recurrence where possible, and improving quality of life. If cancer returns, treatment is chosen with your overall health in mind.

Self-care at home

• Stay active within your limits
• Eat well and stay hydrated
• Rest when you need to
• Keep up with follow-up appointments
• Tell your team about any new symptoms

Medical treatments

If recurrence happens, treatment may include surgery, chemotherapy, targeted therapy, immunotherapy, or radiation therapy. The choice depends on your health, the location of the disease, and your personal preferences. Your doctor will explain the options and their expected side effects.

When is surgery considered?

Surgery may be needed if cancer returns, or to fix a bowel blockage or other long-term complication. The decision will balance benefits against your overall health and quality of life.

Living with this condition

Day-to-day life after cancer can be full and active. Allow yourself time to recover. Plan activities around your energy levels and ask for help when you need it.

Lifestyle tips

• Maintain a healthy weight
• Avoid smoking
• Limit alcohol
• Stay connected with family and friends
• Maintain a regular daily routine
• Keep up with your care plan

Diet and exercise

Eat a varied diet with plenty of fruits, vegetables, and whole grains. Gentle exercise like walking can help energy, mood, and bowel function. Talk to your doctor before starting a new exercise routine.

Mental health and emotional wellbeing

It is normal to feel anxious, sad, or worried after treatment. Talking to a counsellor or joining a support group can help. If you have thoughts of self-harm, get help immediately.

Prevention

You cannot fully prevent cancer from coming back, but you can lower your risk by staying active, eating well, avoiding tobacco, limiting alcohol, and attending follow-up checks.

Vaccines

There is no vaccine to prevent colorectal cancer recurrence. Ask your doctor about vaccines for flu and pneumonia, which are especially important as you age.

Screening programmes

Follow-up surveillance is key. This means regular colonoscopies and other tests to find any new growths early, when they are easier to treat.

Complications

If left untreated

• If you skip follow-up care, a recurrence might go unnoticed.
• Cancer could grow and cause a bowel blockage.
• It might spread to other organs, making treatment harder.
• Severe weight loss and weakness could occur.

Long-term outlook

Many older adults live satisfying, independent lives for years after colorectal cancer treatment. With good follow-up care and healthy habits, the risk of recurrence is low in many cases. Even if cancer returns, there are many treatment options to manage it and keep you comfortable.

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