Second cancer: Colorectal cancer

What is colorectal cancer as a second form of cancer?

This page belongs to Second form of cancer. We recommend reading that information first.

When you swallow food, it goes through the esophagus to the stomach. Here it is broken down into small pieces. Then it enters the intestines, which absorb fluid and nutrients from the food. What remains is stool that you excrete. The organs through which the food passes together form the gastrointestinal tract.

Sometimes intestinal cells begin to divide uncontrollably and form a malignant tumor. This is called colorectal cancer. The chance of developing colorectal cancer after childhood cancer is very small. You can do a number of things to reduce the risk of colorectal cancer, such as watching your weight and eating a healthy and varied diet.

Do I have an increased risk of colorectal cancer?

Everyone, including people who have not had cancer, can develop colorectal cancer. However, some cancer treatments can increase the risk.

The following treatment can increase the risk of colorectal cancer:

• Radiation to the intestines or to an area where the intestines are located

You can see in your treatment summary whether you have received this treatment. If you do not have a summary, you can contact the LATER clinic or the hospital where you were treated.

Colorectal cancer does not always have to be caused by treatment. There may also be other causes, such as overweight and obesity, smoking, and (excessive) alcohol consumption. If you have had intestinal polyps in the past or if cancer occurs more frequently in your family at a young age, this can also increase the risk.

What are the symptoms and signs of colorectal cancer?

Certain symptoms and signs may indicate colorectal cancer. Even if you do not have these symptoms now, it is important to recognize them in case they ever occur.

The following symptoms and signs may indicate colorectal cancer:

• Blood in the stool and/or bleeding through the anus

• Strange or different stool

• More frequent bowel movements or constipation

• Pain, discomfort, or bloated feeling after eating

• Swollen abdomen

• Nausea and/or vomiting

• Pain during bowel movements

Often these symptoms have a different cause. However, rapid diagnosis and treatment of colorectal cancer are very important. Therefore, contact your general practitioner immediately if you recognize any of these symptoms.

I have an increased risk of colorectal cancer. What tests are necessary and when?

If you have an increased risk of colorectal cancer, the recommendation is to start from age 30 or from 5 years after treatment:

• Have your stool checked for blood every 3 years, or

• Have a colonoscopy every 5 years. During this procedure, the doctor examines the intestines with a small camera.

Blood in the stool does not automatically mean you have colorectal cancer, but further testing will be done. If colorectal cancer occurs more frequently in your family, genetic testing can determine whether you have a hereditary predisposition.

What happens if I (might) have colorectal cancer?

If you (might) have colorectal cancer, your general practitioner or LATER physician will refer you to an oncology team. This team consists of:

• Medical oncologist (physician specialized in cancer)

• Gastroenterologist (physician specialized in the digestive system)

• Surgeon

• Radiation oncologist (physician specialized in radiotherapy)

The oncology team will conduct further tests and discuss treatment options with you if necessary.

What else can I do?

Living with an (increased risk of) colorectal cancer can be difficult. Talking with friends and family can help. Contact with people in a similar situation can also provide support, for example through a patient association such as VOX, part of the Dutch Childhood Cancer Association.

Above all, take good care of yourself. You can reduce the risk of colorectal cancer with a healthy lifestyle. It is especially important to watch your weight, drink little or no alcohol, and not smoke (or be exposed to secondhand smoke). Also take care of your mental health. Small changes can already have a positive impact on your physical and mental wellbeing.

It is important that you know you have an increased risk of colorectal cancer and that you recognize the symptoms and signs. Contact your general practitioner or LATER physician if you have questions or are concerned.

Where can I find more information?

This LATER website also contains information about:

• Healthy lifestyle

• Gastrointestinal problems

• Overweight and obesity

• Second form of cancer

• Urinary tract problems

In the PanCare Plain Language Summaries you will find links to reliable information in English.

You can search for information about colorectal cancer online, but keep in mind that it is not always up-to-date and accurate.

Disclaimer

This information is based on the plain language summary of the guideline below, created by the PanCare Plain Information Group, and has been adapted to the Dutch LATER guideline where necessary. If you experience symptoms and signs, do not rely solely on this information, but consult your general practitioner, LATER physician, or specialist.

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