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Content Map Terms
Illnesses & Conditions Categories
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Allergies
- Allergy to Natural Rubber (Latex)
- Jellyfish Stings: Allergic Reaction
- Allergies: Should I Take Allergy Shots?
- Non-Allergic Rhinitis
- Allergic Reaction
- Allergies
- Allergy Shots for Allergic Rhinitis
- Allergies: Rush Immunotherapy
- Over-the-Counter Medicines for Allergies
- Allergic Rhinitis
- Types of Allergens
- Allergies: Avoiding Indoor Triggers
- Allergies: Avoiding Outdoor Triggers
- Controlling Dust, Dust Mites, and Other Allergens in Your Home
- Controlling Pet Allergens
- Allergies to Insect Stings
- Allergies: Should I Take Shots for Insect Sting Allergies?
- Immunotherapy for Allergies to Insect Stings
- Types of Allergic Rhinitis
- Allergic Reaction to Tattoo Dye
- Drug Allergies
- Penicillin Allergy
- Hay Fever and Other Seasonal Allergies
- Allergies: Giving Yourself an Epinephrine Shot
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Arthritis and Osteoporosis
- Rheumatoid Arthritis: Finger and Hand Surgeries
- Rheumatoid Arthritis: Classification Criteria
- Rheumatoid Arthritis: Systemic Symptoms
- Comparing Rheumatoid Arthritis and Osteoarthritis
- Rheumatoid Arthritis: Neck Symptoms
- Osteoporosis in Men
- Psoriatic Arthritis
- Arthritis: Shots for Knee Pain
- Complementary Medicine for Arthritis
- Steve's Story: Coping With Arthritis
- Bev's Story: Coping With Arthritis
- Quick Tips: Modifying Your Home and Work Area When You Have Arthritis
- Coping With Osteoarthritis
- Arthritis: Should I Have Shoulder Replacement Surgery?
- Juvenile Idiopathic Arthritis: Stretching and Strengthening Exercises
- Juvenile Idiopathic Arthritis
- Capsaicin for Osteoarthritis
- Small Joint Surgery for Osteoarthritis
- Osteoarthritis: Heat and Cold Therapy
- Modifying Activities for Osteoarthritis
- Osteoarthritis
- Gout
- Rheumatoid Arthritis
- Juvenile Idiopathic Arthritis: Inflammatory Eye Disease
- Juvenile Idiopathic Arthritis: Range-of-Motion Exercises
- Juvenile Idiopathic Arthritis: Deciding About Total Joint Replacement
- Complications of Osteoarthritis
- Arthritis: Managing Rheumatoid Arthritis
- Arthritis: Should I Have Knee Replacement Surgery?
- Arthritis: Should I Have Hip Replacement Surgery?
- Juvenile Idiopathic Arthritis: Pain Management
- Osteoporosis Risk in Younger Women
- Osteoporosis Screening
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Asthma
- Asthma: Peak Expiratory Flow and Personal Best
- Asthma and Wheezing
- Asthma: Using an Asthma Action Plan
- Asthma: Measuring Peak Flow
- Asthma: Identifying Your Triggers
- Steroid Medicine for Asthma: Myths and Facts
- Asthma
- Inhaled corticosteroids for asthma
- Inhaled quick-relief medicines for asthma
- Classification of Asthma
- Challenge Tests for Asthma
- Asthma's Impact on Your Child's Life
- Asthma Action Plan: Yellow Zone
- Asthma Triggers
- Asthma Action Plan: Red Zone
- Asthma and GERD
- Occupational Asthma
- Asthma Attack
- Asthma: Symptoms of Difficulty Breathing
- Exercise-Induced Asthma
- Asthma Treatment Goals
- Asthma: Overcoming Obstacles to Taking Medicines
- Asthma in Older Adults: Managing Treatment
- Asthma: Controlling Cockroaches
- Asthma: Educating Yourself and Your Child
- Allergy Shots for Asthma
- Asthma: Taking Charge of Your Asthma
- Monitoring Asthma Treatment
- Omalizumab for Asthma
- Asthma: Ways to Take Inhaled Medicines
- Asthma: Overuse of Quick-Relief Medicines
- Asthma Diary
- Asthma Diary Template
- Asthma Action Plan
- Assessing Your Asthma Knowledge
- My Asthma Action Plan
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Bowel and Gastrointestinal Conditions
- Abdominal Fullness or Bloating
- Irritable Bowel Syndrome: Criteria for Diagnosis
- Gastritis
- Gas, Bloating, and Burping
- Irritable Bowel Syndrome (IBS)
- Constipation: Keeping Your Bowels Healthy
- Rectal Problems
- Mild, Moderate, or Severe Diarrhea
- Torn or Detached Nail
- Chronic Constipation
- Gas (Flatus)
- Dyspepsia
- Diverticulosis
- Bowel Obstruction
- Anal Fissure
- Bowel Disease: Caring for Your Ostomy
- Anal Fistulas and Crohn's Disease
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Cancer
- Lung Cancer and Other Lung Problems From Smoking
- Skin Cancer, Non-Melanoma
- Radiation Therapy for Non-Melanoma Skin Cancer
- Colorectal Cancer Test Recommendations
- Breast Cancer Screening: When Should I Start Having Mammograms?
- Lifestyle Changes That May Help Prevent Cancer
- Choosing a Prosthesis After Breast Cancer Surgery
- Hormone Treatment for Breast Cancer
- Cancer Staging and Grading
- Pancreatic Cancer
- Kidney (Renal Cell) Cancer
- Cancer Support: Managing Stress
- Cancer Support: When Your Cancer Comes Back or Gets Worse
- Cancer Support: Dealing With Emotions and Fears
- Cancer Support: Finding Out That You Have Cancer
- Cancer Support: Being an Active Patient
- Cancer Support: Coping With Cancer Treatments
- Cancer Support: Life After Treatment
- Cancer Support: Family, Friends, and Relationships
- Reducing Cancer Risk When You Are BRCA-Positive
- Anal Cancer
- Prostate Cancer: Should I Choose Active Surveillance?
- Lung Cancer Screening
- Basal Cell Skin Cancer: Should I Have Surgery or Use Medicated Cream?
- Tumour Markers
- Does Aspirin Prevent Cancer?
- Cancer
- Lung Cancer
- Oral Cancer
- Colorectal Cancer
- Metastatic Melanoma
- Radiation Treatment for Cancer
- Skin Cancer, Melanoma
- Cervical Cancer Screening
- Hepatitis B and C: Risk of Liver Cancer
- Inflammatory Bowel Disease and Cancer Risk
- Radiation Therapy for Prostate Cancer
- Prostate Cancer
- Cancer: Home Treatment for Mouth Sores
- Skin Cancer Screening
- Breast Cancer: Should I Have Breast Reconstruction After a Mastectomy?
- Prostate Cancer: Should I Have Radiation or Surgery for Localized Prostate Cancer?
- Prostate Cancer Screening
- Side Effects of Chemotherapy
- Breast Cancer: Lymph Node Surgery for Staging Cancer
- Endometrial (Uterine) Cancer
- Cryosurgery for Prostate Cancer
- Breast Cancer
- Cancer: Home Treatment for Nausea or Vomiting
- Cancer: Home Treatment for Pain
- Cancer: Home Treatment for Diarrhea
- Cancer: Home Treatment for Constipation
- Breast Cancer Types
- Cancer: Home Treatment for Sleep Problems
- Cancer: Home Treatment for Fatigue
- Hair Loss From Cancer Treatment
- Body Image After Cancer Treatment
- Breast Cancer: Should I Have Breast-Conserving Surgery or a Mastectomy for Early-Stage Cancer?
- Breast Cancer, Metastatic or Recurrent
- Cancer Pain
- Leukemia
- Colorectal Cancer, Metastatic or Recurrent
- Thyroid Cancer
- Types of Thyroid Cancer
- Radiation Therapy for Cancer Pain
- Breast Cancer in Men (Male Breast Cancer)
- Breast Cancer Screening
- Breast Cancer: Should I Have Chemotherapy for Early-Stage Breast Cancer?
- Asbestos and Lung Cancer
- Cervical Cancer
- Ovarian Cancer
- Colon Cancer Genetic Testing
- Testicular Cancer Screening
- Skin Cancer: Protecting Your Skin
- Non-Melanoma Skin Cancer: Comparing Treatments
- Bladder Cancer
- Prostate Cancer, Advanced or Metastatic
- Active Surveillance for Prostate Cancer
- Urinary Problems and Prostate Cancer
- Cancer: Controlling Cancer Pain
- Heat and Cold Treatment for Cancer Pain
- Testicular Cancer
- Testicular Cancer: Which Treatment Should I Have for Stage I Non-Seminoma Testicular Cancer After My Surgery?
- Testicular Cancer: Which Treatment Should I Have for Stage I Seminoma Testicular Cancer After My Surgery?
- Cancer: Controlling Nausea and Vomiting From Chemotherapy
- Lymphedema: Managing Lymphedema
- Breast Cancer Risk: Should I Have a BRCA Gene Test?
- Inflammatory Breast Cancer
- Ovarian Cancer: Should I Have My Ovaries Removed to Prevent Ovarian Cancer?
- Family History and the Risk for Breast or Ovarian Cancer
- Breast Cancer: What Should I Do if I'm at High Risk?
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Cold and Flu
- Difference Between Influenza (Flu) and a Cold
- Colds and Flu
- Influenza (Flu) Complications
- Flu Vaccine Myths
- Influenza (Seasonal Flu)
- Whooping Cough (Pertussis)
- Productive Coughs
- Dry Coughs
- Influenza (Flu): Should I Take Antiviral Medicine?
- Flu Vaccines: Should I Get a Flu Vaccine?
- Relieving A Cough
- Colds
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COPD
- Cal's Story: Learning to Exercise When You have COPD
- Conserving Energy When You Have COPD or Other Chronic Conditions
- Nebulizer for COPD Treatment
- COPD Action Plan
- COPD: Help for Caregivers
- COPD: Keeping Your Diet Healthy
- COPD: Using Exercise to Feel Better
- COPD
- COPD Flare-Ups
- Bullectomy for COPD
- COPD and Alpha-1 Antitrypsin (AAT) Deficiency
- COPD and Sex
- Pulmonary Rehabilitation for Chronic Obstructive Pulmonary Disease (COPD)
- COPD
- Oxygen Treatment for Chronic Obstructive Pulmonary Disease (COPD)
- COPD: Avoiding Weight Loss
- COPD: Avoiding Your Triggers
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Dementia
- Alzheimer's or Other Dementia: Should I Move My Relative Into Long-Term Care?
- Alzheimer's and Other Dementias: Coping With Sundowning
- Dementia: Assessing Pain
- Medical History and Physical Examination for Dementia or Alzheimer's Disease
- Alzheimer's and Other Dementias: Making the Most of Remaining Abilities
- Dementia: Helping a Person Avoid Confusion
- Alzheimer's and Other Dementias: Maintaining Good Nutrition
- Dementia: Tips for Communicating
- Agitation and Dementia
- Dementia: Bladder and Bowel Problems
- Dementia: Support for Caregivers
- Dementia: Legal Issues
- Dementia: Understanding Behaviour Changes
- Dementia: Medicines to Treat Behaviour Changes
- Dementia
- Mild Cognitive Impairment and Dementia
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Diabetes
- Diabetes: Blood Sugar Levels
- Diabetes: Counting Carbs if You Don't Use Insulin
- Diabetes: Coping With Your Feelings About Your Diet
- Diabetes: Tracking My Feelings
- Diabetes: Taking Care of Your Feet
- Diabetes: Care of Blood Sugar Test Supplies
- Diabetes: Checking Your Blood Sugar
- Diabetes: Checking Your Feet
- Diabetes: Steps for Foot-Washing
- Diabetes: Protecting Your Feet
- Diabetes: Dealing With Low Blood Sugar From Medicines
- Diabetes: Dealing With Low Blood Sugar From Insulin
- Diabetes: How to Give Glucagon
- Low Blood Sugar Level Record
- Symptoms of Low Blood Sugar
- Diabetes: Preventing High Blood Sugar Emergencies
- Diabetic Ketoacidosis (DKA)
- High Blood Sugar Level Record
- Symptoms of High Blood Sugar
- Diabetes: Using a Plate Format to Plan Meals
- Diabetes: Giving Yourself an Insulin Shot
- Diabetes: Eating Low-Glycemic Foods
- Diabetes and Alcohol
- Continuous Glucose Monitoring
- Quick Tips: Diabetes and Shift Work
- Diabetes: How to Prepare for a Colonoscopy
- Type 2 Diabetes: Can You Cure It?
- Diabetes, Type 2: Should I Take Insulin?
- Prediabetes: Which Treatment Should I Use to Prevent Type 2 Diabetes?
- Diabetes: Making Medical Decisions as Your Health Changes
- Diabetes Care Plan
- Diabetes: Caregiving for an Older Adult
- Quick Tips: Smart Snacking When You Have Diabetes
- Testing Tips From a Diabetes Educator
- Gloria's Story: Adding Activity to Help Control Blood Sugar
- Andy's Story: Finding Your Own Routine When You Have Diabetes
- Jerry's Story: Take Prediabetes Seriously
- Linda's Story: Getting Active When You Have Prediabetes
- Diabetes
- Tips for Exercising Safely When You Have Diabetes
- Diabetes: Travel Tips
- Type 2 Diabetes
- Type 1 Diabetes
- Care of Your Skin When You Have Diabetes
- Care of Your Teeth and Gums When You Have Diabetes
- Non-insulin medicines for type 2 diabetes
- Metformin for diabetes
- Hypoglycemia (Low Blood Sugar) in People Without Diabetes
- Diabetic Retinopathy
- Laser Photocoagulation for Diabetic Retinopathy
- Diabetic Neuropathy
- Diabetic Focal Neuropathy
- Diabetic Neuropathy: Exercising Safely
- Diabetic Autonomic Neuropathy
- Criteria for Diagnosing Diabetes
- Diabetes-Related High and Low Blood Sugar Levels
- Diabetic Nephropathy
- Diabetes: Counting Carbs if You Use Insulin
- Diabetes: Cholesterol Levels
- Diabetes and Infections
- Diabetes: Tests to Watch for Complications
- Diabetes: Differences Between Type 1 and 2
- Diabetes Complications
- How Diabetes Causes Blindness
- How Diabetes Causes Foot Problems
- Reading Food Labels When You Have Diabetes
- Eating Out When You Have Diabetes
- Breastfeeding When You Have Diabetes
- Diabetes: Staying Motivated
- Sick-Day Guidelines for People With Diabetes
- Diabetes: Amputation for Foot Problems
- Prediabetes
- Prediabetes: Exercise Tips
- Type 2 Diabetes: Screening for Adults
- Diabetes: Should I Get an Insulin Pump?
- Diabetes: Living With an Insulin Pump
- Form for Carbohydrate Counting
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Disease and Disease Prevention
- Diseases and Conditions
- Osgood-Schlatter Disease
- Needle Aponeurotomy for Dupuytren's Disease
- Mitochondrial Diseases
- Disease and Injury Prevention
- Alzheimer's Disease
- Root Planing and Scaling for Gum Disease
- Kawasaki Disease
- Tay-Sachs Disease
- Von Willebrand's Disease
- Hirschsprung's Disease
- Complications of Paget's Disease
- Paget's Disease of Bone
- Celiac Disease
- Peptic Ulcer Disease
- Ménière's Disease
- Pelvic Inflammatory Disease: Tubo-Ovarian Abscess
- Pelvic Inflammatory Disease
- Addison's Disease
- Misdiagnosis of Lyme Disease
- Lyme Disease
- Parkinson's Disease and Freezing
- Parkinson's Disease: Other Symptoms
- Parkinson's Disease: Modifying Your Activities and Your Home
- Parkinson's Disease and Tremors
- Parkinson's Disease and Speech Problems
- Parkinson's Disease
- Disease-modifying antirheumatic drugs (DMARDs)
- Parkinson's Disease: Movement Problems From Levodopa
- Mad Cow Disease
- Handwashing
- Peyronie's Disease
- Stages of Lyme Disease
- Osteotomy and Paget's Disease
- Dupuytren's Disease
- Crohn's Disease
- Crohn's Disease: Problems Outside the Digestive Tract
- Pilonidal Disease
- Acquired Von Willebrand's Disease
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Down Syndrome, Autism and Developmental Delays
- Autism
- Down Syndrome: Helping Your Child Eat Independently
- Down Syndrome: Grooming and Hygiene
- Down Syndrome: Helping Your Child Learn to Walk and Use Other Motor Skills
- Down Syndrome: Helping Your Child Learn to Communicate
- Down Syndrome
- Dyslexia
- Conditions Related to Dyslexia
- Autism: Behavioural Training and Management
- Autism: Support and Training for the Family
- Unproven Treatments for Autism
- Caring for Adults With Autism
- Down Syndrome: Helping Your Child Avoid Social Problems
- Down Syndrome: Training and Therapy for Young People
- Down Syndrome: Helping Your Child Dress Independently
- Down Syndrome, Ages Birth to 1 Month
- Down Syndrome, Ages 1 Month to 1 Year
- Down Syndrome, Ages 1 to 5
- Down Syndrome, Ages 5 to 13
- Down Syndrome, Ages 13 to 21
- Eating Disorders
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Epilepsy
- Absence Epilepsy
- Juvenile Myoclonic Epilepsy
- Temporal Lobe Epilepsy
- Focal Epilepsy
- Epilepsy: Simple Partial Seizures
- Epilepsy
- Epilepsy and Driving
- Epilepsy: Generalized Seizures
- Epilepsy: Generalized Tonic-Clonic Seizures
- Epilepsy: Myoclonic Seizures
- Epilepsy: Atonic Seizures
- Epilepsy: Tonic Seizures
- Epilepsy: Complex Partial Seizures
- Epilepsy Medicine Therapy Failure
- Stopping Medicine for Epilepsy
- Questions About Medicines for Epilepsy
- Epilepsy: Taking Your Medicines Properly
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Fatigue and Sleep
- Sleep Apnea: Should I Have a Sleep Study?
- Sleep and Your Health
- Quick Tips: Making the Best of Shift Work
- Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Managing Your Energy
- Sleeping Better
- Sleep Problems
- Doxepin (Sleep) - Oral
- Improving Sleep When You Have Chronic Pain
- Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
- Chronic Fatigue: Changing Your Schedule
- Chronic Fatigue: Getting Support
- Snoring and Obstructive Sleep Apnea
- Coping With Changing Sleep Patterns as You Get Older
- Stages of Sleep
- Sleep Apnea: Fibre-Optic Pharyngoscopy
- Sleep Apnea: Oral Devices
- Continuous Positive Airway Pressure (CPAP) Therapy for Obstructive Sleep Apnea
- Sleep Apnea
- Sleep Problems, Age 12 and Older
- Stages of Sleep Apnea
- Sleep Journal
- Shift Work Sleep Disorder
- Snoring
- Sleep Problems: Dealing With Jet Lag
- Insomnia
- Sleep and Your Body Clock
- Weakness and Fatigue
- Insomnia: Improving Your Sleep
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Heart Health and Stroke
- Peripheral Arterial Disease of the Legs
- Bradycardia (Slow Heart Rate)
- Types of Bradycardia
- Cardiac Device Monitoring
- Angioplasty for Peripheral Arterial Disease of the Legs
- Isolated Systolic High Blood Pressure
- Atrial Fibrillation: Should I Try Electrical Cardioversion?
- Change in Heartbeat
- Deep Vein Thrombosis
- Fast Heart Rate
- Heart Failure: Symptom Record
- Heart Failure: Compensation by the Heart and Body
- Heart Failure: Taking Medicines Properly
- Heart Failure: Watching Your Fluids
- Heart Failure: Avoiding Triggers for Sudden Heart Failure
- Heart Failure: Activity and Exercise
- Heart Tests: When Do You Need Them?
- Low Blood Pressure (Hypotension)
- Cardiac Arrest
- Heart Failure Daily Action Plan
- Premature Ventricular Contractions (PVCs)
- Heart Rate Problems: Should I Get a Pacemaker?
- Heart Rhythm Problems: Should I Get an Implantable Cardioverter-Defibrillator (ICD)?
- What to Do if Your Cardiac Device Is Recalled
- Venous Insufficiency
- Carotid Artery Stenting
- ICD: Living Well With It
- Diabetes: Lower Your Risk for Heart Attack and Stroke
- Pacemaker for Heart Failure (Cardiac Resynchronization Therapy)
- Heart Attack: How to Prevent Another One
- Stroke: How to Prevent Another One
- Sex and Your Heart
- Supraventricular Tachycardia: Should I Have Catheter Ablation?
- Carotid Artery Disease
- Giant Cell Arteritis
- High Blood Pressure: Over-the-Counter Medicines to Avoid
- Postural Orthostatic Tachycardia Syndrome (POTS)
- Leg Aneurysm
- Pulmonary Hypertension
- Left Ventricular Hypertrophy (LVH)
- Heart Failure: Checking Your Weight
- Alan's Story: Coping With Change After a Heart Attack
- Coronary Artery Disease: Prevention Myths
- Quick Tips: Taking Charge of Your Angina
- Heart and Circulation
- High Blood Pressure
- Heartburn
- Angioplasty for Coronary Artery Disease
- Coronary Artery Disease
- Implantable Cardioverter-Defibrillator (ICD)
- Aortic Valve Regurgitation
- Aortic Valve Stenosis
- Secondary High Blood Pressure
- Hemorrhagic Stroke
- Stroke: Common Disabilities
- Self-Care After a Stroke
- Stroke: Dealing With Depression
- Stroke: Getting Dressed
- Stroke: Speech and Language Problems
- Stroke: Bladder and Bowel Problems
- Stroke: Preventing Injury in Affected Limbs
- After a Stroke: Helping Your Family Adjust
- Stroke: Behaviour Changes
- Stroke: Changes in Emotions
- Stroke: Perception Changes
- Stroke: Problems With Ignoring the Affected Side
- Stroke: Memory Tips
- Stroke: Your Rehabilitation Team
- Stroke
- Transient Ischemic Attack (TIA)
- Cardiac Rehabilitation: Lifestyle Changes
- Cardiac Rehabilitation: Hospital Program
- Cardiac Rehabilitation: Home Program
- Cardiac Rehabilitation: Outpatient Program
- Cardiac Rehabilitation: Maintenance Program
- Congenital Heart Defects
- Congenital Heart Defects: Caring for Your Child
- Coronary Artery Disease: Should I Have an Angiogram?
- Triggers of Sudden Heart Failure
- Classification of Heart Failure
- Heart Failure: Tips for Easier Breathing
- Heart Failure: Avoiding Colds and Flu
- Heart Failure
- Helping Someone During a Panic Attack
- Aortic Aneurysm
- High Blood Pressure
- Coronary Artery Disease: Family History
- Angina
- Using Nitroglycerin for Angina
- Heartburn: Changing Your Eating Habits
- Angiotensin II receptor blockers (ARBs)
- Beta-blockers
- Heart Rhythm Problems: Diary of Symptoms
- Vagal Manoeuvres for Supraventricular Tachycardia (SVT)
- Electrical Cardioversion (Defibrillation) for a Fast Heart Rate
- Catheter Ablation for a Fast Heart Rate
- Supraventricular Tachycardia
- Home Blood Pressure Log
- Blood Pressure Screening
- Heart Block
- Electrical System of the Heart
- Heart Rhythm Problems and Driving
- Heart Rhythm Problems: Symptoms
- Resuming Sexual Activity After a Heart Attack
- Risk Factors for Coronary Artery Disease
- Pacemaker for Bradycardia
- SPECT Image of the Heart
- Heart Attack and Stroke in Women: Reducing Your Risk
- Ventricular Tachycardia
- Aspirin to Prevent Heart Attack and Stroke
- Temporal Artery Biopsy
- Emergency First Aid for Heatstroke
- Heartburn Symptom Record
- Heart Attack and Unstable Angina
- Congenital Heart Defects in Adults
- Monitoring and Medicines for Heart Failure
- Ventricular Assist Device (VAD) for Heart Failure
- Cardiac Output
- Heart Failure Symptoms
- Heart Failure: Less Common Symptoms
- Heart Failure With Reduced Ejection Fraction (Systolic Heart Failure)
- Heart Failure With Preserved Ejection Fraction (Diastolic Heart Failure)
- High-Output Heart Failure
- Right-Sided Heart Failure
- Heart Failure Complications
- How the Heart Works
- Coronary Arteries and Heart Function
- Heart Failure Types
- Enjoying Life When You Have Heart Failure
- Heart Failure: Tips for Caregivers
- Medicines to Prevent Abnormal Heart Rhythm in Heart Failure
- Cardiac Cachexia
- Heart Failure Stages
- Cardiac Rehabilitation Team
- Cardiac Rehabilitation: Emotional Health Benefits
- Ischemia
- Coronary Artery Disease: Roles of Different Doctors
- Coronary Artery Disease: Helping a Loved One
- Manage Stress for Your Heart
- Intermittent Claudication
- Peripheral Arterial Disease: Pulse and Blood Pressure Measurement
- Heart Failure and Sexual Activity
- Joan's Story: Coping With Depression and Anxiety From Heart Failure
- Rheumatic Fever and the Heart
- Heart Valve Problems: Should I Choose a Mechanical Valve or Tissue Valve to Replace My Heart Valve?
- Acute Coronary Syndrome
- Aspirin: Should I Take Daily Aspirin to Prevent a Heart Attack or Stroke?
- Heart Failure: Should I Get a Pacemaker ?
- Heart Failure: Should I Get an Implantable Cardioverter-Defibrillator (ICD)?
- Heart Valve Disease
- Myxoma Tumours of the Heart
- Aortic Dissection
- Heart Attack and Stroke Risk Screening
- High Blood Pressure: Checking Your Blood Pressure at Home
- Hypertensive Emergency
- Stroke Rehabilitation
- Treatment for Stroke-Related Spasticity
- Driving a Car After a Stroke
- Heart Failure: Avoiding Medicines That Make Symptoms Worse
- Stroke Recovery: Coping With Eating Problems
- Heart Murmur
- High Blood Pressure: Should I Take Medicine?
- Coronary Artery Disease: Should I Have Angioplasty for Stable Angina?
- Tyrell's Story: Taking Pills for High Blood Pressure
- Stroke Prevention: Should I Have a Carotid Artery Procedure?
- Atrial Fibrillation: Which Anticoagulant Should I Take to Prevent Stroke?
- Stroke: Should I Move My Loved One Into Long-Term Care?
- Atrial Fibrillation: Should I Take an Anticoagulant to Prevent Stroke?
- Smoking and Coronary Artery Disease
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Hepatitis
- Hepatitis C: Your Risk for Cirrhosis
- Hepatitis E
- Hepatitis B Immune Globulin - Injection
- Heparin - Injection
- Fulminant Hepatitis
- Protect Yourself From Hepatitis A When Travelling
- Hepatitis A
- Viral Hepatitis
- Hepatitis C
- Hepatitis D
- Hepatitis B: How to Avoid Spreading the Virus
- Hepatitis B
- Hepatitis Panel
- Hepatitis B Treatment Recommendations
- Hepatitis B: Should I Be Tested?
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HIV
- HIV Infection
- HIV Viral Load
- HIV: Stages of Infection
- Ways HIV Cannot Be Spread
- HIV and Exercise
- HIV: Giving Support
- HIV: Tips for Caregivers to Avoid Infection
- HIV: Preventing Other Infections When You Have HIV
- HIV Home Care
- Antiretroviral medicines for HIV
- Resistance to HIV Medicines
- HIV: Preventing Infections
- HIV: Antiretroviral Therapy (ART)
- Opportunistic Infections in HIV
- HIV: Taking Antiretroviral Drugs
- HIV: Non-Progressors and HIV-Resistant People
- HIV Screening
- HIV and Weight Loss
- HIV and Fatigue
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Infectious Diseases
- Anthrax
- Avian Influenza
- Avoiding Infections in the Hospital
- Bacterial Infections of the Spine
- Bites and Stings: Flu-Like Symptoms
- Boric Acid for Vaginal Yeast Infection
- Caregiving: Reducing Germs and Infection in the Home
- Central Venous Catheter: Flushing
- Chickenpox (Varicella)
- Chickenpox: Preventing Skin Infections
- Chikungunya Fever
- Complicated Urinary Tract Infections
- Complications of Ear Infections
- Cranberry Juice and Urinary Tract Infections
- Dengue Fever
- Ear Infection: Should I Give My Child Antibiotics?
- Ear Infections
- Ebola or Marburg Virus Infection
- Ebola Virus Disease
- Enterovirus D68 (EV-D68)
- Fever or Chills, Age 11 and Younger
- Fever or Chills, Age 12 and Older
- Fever Seizures
- Fever Temperatures: Accuracy and Comparison
- Feverfew for Migraines
- Fifth Disease
- Flu: Signs of Bacterial Infection
- Fungal Nail Infections
- Giardiasis
- Hand-Foot-and-Mouth Disease
- Kissing Bugs
- Measles (Rubeola)
- Middle East Respiratory Syndrome (MERS)
- Molluscum Contagiosum
- Monkeypox
- Mononucleosis (Mono)
- Mononucleosis Complications
- Mumps
- Nail Infection: Should I Take Antifungal Pills?
- Neutropenia: Preventing Infections
- Non-Surgical Nail Removal for Fungal Nail Infections
- Noroviruses
- Pleurisy
- Pneumonia
- Preventing Tetanus Infections
- Pseudomonas Infection
- Recurrent Ear Infections and Persistent Effusion
- Recurrent Vaginal Yeast Infections
- Respiratory Syncytial Virus (RSV) Infection
- Rotavirus
- Rubella (German Measles)
- Scarlet Fever
- Sexually Transmitted Infections
- Sexually Transmitted Infections: Genital Examination for Men
- Sexually Transmitted Infections: Symptoms in Women
- Sexually Transmitted Infections: Treatment
- Shingles
- Smallpox
- Sore Throat and Other Throat Problems
- Staph Infection
- Strep Throat
- Symptoms of Pelvic Infection
- Thrush
- Tick Bites: Flu-Like Symptoms
- Tinea Versicolor
- Tuberculosis (TB)
- Tuberculosis Screening
- Urinary Tract Infections (UTIs) in Older Adults
- Vaginal Yeast Infection: Should I Treat It Myself?
- Vaginal Yeast Infections
- Valley Fever
- West Nile Virus
- Zika Virus
- Informed Health Decisions
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Injuries
- Trapped Finger, Toe, or Limb
- Blister Care
- Exercises for Heel Pain or Tightness
- Broken Toe
- Broken Nose (Nasal Fracture)
- Preventing Blisters
- Hip Fracture
- Medial Collateral Ligament (MCL) Injury
- Pressure Injuries From Scuba Diving
- Pressure Injuries: Stages
- Pressure Injuries: Prevention and Treatment
- Calf Muscle Injury
- Avulsion Fracture
- Lateral Collateral Ligament (LCL) Injury
- Posterior Cruciate Ligament (PCL) Injury
- Frozen or Stuck Tongue or Other Body Part
- Fifth Metatarsal Jones Fracture
- Animal and Human Bites
- Blisters
- Burns and Electric Shock
- Choking Rescue Procedure: Heimlich Manoeuvre
- Cold Temperature Exposure
- Cuts
- Ear Problems and Injuries, Age 11 and Younger
- Elbow Injuries
- Elbow Problems, Non-Injury
- Facial Injuries
- Facial Problems, Non-Injury
- Fish Hook Injuries
- Toe, Foot, and Ankle Injuries
- Groin Problems and Injuries
- Finger, Hand, and Wrist Injuries
- Anterior Cruciate Ligament (ACL) Injuries
- Safe Hand and Wrist Movements
- Physical Rehabilitation for ACL Injuries
- Marine Stings and Scrapes
- Mouth Problems, Non-Injury
- Nail Problems and Injuries
- Puncture Wounds
- Shoulder Problems and Injuries
- Removing Splinters
- Swallowed Button Disc Battery, Magnet, or Object With Lead
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British Columbia Specific Information
You can lower your risk of getting colorectal cancer by getting early colon screening. For information on colorectal screening, including the fecal immunochemical test (FIT) and who should be tested under the new BC Colon Screening program, visit British Columbia Cancer Agency Colon Screening.
For additional information on colon screening, visit Ministry of Health Colorectal Screening for Cancer Prevention in Asymptomatic Patients which also includes the Colorectal Cancer: Guide for Patients. You may also be interested in the Appendix A: Factors Influencing Colorectal Cancer Risk.
Making healthy diet and lifestyle changes can also lower your risk of getting colorectal cancer. For more information call 8-1-1 to speak with a registered dietitian, Monday to Friday from 9:00 a.m. – 5:00 p.m. Pacific Time, or you can Email a HealthLinkBC Dietitian.
Topic Overview
Is this topic for you?
This topic is about colorectal cancer that has spread or come back. If you want to learn more about early-stage colorectal cancer, see the topic Colorectal Cancer.
What is colorectal cancer?
Colorectal cancer happens when cells that are not normal grow in your colon or rectum. These cells grow together and form polyps. Over time, some polyps can turn into cancer. This cancer is also called colon cancer or rectal cancer, depending on where the cancer is.
Metastatic cancer is cancer that has spread to other parts of the body. When colon or rectal cancer spreads, it most often spreads to the liver. Sometimes it spreads to the lungs, bones, or other organs in the body.
Colon and rectal cancers often return months or years after treatment. This is called recurrent cancer. If the original cancer was removed before it was able to spread, the chances that it will return are lower.
What causes metastatic or recurrent colorectal cancer?
Doctors don't know the exact cause. But the cancer is more likely to spread or come back if it is in a later, more advanced stage when it is first discovered.
Sometimes cancer cells are too small to be found by tests. These cells may continue to grow and show up later as metastatic cancer, even years after treatment.
What are the symptoms?
The most common symptoms are:
- A change in your bowel habits, such as more frequent stools, thinner stools, or a feeling that your bowels are not emptying completely.
- Blood in your stool or very dark stools.
- Loss of appetite.
- Belly pain, especially gas pains, cramps, or a feeling of fullness.
- Losing weight without trying.
- Constant tiredness (fatigue).
Some people don't have any symptoms.
If your cancer has spread, you may have other symptoms, depending on where the cancer is.
How is metastatic or recurrent colorectal cancer diagnosed?
Colon or rectal cancer that has spread or returned is diagnosed using a physical examination and several tests, including blood tests, chest X-rays, bone scans, ultrasounds, and CT, PET, or MRI scans.
The diagnosis is usually confirmed with a biopsy. During this test, your doctor will take tissue samples from any areas that don't look normal. The tissue will be looked at under a microscope to see if it contains cancer.
If you have been treated for colon or rectal cancer in the past, it's important to have regular checkups to find any new cancer as soon as possible.
How is it treated?
Colon and rectal cancers that have spread or returned may be cured in some cases. Treatment may include surgery, radiation, chemotherapy, and targeted therapy. When the cancer cannot be cured, treatment can help you feel better and live longer.
Learning that you have cancer that has spread or come back can be very hard. Some people find that it helps to talk about their feelings with their family and friends. You may also want to talk with your doctor or with other people who have had this kind of cancer. Your local cancer centre or Canadian Cancer Society chapter can help you find a support group.
Health Tools
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Cause
The exact cause of colorectal cancer is not known. Most cases start as small growths, or polyps, inside the intestine.
Metastatic and recurrent colorectal cancer is caused when the cancer spreads or comes back, even years after treatment. Sometimes cancer cells are too small to be found and removed. They keep growing and cause problems later.
Symptoms
The most common symptoms are:
- A change in bowel habits, such as narrow stools or frequent diarrhea or constipation.
- Blood in the stool, or stools that look like black tar.
- Loss of appetite.
- Pain in the belly, especially gas pains, cramps, or a feeling of fullness.
- Unexplained weight loss.
- Constant tiredness (fatigue).
Some people don't have any symptoms for some time.
If your cancer has spread, you may have other symptoms, depending on where the cancer is.
What Happens
How cancer grows and spreads
Cancer is the growth of abnormal cells in the body. These extra cells grow together and form masses, lumps, or tumours. In colorectal cancer, these growths usually start as harmless polyps in the large intestine. If polyps are not found and removed, some of them can turn into cancer.
If the cancer is allowed to keep growing, over time it will invade and destroy nearby tissues and then spread farther.
- Colon cancer often spreads first to nearby lymph nodes. From there it may spread to other parts of the body, usually to the liver. It may also spread to the lungs, bones, or other organs in the body.
- Rectal cancer may spread directly to the lungs, bypassing the liver.
Recurrent colorectal cancer occurs when the cancer begins to grow again months or years after treatment.
Survival rates
The long-term outcome, or prognosis, for colorectal cancer depends on how much the cancer has grown and spread. Experts talk about prognosis in terms of "5-year survival rates." This means the percentage of people who are still alive 5 years or longer after their cancer was found. It is important to remember that these are only averages. Everyone's case is different. And these numbers don't necessarily show what will happen to you.
The 5-year survival rate:footnote 1
- Is 71% for people whose cancer has spread to nearby organs or lymph nodes. This means that about 71 out of 100 people are still alive 5 years or longer after their cancer was discovered.
- Is 14% for people whose cancer has spread farther away to other parts of their bodies. This means that about 14 out of 100 people are still alive 5 years or longer after their cancer was discovered.
These numbers are taken from reports that were done from 2007 to 2013, before newer treatments were available. So the actual chances of your survival are likely to be higher than these numbers.
What Increases Your Risk
Even after treatment that seems successful, colorectal cancer may come back (recur). But this depends on the stage of the cancer before treatment.
Your risk for recurrent or metastatic cancer depends on how aggressive your cancer is and how well treatments work.
When should you call your doctor?
Be sure to follow your doctor's instructions about calling when you have problems, new symptoms, or symptoms that get worse.
Call your doctor if you have:
- A change in bowel habits, such as constipation or diarrhea.
- Pain or bloating in your belly.
- Weight loss, loss of appetite, or severe tiredness.
- Persistent shortness of breath or cough (especially coughing up blood).
- Bone pain.
- Confusion or memory problems that get worse.
Examinations and Tests
Tests to help your doctor see if colorectal cancer has spread or come back include:
- An abdominal ultrasound to find the cause of pain or swelling in your belly.
- A colonoscopy to see if cancer has returned to your intestine.
- Blood tests to find out if cancer has returned (CEA) or to find the cause of symptoms such as weakness, fatigue, fever, bruising, or weight loss (complete blood count).
- A chest X-ray to find the cause of symptoms such as persistent coughing, coughing up blood, chest pain, or trouble breathing.
- A CT scan, an MRI, or a PET scan to see if colorectal cancer has spread into the chest or organs in the belly or pelvis.
- A brain CT scan or MRI to look into symptoms such as confusion, paralysis, numbness, vision problems, vertigo, or headaches.
- A biopsy, such as a liver biopsy or a lung biopsy, to find out where the cancer cells have spread.
- A bone scan to find out if cancer cells have spread to the bones.
If metastatic cancer is found, you may also have genetic tests before your doctor recommends a treatment plan. These tests look for gene changes (mutations) that can occur with colorectal cancer. They can show which chemotherapy medicines will help.
Treatment Overview
Your treatment for colorectal cancer that has spread or come back may include:
- Surgery . If cancer has come back in your intestine or another part of your body, surgery may be used to remove it. To learn more, see Surgery.
- Chemotherapy . These medicines kill cancer cells that have spread to other parts of your body. They also can relieve pain caused by the cancer. To learn more, see Medications.
- Radiation therapy . X-rays can be used to shrink colorectal tumours that may be causing blockages. They can also reduce bleeding or pain. To learn more, see Other Treatment.
- Targeted therapy . This treatment uses medicines called monoclonal antibodies to treat colorectal cancer. It is often given along with chemotherapy. To learn more, see Medications.
- Clinical trials . These are studies of new or different ways to treat cancer.
Colorectal cancer often comes back, even after treatment that seemed successful. Your cancer may return even if you do everything you can to prevent it. If this happens, focus on what you and your doctor can do to treat your symptoms to help you feel better and live longer.
Your treatment will depend on specific information about the cancer, your preferences, and your health.
Some cases can still be cured. When the cancer can't be cured, treatment can help you feel better and live longer.
Pain control
Pain is one of the main concerns of people who have cancer. But cancer pain can almost always be controlled. There are several ways to control your pain, such as using strong medicines like opioids. Or you can have treatments that shrink tumours and block nerve pain.
Supportive care
As your cancer gets worse, you may want to think about hospice palliative care. Hospice palliative care can improve your quality of life—not just in your body but also in your mind and spirit. Hospice palliative care providers will work to help manage pain and other symptoms or side effects. They may help you decide what treatment you want or don't want. And they can help your loved ones understand how to support you.
There may come a time when treatments to cure your cancer are no longer working. Or you may decide that you want to spend the time you have left in other ways and only have medical care that keeps you comfortable. If so, talk to your doctor about hospice palliative care. Hospice palliative caregivers help to enhance the quality of your remaining life by keeping you as alert and comfortable as possible in a familiar environment with family and friends.
You may also want to:
- Discuss health care and other legal issues that arise near the end of life with your family and your doctor.
- State your health care choices in writing (with an advance care plan) while you are still able to make and communicate these decisions.
- Choose a substitute decision-maker in case you become unable to speak for yourself.
To learn more about supportive care, see:
Prevention
There is no sure way to prevent colorectal cancer from coming back or spreading to other parts of your body.
But there are lifestyle changes that can help you after treatment. Research shows that these things may help:footnote 2
- Quit smoking, if you smoke.
- Keep a healthy body mass index (BMI).
- Get regular exercise.
- Eat more whole grains, fruits, vegetables, poultry, and fish.
- Eat less red meat, refined grains, and sweets.
Initial treatment for colorectal cancer is followed by regular doctor visits and screening to help find the cancer if it returns.
Home Treatment
Managing side effects
During your treatment, you can help manage your side effects and symptoms at home. If your doctor has given you instructions or medicines to treat these problems, be sure to also use them.
Try home treatments for:
- Nausea or vomiting, such as ginger tea, peppermint candy or gum. Be sure to drink enough fluids so that you don't get dehydrated.
- Pain, such as over-the-counter pain relievers, heat packs, or cold packs. Talk to your doctor before using any home treatment for pain. To learn more, see the topic Cancer Pain.
- Diarrhea, such as taking small, frequent sips of water and bites of salty crackers.
- Constipation, such as getting plenty of water and fibre in your diet. Don't use a laxative without first talking to your doctor.
Other problems that can be treated at home include:
- Sleep problems. If you have trouble sleeping, try having a regular bedtime, getting exercise daily, and avoiding caffeine late in the day.
- Feeling very tired. If you lack energy or become weak easily, try to get extra rest. Plan your schedule to make the most of the energy you have.
- Mouth sores. Watch what you eat and drink. Rinse your mouth regularly with mouthwash or a liquid antacid.
In general, healthy habits such as eating a balanced diet and getting enough sleep and exercise may help control your symptoms.
Managing stress
Having cancer can be very stressful. Finding new ways to handle stress may help you feel better.
For example, you could:
- Try techniques to reduce your stress, such as yoga and visualization exercises.
- Talk about your feelings. Your cancer treatment centre may offer counselling services and support groups.
- Ask your doctor to help you find other sources of support and information.
Your feelings about your body may change after treatment. Dealing with your body image may involve talking openly with your partner about your worries and discussing your feelings with a doctor.
Contact your local cancer centre or chapter of the Canadian Cancer Society to find a support group. Talking with other people who have had similar experiences can be very helpful.
Having cancer can change your life in many ways. For help with managing these changes, see the topic Getting Support When You Have Cancer.
Medications
Chemotherapy is the use of medicines to stop cancer's growth or relieve symptoms. Sometimes chemotherapy may be used to shrink tumours in the liver so they can be removed with surgery.
The medicines may be given through a needle in your vein, as pills you can swallow, or as a shot (injection).
Medicine choices
The most commonly used medicines are:
- Bevacizumab (Avastin).
- Capecitabine (Xeloda).
- Fluorouracil (5-FU).
- Irinotecan (Camptosar).
- Leucovorin.
- Oxaliplatin (Eloxatin).
Cetuximab (Erbitux) and panitumumab (Vectibix) may be used for colorectal cancer that has spread and has not improved during or after treatment with other drugs. These kinds of medicines, called monoclonal antibodies, may not work for some people. So before you have this treatment, your tumour tissue will be checked for certain gene changes (mutations).
Your doctor may prescribe medicines to control nausea and vomiting.
Surgery
Surgery may be used to remove cancer from the colon or rectum. Or it may be done to remove cancer that has spread to other organs in the body. The type of surgery chosen depends upon the stage of the cancer.
Surgery choices
- Bowel resection . The surgeon cuts out the cancer in the colon or rectum as well as the parts of the colon or rectum that are next to it. Then the two healthy ends of the colon or rectum are sewn back together.
- Liver resection . The surgeon cuts out cancer that has spread to the liver, as well as parts of the liver that are next to the cancer. If the cancer in your liver is too large to remove with surgery, you may be given chemotherapy. It can shrink the tumour so it can be removed.
- Lung, adrenal, or ovarian resection, depending on where the cancer has spread and whether you are a good candidate for this surgery.
If cancer that has returned to your intestine is large, more of your colon or rectum may have to be removed. If the ends of your colon or rectum can't be rejoined, you may need a colostomy. Most people don't need a permanent colostomy.
Sometimes surgery is used not to cure your cancer but to make your life more comfortable. For example, the surgeon may create a colostomy to give you relief from symptoms caused by a tumour blocking your colon.
Other Treatment
Radiation treatment
Radiation treatment uses X-rays to destroy colorectal cancer cells. It is often combined with surgery or chemotherapy. Radiation may also be used to reduce the cancer's size when it is blocking the colon or rectum.
Radiation treatments aren't likely to cure metastatic or recurrent colorectal cancer. But they may ease pain and discomfort, slow the spread of the disease, and help you live longer.
Treatment for cancer that has spread to the liver
Sometimes colorectal cancer that has spread to the liver can be removed by surgery. But usually other treatments are needed, such as:
- Radiofrequency ablation. A small wire that sends out radio waves is inserted into the tumour. The radio waves destroy the cancer that has spread to the liver without harming healthy tissue.
- Cryosurgery. This may be done in surgery for cancer that has spread to the liver. Liquid nitrogen is used to freeze and destroy cancer cells.
- Embolization. This shrinks a cancer that has spread to the liver by cutting off its blood supply.
- Interstitial radiation therapy. In this type of internal radiation treatment, radioactive material sealed in needles, wires, seeds, or catheters is placed directly into the tumour or body tissue.
- Intra-arterial hepatic chemotherapy. The surgeon implants a small pump in the belly that delivers chemotherapy right into the tumour. The pump can be left in place as long as needed.
Clinical trials
Clinical trials are studies that look for new treatments. If you are interested, ask your doctor if there are trials you can take part in. Your provincial cancer agency or your local chapter of the Canadian Cancer Society can also help you find clinical trials.
Complementary therapies
People sometimes use complementary therapies along with medical treatment to help relieve symptoms and side effects of treatments. Some of the complementary therapies that may be helpful include:
- Acupuncture to relieve pain.
- Meditation or yoga to relieve stress.
- Massage and biofeedback to reduce pain and ease tension.
- Breathing exercises for relaxation.
These treatments may help you feel better. They can make it easier to cope with cancer treatments. They also may reduce chronic low back pain, joint pain, headaches, and pain from treatments.
Before you try a complementary therapy, talk to your doctor about the possible value and side effects. Let your doctor know if you are already using any such therapies. These treatments aren't meant to take the place of standard medical treatment. But they may improve your quality of life and help you deal with the stress and side effects of cancer treatment.
Related Information
References
Citations
- National Cancer Institute (2017). SEER cancer stat facts: Colon and rectum cancer. National Cancer Institute. https://seer.cancer.gov/statfacts/html/colorect.html. Accessed November 10, 2017.
- National Comprehensive Cancer Network (2012). Colon cancer. NCCN Clinical Practice Guidelines in Oncology, version 3. Available online: http://www.nccn.org/professionals/physician_gls/f_guidelines.asp#site.
Other Works Consulted
- Libutti SK, et al. (2015). Cancer of the rectum. In VT DeVita Jr et al., eds., DeVita, Hellman, and Rosenberg's Cancer Principles and Practices of Oncology, 10th ed., pp. 823–841. Philadelphia: Walters Kluwer.
- National Cancer Institute (2011). Colon Cancer PDQ: Treatment—Patient Version. Available online: http://www.cancer.gov/cancertopics/pdq/treatment/colon/Patient.
- National Cancer Institute (2011). Rectal Cancer PDQ: Treatment—Health Professional Version. Available online: http://www.cancer.gov/cancertopics/pdq/treatment/rectal/HealthProfessional/allpages.
- National Cancer Institute (2012). Rectal Cancer Treatment (PDQ)—Patient Version. Available online: http://www.cancer.gov/cancertopics/pdq/treatment/rectal/Patient.
Credits
Current as of: September 8, 2021
Author: Healthwise Staff
Medical Review:
E. Gregory Thompson MD - Internal Medicine
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine
Kenneth Bark MD - General Surgery, Colon and Rectal Surgery
Current as of: September 8, 2021
Author: Healthwise Staff
Medical Review:E. Gregory Thompson MD - Internal Medicine & Adam Husney MD - Family Medicine & Kathleen Romito MD - Family Medicine & Kenneth Bark MD - General Surgery, Colon and Rectal Surgery
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