Will my bowel cancer come back?

Even after treatment for bowel cancer, there is a risk that your cancer will come back. Of people in England and Wales diagnosed with colon or rectal cancer, more than 50% live for at least five years after their diagnosis. Recent estimates, quoted by Cancer Research UK, show that about 46% of people with rectal cancer and almost 50% with colon cancer live for at least 10 years. These survival rates have improved significantly over the past 20 years. About 80% of people with bowel cancer (also known as colorectal cancer) have surgery intended to cure them. However, the cancer comes back in about half of these people. The cancer may recur in the colon or rectum, or in another part of the body. Recurrent bowel cancer is often found in the liver and/or lungs.

What is the outlook following treatment for bowel cancer?

Every person is different and responds differently to bowel cancer treatment. However, with prompt and appropriate treatment, the outlook for someone with bowel cancer is hopeful. The survival rate for people with bowel cancer depends on the extent of the cancer at the time of diagnosis (the stage of the cancer) and the person's response to treatment. In addition, many new discoveries have the potential for improving the treatment of bowel cancer, as well as the prognosis.

The following factors determine how well a person will do after treatment for bowel cancer:

• Size of the cancer. The size of the tumour and how deep it has gone into the tissue affects whether or not it will return. The deeper the tumour invades tissues, the higher the chance of recurrence.
• Number of lymph glands involved. The lymphatic system helps coordinate the immune system's function to protect the body from foreign substances. The more lymph glands that have been affected by the cancer, the more likely the cancer will return.
• Spread to other organs. If the colorectal cancer is discovered in the later stages, it may have spread to other organs, such as the liver or lungs. This may increase the chances of the cancer recurring. In this case, additional chemotherapy or radiotherapy may be needed to help prevent further spread of the cancer.
• Quality of the surgery. This is most important for rectal cancers, where surgery can be difficult.

Many people who have had bowel cancer live normal life spans. The treatments available today offer a lot of hope, but you may need several treatments or a combination of treatments, including surgery, chemotherapy and radiotherapy, to have the best chance of preventing any recurrence of cancer.

What happens if bowel cancer comes back?

If bowel cancer has come back in only one part of the body, treatment may consist of an operation to remove the cancer. If the cancer has spread to several parts of the body, a specialist may offer either chemotherapy or radiotherapy. You also may choose to participate in a clinical trial testing new chemotherapy medications or biological therapy.