Caring for a Parent with Colorectal Cancer

Colorectal cancer starts in the lining of the large intestine (colon) or rectum. Most cases develop slowly from small growths called polyps. When caught early through colonoscopy screening, it is highly treatable.

Colon cancer and rectal cancer are treated somewhat differently. Rectal cancer, because of its location in the pelvis, often requires radiation in addition to surgery and chemotherapy.

Changes in bowel habits, blood in the stool, cramping or abdominal pain, bloating, feeling that the bowel does not fully empty, fatigue, and unexplained weight loss. Some of these may also be side effects of treatment — keep a log and share it with the oncology team.

The most common treatment for colorectal cancer. The surgeon removes the tumor and a portion of the surrounding bowel. Recovery takes time and your parent will need significant help at home.

In some cases, a temporary or permanent colostomy is needed — an opening in the abdomen through which waste exits into a bag. Your parent will work with an ostomy nurse. Learn alongside them so you can help. It takes time to get used to, but most people adapt more quickly than they expect.

Used to reduce recurrence risk after surgery or to treat cancer that has spread. Colorectal chemotherapy can cause neuropathy — tingling or numbness in the hands and feet — in addition to the usual fatigue and nausea.

Used more often for rectal cancer than colon cancer. May be given before surgery to shrink the tumor or after surgery to reduce recurrence risk.

Options for certain types of colorectal cancer, particularly those with specific genetic markers. Ask the oncologist whether your parent's tumor has been tested — this is an important question that can open additional treatment doors.

After bowel surgery, the digestive system needs time to heal. Your parent may start with clear liquids and slowly progress to solid foods. High-fiber foods, raw vegetables, and carbonated drinks are common culprits in the early recovery period.

Ask for a referral if one has not been offered. A food diary noting what was eaten and any symptoms that followed can be very helpful in identifying problem foods during recovery.

If your parent has a colostomy, output consistency and volume will help guide dietary choices. The ostomy nurse is your best resource for this and can answer questions the oncology team may not think to address.

Chemotherapy-related numbness and tingling in the hands and feet can be uncomfortable and affect daily activities. Warm gloves and socks help. Tell the oncology team — dose adjustments may be needed.

"Will my parent need a colostomy, and if so, is it likely to be temporary or permanent?"

"Has the tumor been tested for genetic markers like MSI or KRAS that affect treatment options?"

"Can we meet with an ostomy nurse before surgery so we know what to expect?"

"Is there an oncology dietitian we can work with during and after treatment?"

"What are the signs of recurrence we should watch for after treatment ends?"

When colorectal cancer reaches its final stages, hospice shifts the focus to comfort, dignity, and quality of life. Families who call hospice early consistently say they wish they had done it sooner.

Treatment is no longer controlling the cancer, your parent is losing significant weight and strength, they are spending more time in the hospital than at home, or they have expressed that they do not want more aggressive treatment.

Advanced colorectal cancer can cause bowel obstruction — a serious and painful complication. Having a hospice team already in place means expert help is a phone call away when this kind of crisis occurs.

Medicare's hospice benefit covers care when a doctor certifies life expectancy is six months or less if the disease follows its expected course. Many people receive hospice for longer.

Nurses, aides, social workers, and chaplains come to your home. They manage pain, nausea, and other symptoms effectively, provide personal care, give you rest, and are available by phone at any hour. Bereavement support is included.