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Expert Offers Surveillance, Lifestyle Guidance After CRC, Anal Cancer

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Avoiding smoking, eating a high-fiber diet and routine screenings are key to reducing the risk of recurrence in colorectal or anal cancer.

Survivors of colorectal (also known as CRC) or anal cancer should remain vigilant through regular follow-up and routine screenings, according to Dr. Rebecca Rhee. While healthy lifestyle choices — such as avoiding smoking, limiting red meat and eating more fiber — can help lower the risk of cancer or recurrence, these steps do not eliminate it entirely.

Rhee works at Maimonides Medical Center where she is a colorectal surgeon and program director of the general surgery residence. She sat down for a video interview with CURE to discuss more on the topic.

After treatment, routine surveillance is important. This can include physical exams, endoscopy, imaging scans and blood tests. One blood test commonly used in colorectal cancer follow-up is the carcinoembryonic antigen (CEA) test, which tracks tumor markers, as explained by Rhee. A newer test, circulating tumor DNA (ctDNA), can also detect traces of cancer DNA in the bloodstream and may offer another tool for monitoring recurrence.

Signs of recurrence can resemble initial symptoms of cancer, such as changes in bowel movements, bleeding or pain. However, many recurrences are detected through scheduled follow-up exams rather than symptoms alone.

Rhee emphasized that while making healthy lifestyle choices can be beneficial, they are not a substitute for routine surveillance.

Transcript:

Question: Are there any lifestyle or dietary changes that can support treatment effectiveness or reduce the risk of occurrence after therapy?

Answer: I would say the biggest thing, of course, with many cancers, is to not smoke. Smoking is a universal thing that you should definitely stop to decrease your risk of cancer or recurrence. But other than that, general lifestyle things like eating a high fiber diet [can help], and some say avoiding red meat has provided some benefit.

But even if you do all of those things perfectly, no smoking, no red meat, eating a high fiber diet, there's still risk. That's why you get treatment and we do checkups. Surveillance to detect any possible recurrence, and, of course, to drive home the screening [is a key takeaway]. That's the real way we detect things and hopefully prevent cancers.

Transcript has been edited for clarity and conciseness.

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