Learn some ways to reduce the risk of colorectal cancer recurrence.
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Sometimes colon or rectal cancer comes back after treatment. This is called colorectal cancer recurrence. Often, treatment can cure colorectal cancer, but it returns in about 20 percent of people.
One large study found that more advanced cases of colorectal cancer had a higher likelihood of returning. For example, if participants had stage 3 colon cancer, almost 25 percent experienced a recurrence within five years, but in those who had stage 1 cancer, that number went down to about 7 percent.
Why Might Colon Cancer Come Back?
Colorectal cancer recurrence typically happens because of insufficient or incomplete treatment. “The most likely reason would be that [the cancer] was not all removed with the initial surgery, with or without chemotherapy,” says Michael Cecchini, MD, medical oncologist and codirector of the colorectal program for the Center for Gastrointestinal Cancers at Yale Cancer Center and Smilow Cancer Hospital. Treatment aims to fully cure a patient, and it may include surgery, chemotherapy, and additional medical approaches.
While wellness and complementary treatments can offer comfort as a treatment add-on, providers urge patients to use them alongside medical treatments. “A growing number of people don’t do proven treatments and pursue holistic treatments instead, but the reality is the body will not heal itself of cancer through wellness, diet, or exercise alone,” says Suneel Kamath, MD, a gastrointestinal oncologist at Cleveland Clinic.
Even when do you follow treatment protocols, it sometimes doesn’t kill all the cancer cells. Cancer can also grow back even when no microscopic cancer cells are left behind, and experts aren’t sure why.
5 Ways to Prevent Colon Cancer Recurrence
You can help prevent colorectal cancer recurrence by lessening risk factors and following a healthy lifestyle, as well as following up regularly with your provider.
Lowering hormones like estrogen and growth factors
“We know obesity increases risk of colorectal cancer recurrence because it also drives inflammation throughout the body,” says Dr. Kamath. Staying active can reduce that risk.
One meta-analysis showed a lower recurrence rate in participants who exercised more often. Another recent study found that a structured exercise program reduced recurrence rates by 28 percent after five years and also improved survival following surgery and chemotherapy.
After treatment, you may not feel like hopping on a treadmill, but you can start small and ask your doctor for help building up to at least 30 minutes of moderately intense exercise five days a week.
2. Adjust Your Diet
Diet plays an important role not only in colorectal cancer recurrence but also cancer development overall. For example, a Western diet high in fat and protein may bring more risk than the Mediterranean diet. “A diet like the Mediterranean diet is ideal, as it is high in leafy green vegetables, lean protein sources like fish, poultry, beans/legumes, and olive oil for cooking,” says Kamath.
It’s also important to avoid red meat, processed foods, and sugar-sweetened beverages, which increase colorectal cancer risk, Kamath adds. A recent study found that a healthy diet lowers inflammation, which provides protection against colorectal cancer. “Fortunately, this is the heart healthy diet that we already knew about, so it doesn’t require people to eat anything outlandish or start buying expensive supplements,” says Kamath.
“Some observational studies suggest tree-nut consumption [like almonds and walnuts] may be associated with some reduced risk of recurrence,” says Dr. Cecchini. Fiber also plays a protective role against colorectal cancer, with whole grains possibly providing the most benefit.
3. Quit Smoking and Limit Alcohol
Smoking cigarettes exposes you to over 7,000 toxic chemicals, at least 70 of which cause cancer. Long-term cigarette smoking can not only promote colorectal polyp and cancer growth, but can lead to worse treatment outcomes.
“Don’t smoke. Ever. This is probably the most important lifestyle choice anyone can make,” says Kamath. If you already smoke, cutting back or quitting can lessen your risk, especially over time. For anyone looking to quit, the American Cancer Society offers free resources to help you kick the habit.
“You can also protect against cancer recurrence by cutting back or eliminating alcohol,” says Kamath. Alcohol can increase colorectal cancer risk by introducing toxic chemicals; damaging DNA, proteins, and fats; and by making it easier for your body to absorb carcinogens. If you drink, try to limit it to one drink a day for women, two for men.
4. Follow Up With Your Provider
After you recover from colon cancer, going to regular checkups can help your provider catch any developing recurrence early, says Kamath. To check for cancer growth, they may order:
These follow-up appointments and tests are vital to prevent the return of colorectal cancer.
5. Ask About Aspirin
Recent research suggests that taking low-dose aspirin daily may protect against colorectal cancer recurrence and even lower mortality. “A recent clinical trial revealed a reduced risk of recurrence for patients that took 160 milligrams of aspirin daily for three years, if their tumors had mutations in [certain] genes,” says Cecchini.
However, other studies showed conflicting results, and not everyone should take aspirin, which can also cause some serious side effects. So, be sure to ask your provider before you try it, says Kamath.
The Takeaway
Colorectal cancer recurrence means cancer in the colon or rectum has come back after remission.
Most commonly, colorectal cancer recurrence happens when someone doesn’t finish treatment, or when some cancer cells were left behind in surgery.
You can lower your risk of colorectal cancer recurrence by getting regular exercise, eating a healthy diet, limiting smoking and alcohol, and attending all follow-up visits with your provider.
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Tips on How to Prevent Colorectal Cancer. Cleveland Clinic. April 17, 2025.
Char SK et al. Association Between Empirical Dietary Inflammatory Pattern (Edip) and Survival in Patients With Stage III Colon Cancer: Findings From Calgb/Swog 80702 (Alliance). Journal of Clinical Oncology. June 4, 2025.
Hossain MS et al. Colorectal Cancer: A Review of Carcinogenesis, Global Epidemiology, Current Challenges, Risk Factors, Preventive and Treatment Strategies. Cancers. March 2022.
Martling A et al. Low-Dose Aspirin to Reduce Recurrence Rate in Colorectal Cancer Patients With PI3K Pathway Alterations: 3-Year Results From a Randomized Placebo-Controlled Trial. Journal of Clinical Oncology. January 2025.
Daniel Landau, MD, is a distinguished board-certified hematologist-oncologist with a career that has spanned two eminent institutions: the Orlando Health Cancer Institute and the Medical University of South Carolina. With a specialized interest in genitourinary oncology and hematology, he has been at the forefront of managing both benign and malignant conditions.
Dr. Landau is a pioneering figure in integrating advanced technology into oncology, having served as a director of telemedicine services. Under his leadership, multiple innovative systems have been designed and piloted, all with a singular focus: enhancing the patient experience.
Beyond his clinical and technological endeavors, Landau is deeply committed to medical education. He has dedicated significant time and expertise to nurturing the skills of medical students, residents, and fellows, ensuring that the flame of knowledge and compassion burns bright in the next generation of oncologists.
Abby McCoy is an experienced registered nurse who has worked with adults and pediatric patients encompassing trauma, orthopedics, home care, transplant, and case management. She is a married mother of four and loves the circus — that is her home! She has family all over the world, and loves to travel as much as possible.
McCoy has written for publications like Remedy Health Media, Sleepopolis, and Expectful. She is passionate about health education and loves using her experience and knowledge in her writing.
