Please see enclosed product information for CAMPTOSAR, including black box warning.
This booklet is for people with cancer of the colon or rectum. Hearing you have cancer is not easy. It’s normal to feel frightened and confused. You may have many questions. This booklet is meant to give you some of the information you need. It will make you better prepared to cope with your illness. It will also make you a better partner with your doctors and nurses in your treatment.
In it, you’ll learn more about:
This booklet is laid out in useful sections:
Your Treatment Team
Who treats colorectal cancer? What is each person’s role in your care?
About Colorectal Cancer
What is it? Who gets it? How is it found?
Stages of Colorectal Cancer
How do doctors know how serious your cancer is? How can they
help you decide which treatment is best for you?
Treatment
What treatments are there for your cancer? Will you need surgery?
Will you take drugs? Are there new treatments?
Managing Side Effects
What side effects can you expect? How serious will they be?
How can you cope with them?
Pain Management
Will you have cancer pain? How will your pain be managed?
Coping With Cancer
Will you have body changes? What if you lose your hair? Will your
sex life change?
Getting the Support You Need
How to find information and support in your community and on
the Internet.
Notes
Handy blank pages. Use these to make notes and keep track of questions
you want to ask your doctor or nurse.
While reading this booklet, always keep in mind that your best source of answers is your treatment team. You should always feel comfortable asking any questions you have.
Cancer is a complex disease. Its treatment is also complex. You will need a team of doctors, nurses, and others with special training. Each member of the team has a role. Each helps with one or more aspects of care. The makeup of your team depends on your cancer and your needs. Below are some of the key specialists who care for people with cancer. The role of each is explained. You might wish to use your treatment journal to jot down the names and phone numbers of people on your team. Remember, though, that you are also an important member of the team.
This section discusses cancer in general, and cancer of the colon and rectum. It will help your understanding of colorectal cancer. The more you know about it, the better you’ll be able to meet its challenges.
Cancer is a group of diseases in which the cells do not grow and die as they should. There are many types of cancer. Most are named after the part of the body where they start.
Cells are the tiny building blocks that form the tissues of the body. Normally, they grow, divide, and die in a controlled way. When cells age and die, new ones replace them. Sometimes, something changes in the cell to keep this process from working as it should: cells grow too fast, or they don’t die when they’re supposed to. These cells form growths called tumors.
Tumors can be benign or malignant. Benign tumors don’t spread and are rarely life-threatening. Malignant tumors can spread throughout the body. Malignant tumors are cancer, which can cause death.
Cancer is caused by changes in genes. Genes are the “blueprints” of life in the cell. Genes direct the way cells grow, divide, and die. Sometimes, a gene might fail to do its job because of heredity. Other factors can also cause genes to change. These factors include:
Some viruses can also change genes.
Cancer spreads when malignant cells break away from a tumor and go to other parts of the body. The spread of cancer cells is called metastasis (meh-TA-stah-sis).
Cancer spreads by moving into nearby tissue. It can also spread through the blood or the lymph. This allows cancer to invade organs far from where it begins.
Lymph is a watery fluid that travels through the body. Its role is to carry infection-fighting cells. Lymph travels through tubes like small veins. These connect to lymph nodes—small sacs where the cells are stored.
Colon cancer is cancer that starts in the colon (the large intestine or bowel). Rectal cancer starts in the rectum. These 2 cancers are alike in many ways. Their treatment may be slightly different. Together, they are called colorectal cancer.
No one knows for sure. It usually starts as a polyp (PAH-lip). This is a small, harmless growth on the inside of the colon. Some polyps turn into cancer. If a polyp is found and removed early, the cancer can be prevented.
Studies have found things that raise the risk of getting colorectal cancer.
Doctors use a number of tests to screen for and detect colorectal cancer.
To check for cancer before a person has symptoms, there are screening tests:
New tests are also being studied:
If the doctor thinks you might have cancer or some other disease, a full colonoscopy should be done. Also, your doctor may give you a CEA test.
When cancer has been found, your doctor may want you to get other tests to find out if it has spread. Testing can also help guide your treatment. These tests might include:
In this section, you’ll learn about staging. This is what doctors use to describe how far your cancer has spread. It also helps guide treatment.
The main system now in use goes by 2 names: AJCC and TNM. AJCC stands for the American Joint Committee on Cancer. It’s also called TNM because it describes:
| T | — | the extent of the Tumor into or through the wall of the colon or rectum |
| N | — | if it has spread to lymph Nodes |
| M | — | if there is Metastasis (if it has spread to other parts of the body) |
This system uses Roman numerals (0-IV) to stage cancer. In general, the lower the number, the less the cancer has spread. Also, the better the chances are for long-term survival. Dukes, a similar system, uses letters (A-D).
| Stage 0 | The cancer is in its earliest form. It has not grown beyond the inner layer of the colon or rectum. This is also called cancer in situ. |
| Stage I | (Also called Dukes A): The cancer is inside the wall of the colon or rectum. It has not spread any farther. |
| Stage II | (Also called Dukes B): The cancer has spread through the wall of the colon or rectum, but it has not reached lymph nodes or distant sites. |
| Stage III | (Also called Dukes C): The cancer has spread to the lymph nodes, but it has not reached distant parts of the body. |
| Stage IV | (Also called Dukes D): The cancer has spread to distant parts of the body. |
It is possible for a person to have recurrent cancer. This means the cancer has returned after treatment. It may be local (near the first site) or in some other part of the body.
This section deals with treatment. You’ll learn about the types of therapy you might receive at the stage of your cancer.
Use this index to find the information you need.
The main treatments are:
Many people have at least 2 of these. Some people may have more. It depends on:
You may hear treatments bring referred to as “first-line” or “second-line.”
Here’s what those terms mean:
If you would like more information on treatment, ask your doctor.
Most people with colorectal cancer have surgery. The goal is to remove as much of the cancer as possible. The surgeon recommends what kind of operation you’ll need.
Surgery for colon cancer
Surgery for rectal cancer
Surgery for colorectal cancer that has spread
If your cancer has spread, the surgeon may try to remove the new tumors. In some cases, this might be a cure. If the cancer has spread too far, the goal of surgery is to extend life and ease symptoms.
Preparing for surgery. You will probably need some tests before surgery. The surgeon needs to make sure your heart and lungs are strong and that you don’t have anemia or other health problems. You will need to take a laxative to empty your colon. Your doctor will tell you which of your regular medicines you should take or skip before surgery.
Recovering from surgery. Nurses and doctors will take special care to help avoid infection or other problems. You will not be able to eat or drink for a few days. A tube put in your arm will provide the fluids and nutrition you need. Your nurses will get you up and moving around as soon as possible. If the medicine you receive for pain isn’t helping, talk to your doctor or nurse.
Side effects of surgery. When a person has surgery, the area nearby will be painful for a while. Your doctor will give you something to relieve the pain. You may have constipation or diarrhea. You could get an infection. With a colostomy, the nearby skin may get irritated. There may be sexual problems as well. For men, infertility may be an issue.
This is the use of drugs to kill cancer cells. Some are given by injection and others in pill form. These drugs are carried in the blood to all parts of the body. This makes them very useful for cancers that have spread. Some types of chemo are given by continuous infusion. This means the drug is pumped into a vein continuously for a number of days.
Chemo can be used after surgery to try to destroy areas of cancer that might have been missed. It may also reduce the chances of the cancer coming back. Treatment that makes it less likely that a disease will come back is called adjuvant therapy. In people with metastatic cancer, chemo may:
Most people get these drugs in cycles. There are times of treatment and then times of rest.
Types of chemotherapy
Here are some drugs used for colorectal cancer. Talk to your doctor about what treatments might be right for you.
* Please see full prescribing information for Camptosar on the last pages.
Xeloda is a registered trademark of Roche Laboratories Inc. Camptosar is a registered trademark of Pfizer Inc. Eloxatin is a trademark of Sanofi-Synthelabo Inc.
Side effects of chemotherapy
This is a big concern for a lot of people. Side effects depend on:
Your doctor or nurse can help manage side effects. Some common effects are these:
There is much more about side effects and how to deal with them in the next section, starting on page 40.
RT uses strong x-rays to kill or shrink cancer cells. You may have RT before or after surgery. If done before, the goal is to shrink a large tumor. This will make it easier to take out. If done after, it is used to kill areas of cancer that the surgeon might have missed. In advanced cancer, RT may ease symptoms and may extend life. It is often used at the same time as chemotherapy.
There are a few types of RT:
External-beam radiation therapy
Internal radiation therapy, or implant radiation, or brachytherapy (BRACK-ee-ther-ah-pee)
Endocavitary (en-doe-CAV-uh-tary) radiation therapy
Side effects of radiation therapy
Some side effects you may have are:
In most people, they go away once treatment is over. Sometimes, the irritation of the rectum and bladder may not go away. This can cause diarrhea and frequent urination.
More about side effects and how to cope with them are in the next section. (See page 40.)
This is a new type of treatment. Some kinds use (or boost) your immune system to fight cancer. Others find and kill cancer cells or the compounds they need to grow.
Cancer vaccines
Targeted therapy
Bevacizumab (be-va-KIZ-uh-mab), or Avastin™ (a-VAST-in)
Cetuximab (seh-TUX-i-mab), or Erbitux™ (ER-bi-tux)
Panitumumab (pan- i- TUE- moo- mab), or Vectibix® (VEC- ti- bix)
Avastin is a trademark of Genentech. Erbitux is a trademark of ImClone Systems Incorporated.
Vectibix is a registered trademark of Amgen.
Sometimes, blood tests for “tumor markers” are used to track treatment. Tumor markers are compounds that cancer cells release. One that may be checked for in colorectal cancer is CEA. High levels might mean your cancer has come back.
For some people, a clinical trial might be a good choice. They are research studies. They seek improved ways to treat a disease. People who take part are volunteers. You would not be part of one and not know it.
Why clinical trials are important. They aid in the fight against cancer. They may also help you.
There are some risks, though.
If you think about taking part in a trial, you’ll be told all of the possible benefits and risks ahead of time.
Knowing if a clinical trial is right for you
Here are some questions you might ask your doctor or nurse to help you decide:
For more information about clinical trials
To find out more, you, your doctor, or your nurse can call:
Some people turn to treatments that are not part of the standard approach.
Alternative therapy
A treatment that takes the place of standard medicine
Complementary therapy
A treatment used along with standard medicine
Learning about alternative and complementary therapies
Talk to your doctor or nurse before using any treatments like these. While some may have good results, others may not. Some may get in the way of your doctor’s care, or even cause harm.
Here are questions to ask about alternative and complementary therapies:
Unless your cancer is very advanced (Stage IV), your first treatment will probably be surgery. You may also get chemo, RT, or both. For a clinical trial, chemo, RT, and/or biologic therapies are choices.
Stage 0
Stage I
Stage II
Stage III
Stage IV
Your doctor might recommend surgery to:
Your doctor may recommend RT or chemo to:
Recurrent colon cancer
Unless your cancer is in Stage IV, your first treatment will most likely be surgery. You may also get chemo, RT, or both. For a clinical trial, chemo, RT, and/or biologic therapies are choices.
Stage 0
Stage I
The standard treatment is resection. (See page 26.)
Stage II
You may get chemo, RT, or both.
Stage III
You may get chemo, RT, or both.
Stage IV
Your doctor might recommend surgery to:
Recurrent rectal cancer
For more on treatment options, please see pages 23-33.
Many people worry about the side effects of cancer treatment. In this section, you’ll learn more about side effects. You’ll learn what your doctor, nurse, and you can do to ease them. The more you know about the side effects, the less they’ll disrupt your life.
Chemotherapy is a strong treatment used to kill cancer cells. Many people do have side effects. But, not everyone has serious side effects. It depends on the treatment. It also depends on the person.
Your doctor and nurse are your best sources of information about your treatment and its effects. Be sure to talk to them about what side effects you should expect and what to do about them.
Cancer cells grow and divide faster than normal cells do. Many chemo drugs are made to destroy cells that grow fast. The problem is, some normal cells grow fast, too. The drugs often harm these cells along with cancer cells. This is what causes the side effects.
The cells most likely to be harmed are these:
In the next few pages, you will learn more about these side effects. You should keep in mind that most side effects go away when treatment is over. If the side effects are too serious, tell your doctor or nurse.
While chemo fights cancer, it can also cause diarrhea. If not managed, this can be dangerous. It can even threaten life. Ask your doctor what to do when you have loose stools after your chemo treatment. If you have more than 6 loose stools in 24 hours, tell your doctor or nurse at once. Your doctor can give you medicines to ease the problem.
Call your doctor if:
Often, a drug called Imodium® A-D is used. It can be bought over the counter. Your doctor will tell you how to take it.
Your doctor will want to know if taking Imodium A-D does not work.
Remember, if your diarrhea is severe, don’t wait to call your doctor—even at night or over the weekend.
Imodium A-D is a registered trademark of McNeil-PPC, Inc.
Taking Imodium® A-D
Your doctor may recommend these instructions (which are not the same directions on the package):
Take 2 caplets (4 mg) at the first sign of late diarrhea*
Take 1 caplet (2 mg) every 2 hours until you have had no diarrhea for at least 12 hours
During the night you must take 2 caplets (4 mg) every 4 hours
* Late diarrhea happens more than 24 hours after you are given your medicine.
Tips for Coping With Diarrhea
 – Whole-grain breads and cereals |
– Raw vegetables |
| – Beans |
– Nuts |
| – Seeds |
– Popcorn |
| – Fresh and dried fruit | |
| – White bread |
– White rice or noodles |
| – Creamed cereals |
– Ripe bananas |
| – Canned or cooked fruit without skins |
– Cottage cheese |
| – Yogurt |
– Eggs |
| – Mashed or baked potatoes without the skin |
– Puréed vegetables |
| – Chicken or turkey without the skin |
– Fish |
| – Ask your doctor about the BRAT diet: Bananas, Rice, Applesauce, and Toast | |
| – Bananas |
– Oranges |
| – Potatoes |
– Peach and apricot nectars |
| – Apple juice |
– Clear broth |
| – Water |
– Ginger ale |
| – Weak tea | |
Let carbonated drinks go flat (lose their fizz) before you drink them.
When dealing with diarrhea or constipation, a food diary might help. This will help you know which foods make the problem worse.
Some drugs can damage nerve cells. This causes a disorder called neuropathy (new-ROP-a-thee) that affects nerves that help you move and feel. Some of the things that can happen to you if you have neuropathy are:
Some of these symptoms go away after a few weeks. Others might last longer before getting better. Tell your doctor if you have any of these symptoms. If they are severe, the doctor may wish to lower the dose of chemo.
Tips for Coping With Neuropathy
Here are things you can do to deal with these side effects:
Many people fear that chemo will cause nausea (feeling sick to your stomach) and vomiting (throwing up). These do happen. But with current treatments, they are less common than before. They are also less severe. If they happen to you, your doctor can give you 1 or more medicines to help. Your doctor might also give you medicine before your chemo to prevent nausea. Call your doctor right away if you can’t keep fluids down, or if you also have diarrhea.
TIP: Try to distract yourself by listening to music, or doing something else that relaxes you.
Tips for Coping With Nausea and Vomiting
There are many steps you can take to prevent or ease this problem:
Eating and Drinking
General
Treatment can cause your mouth, gums, and throat to become dry and irritated. You may also get sores in your mouth or throat. This is called mucositis (mew-koh-SY-tis). Germs that live in the mouth can infect the sores. Make sure you tell your doctor or nurse about soreness or dryness in your mouth or throat.
Sucking on ice chips just before and during each chemo treatment might help prevent this problem.
TIP: Ask your doctor if you need to see a dentist before you start treatment.
Dental Health
Mouth Sores
Dry Mouth
If your mouth becomes dry, you should:
Neutropenia (new-troe-PEE-nee-ah) is also called low white blood cell count. Since white blood cells fight infection, a low count raises the risk of getting one.
If you get an infection, your doctor will want to treat it right away. Here are some signs you should know about. If you notice any of these, let your doctor or nurse know at once—even at night or on weekends.
Danger signs to report:
Tips for Preventing Infection
Here are some tips to lower your risk of infection during treatment. Be sure to:
Avoid Germs
Avoid Cuts, Scrapes, and Burns
General
Treatment can lower the number of platelets (PLATE-lets) in your blood. These are cells that help form clots and stop bleeding. When you have too few, you bruise or bleed easily.
Your doctor will test your blood often and treat you if needed. Here are some signs that might mean your platelet count is low. Call your doctor if you notice any of these:
Follow this advice if your doctor tells you that your platelet count is low. This will help prevent bleeding problems.
When you have too few red blood cells, you have anemia. It can cause these symptoms:
Tell your doctor if you have any of these. The doctor can give you a treatment to raise your red blood cell count.
Fatigue is a common complaint of people who are treated for cancer. Many people feel a deep tiredness that doesn’t always get better with rest. If it happens to you, here are some hints on how to deal with it:
Make sure you:
Don’t feel guilty if work isn’t finished. Your most important job during treatment is getting well.
Chemo drugs can cause your hands and feet to become red and sore. The skin might also crack and peel.
If this happens to you, ask your doctor or nurse about creams to help heal your skin. Also, don’t wash dishes or use household cleansers. These might irritate your skin. Tell your doctor if sores develop on your skin.
Sometimes, treatment can affect your sex organs and sex drive. If you are a man, you might not be able to father a child. You probably will still be able to have sex, but you might lose some of your sex drive. If you are a woman, you might not be able to have children, or your periods might not be regular. Your periods may stop. You might also start having hot flashes and vaginal dryness. Intercourse might be painful. You may lose interest in sex.
Talk to your doctor about how treatment might affect your sex organs and your sex life. If any changes do occur, your doctor or nurse will help you cope with them.
Some medicines can cause you to be constipated. You may also have this problem because you are less active than before, or because of changes in what you eat. Some pain medications can cause constipation.
If you don’t have a bowel movement for 1 or 2 days, let your doctor or nurse know about it. Do not take any drugs or laxatives without your doctor’s OK. This includes drugs you can buy over the counter.
Call your doctor right away if you have constipation plus vomiting or painful cramps.
These simple tips can help prevent and ease constipation.
You should:
| – Bran |
– Whole-wheat breads and cereals |
| – Vegetables |
– Fruits |
Hair loss is called alopecia (al-oh-PEE-shee-ah). Some cancer drugs cause people to lose some or all of their hair. Others do not. It depends on the person and on the treatment you receive. Your doctor will tell you if your treatment is likely to cause hair loss. Complete hair loss is not common in people treated for colorectal cancer. Radiation can also cause hair to fall out, but only near the area that’s treated.
To many people, hair loss is very upsetting. They see it as a sign of having cancer. But, it is not permanent. The hair you lose almost always grows back. Sometimes, it’s a different color than before. It might also be more or less curly than it was. But it comes back.
Here’s what the American Cancer Society recommends to help cope with it:
Some people who lose their hair wear wigs, scarves, turbans, or caps. If you think a wig will be right for you, it’s best to shop for it before you lose a lot of hair. This will make it easier to match the color and style to your own hair. Your insurance might cover the cost of a wig. Ask your doctor for a prescription.
Treatment might cause other side effects that have not been covered in this booklet. For example, some people might have lasting damage to the heart, lungs, kidneys, or other organs. Your doctor or nurse will let you know all of the risks of your treatment. If you have any questions, ask. So you don’t forget, use your journal to jot down your questions. Then take it with you to your appointments.
Always remember, if you have any questions about cancer, your treatment, and the possible effects of treatment, your doctor or nurse are your best sources of information.
This section talks about cancer pain. It will explain why some people with cancer have pain, how it’s treated, and what you should do if you have pain.
Above all, if you’re worried about having pain, always remember:
It’s usually because a tumor is pressing on a bone, nerve, or organ. It can also be caused by treatments you receive. Whether you have pain depends on where your cancer is, its stage, and your own tolerance for pain.
Only you know if you’re having pain and how strong it is. There’s no way for your doctor and nurse to know unless you tell them about it. If you have pain, you should speak up and tell them as much as you can:
There are many good treatments for pain. They are an important part of cancer care. You have a right to have your pain relieved, and you should insist on it. If your doctor can’t give you the relief you need, ask to see a pain specialist. These are just some of the benefits of pain relief:
Pain is treated with drugs and with nondrug treatments. (These include relaxation techniques.) What you receive depends on the type of pain you have. For many people, treatments are combined.
For mild to moderate pain. Your doctor may suggest these:
Even though you can buy these over the counter, always check with your doctor or nurse first.
Tylenol is a registered trademark of McNeil-PPC, Inc.
Advil and Nuprin are registered trademarks of Wyeth Consumer Healthcare.
For moderate to severe pain. Most doctors prescribe narcotics. These are also known as opioids (OH-pee-oyds):Some people are afraid to take these for pain. They think they may become “hooked.” This is rare in the treatment of cancer pain. Possible side effects are:
If you have any of these, tell your doctor or nurse.
Medicines used to treat depression or seizures may also be helpful for some kinds of cancer pain.
MS-Contin is a registered trademark of Purdue Frederick Company. Roxanol is a trademark of Elan Biopharmaceuticals. Duragesic is a registered trademark of Janssen Pharmaceutica Products, L.P. Dilaudid is a registered trademark of Abbott Laboratories. Percocet and Percodan are registered trademarks of Endo Pharma. OxyContin is a registered trademark of Purdue Pharma L.P.
Here are some questions to ask your doctor or nurse about cancer pain and its treatment:
Other ways to treat pain. Drugs are not the only treatments for cancer pain. Sometimes, RT or chemo can also help ease pain. This is because they can shrink the size of tumors. Also, doctors can try to numb painful nerves with injections.
Other ways to help relieve pain for some people are:
Learning that you have cancer is hard, and it can affect many areas of your life. It’s not unusual to feel anxious, depressed, afraid, angry, frustrated, alone, or helpless. This section contains advice to help you cope with these feelings.
When you find out you have cancer, you have feelings of shock, fear, and disbelief. You might not have felt at all sick before hearing the news. Now, you might feel as if your life has changed forever; as if you have no control over what’s happening to you.
You should keep in mind that most people with early colorectal cancer can be treated with success. Many lead long, productive lives. As you learn more about your cancer, and as you start treatment, you’ll feel more in control.
It’s natural to feel anxious and depressed. But these feelings can have a serious effect on you. Talk to your doctor, nurse, or social worker. They can offer advice and treatment.
It may help to talk about your feelings. This can be with a close friend, family member, religious leader, or others with whom you feel at ease. Talking with another person who has cancer can help, too. You’ll see listings of some support groups in the next section.
Some treatments can change the way you look and feel. Examples are hair loss, skin redness, and having a colostomy. These can affect self-image, self-esteem, and your interest in sex. You may find you feel depressed or anxious. How your partner reacts to these changes is also very important.
You should discuss these concerns with your partner. You might also discuss them with your doctor, nurse, or social worker. They may have helpful advice. If you have concerns that your doctor or nurse can’t help you solve, ask for the name of a counselor.
With support and clear communication, people with cancer can enjoy rich lives.
Many people with cancer continue working. For some, work provides a sense of purpose. People often have friends at work. If you decide to work, you may wish to adjust your role so you don’t get too tired or stressed.
You should not worry about losing your job because of your cancer. Laws forbid firing a person because of illness, as long as he or she can still do the job. One law is the Family and Medical Leave Act. This guarantees up to 12 weeks of unpaid leave a year to those who can’t work because of poor health.
If you are too ill to work, you might apply for disability benefits.
A social worker can help you solve this type of problem.
Many groups can provide helpful advice and support to you and your family. A good place to start looking is your local phone book. There you might find listings of health services that are nearby. You might also check with your doctor, nurse, and local hospital.
Here are some national groups that can be reached by telephone, mail, or on the Internet.
American Cancer Society (ACS)
1599 Clifton Road
Atlanta, GA 30329
800-ACS-2345 (800-227-2345)
404-320-3333
Web site: www.cancer.org
CancerCare
National Office
275 7th Avenue
New York, NY 10001
800-813-HOPE (800-813-4673)
Web site: www.cancercare.org
Cancer Hope Network
Two North Road
Chester, NY 07930
877-HOPE-NET (877-467-3638)
Web site: www.cancerhopenetwork.org
Cancer Research and Prevention Foundation
1600 Duke Street, Suite 500
Alexandria, VA 22314
800-227-2732
Web site: www.preventcancer.org
CancerSource
263 Summer Street
Boston, MA 02210-1506
Web site: www.cancersource.com
Colon Cancer Alliance
175 9th Avenue
New York, NY 10011
877-422-2030
Web site: www.ccalliance.org
Colorectal Cancer Network
PO Box 182
Kensington, MD 20895-0182
301-879-1500
Web site: www.colorectal-cancer.net
Harvard Center for Cancer Prevention
677 Huntington Avenue, Landmark 3 East
Boston, MA 02115
617-998-1034
Web site: www.yourcancerrisk.harvard.edu
National Cancer Institute (NCI)
Suite 3036A
6116 Executive Boulevard, MSC8322
Bethesda, MD 20892-8322
800-4-CANCER (800-422-6237)
Web sites: www.cancer.gov and http://cis.nci.nih.gov
National Coalition for Cancer Survivorship
1010 Wayne Avenue, Suite 770
Silver Spring, MD 20910
301-650-9127
301-565-9670
877-NCCS-YES (877-622-7937)
Web site: www.canceradvocacy.org
National Colorectal Cancer Research Alliance
Entertainment Industry Foundation
11132 Ventura Boulevard #401
Studio City, CA 91604
818-760-7722
800-872-3000
Web site: www.eifoundation.org/national/nccra/splash/index.html
National Comprehensive Cancer Network
500 Old York Road, Suite 250
Jenkintown, PA 19046
215-690-0300
215-690-0280
888-909-NCCN (888-909-6226)
Web site: www.nccn.com
United Ostomy Association
19772 MacArthur Boulevard #200
Irvine, CA 92612-2405
800-826-0826
949-660-8624
Web site: www.uoa.org
The Wellness Community
919 18th Street, NW, Suite 54
Washington, DC 20006
202-659-9709
888-793-WELL (888-793-9355)
Web site: www.thewellnesscommunity.org
Developed by Pfizer in partnership with the Colon Cancer Alliance.
SUU00237BE1 © 2009 Pfizer Inc. All rights reserved. Printed in USA/May 2009
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