Stubborn relative with colorectal cancer—please help!

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Hi! I'm new here and I was wondering if anyone could please recommend some resources in terms of dietary guidance for improving bowel cancer symptoms?

A close older relative has recently been diagnosed with colorectal cancer, but they need to have a few more tests before it can be staged and treated. At the moment, they're suffering from bowel incontinence, diarrhoea, blood in their stools, and feeling like they still need to poo after going to the bathroom. When the symptoms flare up, they have frequent accidents and it keeps them up at night because they feel like they have to constantly get up to go to the toilet. They're exhausted and completely miserable!

I've been keeping track of when their symptoms worsen, and it definitely coincides with them eating certain foods (the usual suspects: frozen microwave meals, desserts, sugary snacks, and takeout). They’ve been told by family members, their oncologist, and other medical professionals that they need to improve their diet in the lead up to any kind of treatment, but they won’t listen so the flare-ups are often. When I asked why they’re eating foods they’ve been told not to, they said it is “because it’s so good”. They've also expressed that they can't wait for treatment to be over so they can eat whatever they want, but they've already been told by the oncologist that continuing to eat better is a part of treatment and recovery. They live alone so there’s no one to keep an eye on them 24/7 to make sure they're eating well.

Their daughter (who lives across the country) stayed with them for a while so she could take them to their first meeting with the oncologist. She called them out for lying to the oncologist about their diet/smoking/exercising habits. She also cooked all their meals while she was there and got rid of most of the junk food—she found bags of Pez hidden down the side of the couch and in their car. My relative’s bowel habits improved a lot in those two weeks and they said that they were feeling so much better and happier. Their daughter had to go home for a few weeks, so she prepped lots of healthy meals to heat up during that time because my relative refuses to cook. I saw photos of the homemade food—it looks fantastic and there's lots of variety. It's all food my relative has had many times before and said they liked and wanted. The only difference was that the food was made without added salt, which didn't seem to be a problem since it still had lots of flavour.

Things have been going so well for a week and a half but my relative had another flare-up of symptoms the other day. They told me they had been eating healthily, but later admitted to having apple pie delivered and eating a slice without the crust. I also found out that they'd eaten leftovers their neighbour brought them (fried rice with pineapple and a spring roll from a local restaurant). I pointed out the correlation between the food and the flare-up (as I have done the previous times this has happened), but they don't believe that sugary, salty, greasy, and processed foods could have anything to do with it. Now they're acting like being encouraged to eat better is some form of punishment and they've said they'll continue to eat small slices of the pie. I just looked up the nutrition info of the pie and a portion (1/10 of it) contains 44% of their recommended daily sugar. Their "small" slice was at least 1/8, which I think contains roughly 55%. I’ll tell them about it, but I don’t think it’ll make much of a difference.

I've explained how the digestive system works and how food can affect bowel habits, but my relative continues to tell me that I must be wrong, and that these symptoms are solely caused by “this horrible disease” and they can't understand why the flare-ups keep happening. This isn't the only health issue they have—they've acted similarly over other things. Nothing anyone says seems to be getting through to them. I don’t know what to do any more and I don’t know why they’re acting like this. I know this must be terrifying for them, and I feel terrible but so frustrated at the same time! I just want them to be well! They live in another country and even though I call them every day (sometimes several times a day), there’s only so much I can do from here.

Has anyone had a relative who’s been through this before? Or has anyone been through something like this themselves? Are there any resources online that I could direct them to that will show them that what they’re eating is making things worse? Most of the things I’ve found online are in relation to preventing colon cancer, not managing the symptoms. I’ve also heard that some colorectal cancer patients are referred to a dietician, but is there any kind of therapy that they can be referred to as well (that deals with specifically with diet and health)?

I’m sorry for the long post. Any advice you could share would really be appreciated. Thank you!

Maite 29 days ago

Hi Buzzybee,

I understand fully your worry and fear and concern for your relative, especially as they are so far away and you feel so powerless to help. However, sad to say, I truly don't think you are going to get anywhere with this.

Your relative sounds very set in their ways. They have decided - consciously or subconsciously - that they enjoy the food in their life, and this is outweighing for them any possibility that they might become better or healthier. It's a bit like smokers: they know the risks they are taking, and they even buy those packs of ciggies with horrible photos on the box but they either don't even notice those photos, or they decide it doesn't apply to them, or else they decide that the risks outweigh the pleasure that they get from smoking.

In your relative's case, the risk has turned into a real situation of bad health, yet they are perhaps in denial, as it sounds like they are refusing to believe that their lifestyle can have caused their cancer. Maybe it strictly speaking hasn't caused it, but it's certainly not helping them manage the cancer and its effects. They are prepared to put up with all the distressing effects of their condition, because their love and enjoyment of their diet of UPFs trumps everything else, for them. To them, perversely, it seems a suitable price to pay to not have to give up the foods they enjoy. They may even have come to the conclusion that "it's too late now so I may as well enjoy life and enjoy eating what I want, as it won't prevent me getting ill now as I already am ill."

You see a lot of people coughing their heart out, or/and with severe COPD, yet still puffing away at their 20-a-day. I can only assume that apart from being addicted, this is perhaps their only real pleasure, as they see it, to offset their daily suffering from their coughing and their breathing problems.

If even your relative's daughter has put good nutritious food almost literally into their hands, and they still won't eat it, unfortunately there is little you can do. Your relative is their own person; you have tried your utmost and they cannot or will not take it on board. Therefore you are really putting yourself through a great deal of stress with little or no chance of any end result that will help your relative.

Many years ago, my dad had a stroke unexpectedly on the Isle of Wight whilst we were on holiday there. This set off a long, long journey of firstly trying to get him back to the mainland (much harder than you could imagine!) and then once he was back home - in a privately-rented first floor flat with no lift, that he had moved into a year before and loved - I expended immeasurable energy and phone calls, because it was evident that he could no longer get out of the flat due to his paralysis and would be totally reliant on others lifting him physically down the two flights of stairs to the outside. I lived 200 miles away, and couldn't get to him often due to having to hold down my job.

The end result was that he refused to move to a "more suitable" ground floor home, and continued to refuse. It took me a while to accept this, but when I did, I knew it was because of his fiercely independent personality (I take after him) and he knew the risks he was taking, insofar as he was alone in the flat and unstable when moving around, and was at the end of a call phone (he refused to have a button, and normally refused to even cart the phone around the flat with him all the time) and would likely never be able to go out again and socialise and enjoy sitting in the fresh air, under his own steam. My cousin by marriage, lived about ten miles away and would try and call in several times a week, and was the first contact on his phone, but she couldn't get him out physically. For nearly ten years the only time he ever saw the outside again was when he was taken to hospital by ambulance when he got an infection - which happened increasingly frequently over the years.

But my dad valued his right to make his own decisions, which he classed as maintaining his independence in the light of not being able to physically be fully independent. He valued his right to choose how he spent the remaining years of his life, even though his decision seemed illogical at first to me. I eventually realised and accepted, hard as this was as he was my dad, that if he fell in the flat - which he tended to do on a regular basis - and indeed if on any of these occasions he should lie there for many hours unable to get up - as indeed did happen a few times over the years - then I had to let him do it. He was totally compus mentis. He knew exactly the risks he was taking and he accepted those risks.

It's very, very hard to see someone you love, make a decision that could ultimately cost them their life, but at the end of the day it is their right to make that choice, just as we all have the right to live our life in the way we wish, if we possibly can.

I don't know if any of that helps. I can only say, I really do feel you have gone above and beyond in trying to help your relative, and it seems that they have made their own choice and alas, you probably need to row back now that your repeated attempts have still had no effect. Your guidance, and your relative's daughter's, are good. The oncologist's guidance is good. But your relative just doesn't want to know.

Continue to offer your support by way of the phone calls. Obviously don't condone the bad habits. Just continue to show that you care about them and love them, and would love them to be happy and healthy and comfortable if they can be. It may feel like you are being more of a passive support than an active one - but, just the fact that you are there is valuable to your loved one. I do understand the quandary, believe me - hence my lengthy example of my dad, above.

Sending you positive thoughts that you can cope with this situation; perhaps in time your relative will come to their own conclusion over the correlation between their diet and their symptoms, but this may take a while yet.

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