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Colorectal Cancer, Metastatic or Recurrent
Topic Overview
Is this topic for you?
This topic is about metastatic and recurrent colorectal cancer.
- If you want to learn more about early-stage colorectal cancer, see the topic Colorectal Cancer.
- If you want to learn more about anal cancer, see the topic Anal Cancer.
What is colorectal cancer?
Colorectal cancer happens when cells that are not normal grow in your colon or rectum. These cells grow together and form tumors. This cancer is also called colon cancer or rectal cancer, depending on where the cancer is.
Metastatic cancer is cancer that has spread to other parts of the body. When colon or rectal cancer spreads, it most often spreads to the liver. Sometimes it spreads to the lungs, bones, or other organs in the body.
Colon and rectal cancers often return months or years after treatment. This is called recurrent cancer. If the original cancer was removed before it was able to spread, the chances that it will return are lower.
What causes metastatic or recurrent colorectal cancer?
The exact cause is not known, but the cancer is more likely to spread or come back if it is in a later, more advanced stage when it is first discovered.
Sometimes cancer cells are too small to be found by tests. These cells may continue to grow and show up later as metastatic cancer, even years after being treated.
What are the symptoms?
Some people do not have any symptoms. When they do occur, the most common symptoms are:
- Belly pain, especially gas pains, cramps, or a feeling of fullness.
- Blood in your stool or very dark stools.
- A change in your bowel habits, such as more frequent stools, thinner stools, or a feeling that your bowels are not emptying completely.
- Loss of appetite.
- Losing weight without trying.
- Constant tiredness (fatigue).
If your cancer has spread, you may have other symptoms, depending on where the cancer is. If it has spread to:
- The lymph nodes of your belly, it may cause bloating, a swollen belly, loss of appetite, or a feeling of fullness.
- The liver, it may cause pain on the upper right side of your belly, bloating, loss of appetite, or a feeling of fullness.
- The lungs, it may cause you to cough, spit up blood, or have a hard time breathing.
- The bones, it may cause bone pain, especially in your back, hips, and pelvis.
- The brain, it may cause problems with memory, concentration, balance, or movement.
How is metastatic or recurrent colorectal cancer diagnosed?
Colon or rectal cancer that has spread or returned is diagnosed using a physical exam and several tests, including blood tests, chest X-rays, bone scans, ultrasounds, and CT, PET, or MRI scans.
The diagnosis is usually confirmed with a biopsy. During this test, your doctor will take tissue samples from any areas that don't look normal. The tissue will be looked at under a microscope to see if it contains cancer.
If you have been treated for colon or rectal cancer in the past, it's important to have regular checkups to find any new cancer as soon as possible.
How is it treated?
Colon and rectal cancers that have spread or returned may be cured in rare cases. Treatment may include surgery, radiation, and chemotherapy. When the cancer cannot be cured, treatment can help you feel better and live longer.
Learning that you have cancer that has spread or come back can be very hard. Some people find that it helps to talk about their feelings with their family and friends. You may also want to talk with your doctor or with other people who have had this kind of cancer. Your local American Cancer Society chapter can help you find a support group.
Frequently Asked Questions
Learning about metastatic and recurrent colorectal cancer:
Being diagnosed:
Getting treatment:
Ongoing concerns:
End-of-life issues:
Health Tools
Health Tools help you make wise health decisions or take action to improve your health.
|Actionsets are designed to help people take an active role in managing a health condition.
|Bowel Disease: Caring for Your Ostomy
|Cancer: Controlling Nausea and Vomiting From Chemotherapy
|Fitness: Adding More Activity to Your Life
The exact cause of colorectal cancer is not known. Most cases begin as small growths, or polyps, inside the intestine.
If colorectal cancer is not detected and removed, it invades and destroys nearby tissues and may spread to other parts of the body. Even after treatment that seems successful, colorectal cancer may spread or come back.
Sometimes cancer cells are too small to be found by tests. These cells may continue to grow and show up later as metastatic cancer, even years after being treated.
Some people who have metastatic or recurrent colorectal cancer do not have any symptoms for some time. When symptoms do appear, the most common ones are:
- A change in bowel habits, such as narrow stools or frequent diarrhea or constipation.
- Blood in the stool, or stools that look like black tar.
- Loss of appetite.
- Pain in the belly.
- Unexplained weight loss.
- Constant tiredness (fatigue).
If your cancer has spread, you may have other symptoms, depending on where the cancer is. If it has spread to:
- The lymph nodes of your abdomen, it may cause bloating, a swollen belly, loss of appetite, or a feeling of fullness.
- The liver, it may cause pain on the upper right side of your abdomen, bloating, loss of appetite, or a feeling of fullness.
- The lungs, it may cause coughing, spitting up blood, or a hard time breathing.
- The bones, it may cause bone pain, especially in the back, hips, and pelvis.
- The brain, it may cause problems with memory, concentration, balance, or movement.
What Happens
Cancer is the growth of abnormal cells in the body. These extra cells grow together and form masses, lumps, or tumors. In colorectal cancer, these growths usually start as harmless (benign) polyps in the large intestine (colon or rectum). Colon polyps are common and most do not cause problems. But if polyps are not detected and removed, some of them can turn into cancer.
If the cancer is allowed to continue growing, it eventually will invade and destroy nearby tissues and then spread farther.
- Colon cancer often spreads first to nearby lymph nodes. From there it may spread to other parts of the body, usually to the liver. It may also spread to the lungs, bones, or other organs in the body.
- Rectal cancer may spread directly to the lungs, bypassing the liver.
Metastatic or recurrent colorectal cancer occurs when cancer cells travel, through either the bloodstream or the lymph system, to other parts of the body and continue to grow in their new location. Recurrent colorectal cancer occurs when the cancer begins to grow again months or years after treatment.
How colorectal cancer will affect your life span depends on the stage of your cancer. A cancer's stage depends on how far it has spread.
The 5-year survival rate for people with colorectal cancer that has spread to nearby organs or lymph nodes is 68%.1 This means that 68 out of 100 people are still alive 5 years or longer after their cancer was discovered. For people who have colorectal cancer that has spread farther away to other parts of their bodies, the rate is 11%. This means that 11 out of 100 people are still alive 5 years or longer after their cancer was discovered.
These numbers are taken from reports that were done at least 5 years ago, before newer treatments were available. So the actual chances of your survival are likely to be higher than these numbers.
What Increases Your Risk
Even after treatment that seems successful, colorectal cancer comes back (recurs) about half the time.2 But this depends on the stage of the cancer before treatment. For example, if colorectal cancer is removed while it is still contained within the colon and has not spread, your risk of developing metastatic or recurrent colorectal cancer is less.
When To Call a Doctor
Some people who have metastatic or recurrent colorectal cancer do not have any symptoms for some time. Colorectal cancer may be discovered before symptoms appear, either on X-rays or other lab tests.
You may be seeing a doctor regularly to check for symptoms, but symptoms might start between visits. Be aware of what is normal for you, and tell your doctor about any changes right away. Be sure to let your doctor know if you feel even very small changes.
What symptoms you may have will depend on which part of your body is affected by the cancer. Call your doctor if you have any of these symptoms:
- A change in bowel habits, such as bleeding from your rectum, bright red or dark blood in your stools, frequent diarrhea, constipation, a feeling that your bowel is not emptying completely, or stools that are narrow (may be no wider than a pencil)
- Pain in your belly
- Bloating or loss of appetite
- Unexplained weight loss
- Constant tiredness (fatigue)
- Cough
- Difficulty breathing or shortness of breath
- Bone pain
Watchful Waiting
Watchful waiting is a period of time during which you and your doctor observe your symptoms or condition without giving treatment to cure your cancer. Watchful waiting may be an option if treatment may cause more harm than good and cannot cure your cancer. Remember, though, that watchful waiting does not mean your doctor won't treat your symptoms, such as pain.
Who To See
If you have been treated for colorectal cancer, doctors who can evaluate any new symptoms include:
- Gastroenterologist.
- Internist.
- Family medicine doctor.
- Colon and rectal surgeon.
- Medical oncologist.
- Radiation oncologist.
To prepare for your appointment, see the topic Making the Most of Your Appointment.
Exams and Tests
Tests to help your doctor see if colorectal cancer has spread or come back include:
- An abdominal ultrasound to find the cause of pain or swelling in your abdomen.
- A colonoscopy to see if cancer has returned to your intestine.
- Blood tests to find out if cancer has returned (CEA) or to find the cause of symptoms such as weakness, fatigue, fever, bruising, or weight loss (complete blood count and blood profile).
- A chest X-ray to find the cause of symptoms such as persistent coughing, coughing up blood, chest pain, or difficult breathing.
- A computed tomography (CT) scan, magnetic resonance imaging (MRI), or positron emission tomography (PET) scan to see if colorectal cancer has spread into the chest or organs in the abdomen or pelvis.
- A brain CT scan or MRI to look into symptoms such as confusion, paralysis, numbness, vision problems, vertigo, or headaches.
- A biopsy, such as a liver biopsy or a lung biopsy, to find out where the cancer cells have spread.
- A bone scan to find out whether cancer cells have spread to the bones.
What to think about
Colorectal cancer often comes back, even after treatment that seemed successful. If you had colorectal cancer in the past, pay close attention to your body and see your doctor regularly. Tell your doctor about any changes, such as decreased appetite, bloating, or an increase in the size of your belly.
Your cancer may return even if you do everything you can to prevent it. If this happens, focus on what you and your doctor can do to treat your symptoms to help you feel better and live longer.
Treatment Overview
Your treatment for metastatic or recurrent colorectal cancer will depend on specific information about the cancer, your preferences, and your health.
Some cases of metastatic or recurrent colorectal cancer can still be cured. When it cannot be cured, treatment can help you feel better and live longer.
Your treatment may include:
- Surgery. If your cancer has come back in your intestine, surgery may be used to remove it. If it has spread to other parts of the body, it can sometimes be treated surgically. Cancer that has spread to the liver is sometimes successfully removed with surgery. For more information, see the Surgery section of this topic.
- Medicines. The use of medicines, either swallowed or injected with a needle, to treat cancer is called chemotherapy. Medicines can help you live longer by killing cancer cells that have spread to other parts of your body. They also can relieve pain caused by the cancer. For more information, see the Medications section of this topic.
- Radiation therapy. X-rays can be used to shrink colorectal tumors that may be causing blockages. They can also reduce bleeding or pain. For more information, see the Other Treatment section of this topic.
- Clinical trials. Clinical trials are studies of new or different ways to treat cancer.
- Home treatment. There are things you can do at home to manage the side effects caused by cancer and its treatments. For more information, see the Home Treatment section of this topic.
Palliative care
As your cancer gets worse, you may want to think about palliative care. Palliative care is a kind of care for people who have serious illnesses. It is different than care to cure your illness, called curative treatment. Palliative care focuses on improving your quality of life—not just in your body but also in your mind and spirit.
Palliative care may help you manage symptoms or side effects from treatment. It could also help you cope with your feelings about living with a long-term or terminal illness, make future plans around your medical care, or help your family better understand your illness and how to support you.
If you are interested in palliative care, talk to your doctor. He or she may be able to manage your care or refer you to a doctor who specializes in this type of care.
For more information, see the topic Palliative Care.
End-of-life issues
There may come a time when treatments to cure your cancer are no longer working. Or you may decide that you want to spend the time you have left in other ways and only have medical care that keeps you comfortable. If so, talk to your doctor about hospice care.
Hospice care is palliative care for people who are at the end of life, with about 6 months or less to live. Hospice caregivers are concerned with enhancing the quality of your remaining life by keeping you as alert and comfortable as possible in a familiar environment with family and friends. Hospice programs offer services in your own home or in a hospice center, nursing home, or hospital.
You may wish to discuss health care and other legal issues that arise near the end of life with your family and your doctor. You may find it helpful and comforting to state your health care choices in writing (with an advance directive or living will) while you are still able to make and communicate these decisions. Think about your treatment options and which kind of treatment will be best for you. You may wish to choose a health care agent in case you become unable to speak for yourself.
Learning all you can about end-of-life issues may help you feel better. For more information, see one of the following topics:
There is no sure way to prevent colorectal cancer from returning or showing up in other parts of your body. After you have had it, your risk of having it again increases. When it comes back, it is called metastatic or recurrent colorectal cancer. It often comes back after surgery, especially if it was not discovered when it was in an early stage.2
But there are lifestyle changes that can help you after treatment. Research shows that these things may help:3
- Quitting smoking, if you smoke
- Keeping a healthy body mass index (BMI)
- Being physically active with regular exercise
- Eating more whole grains, fruits, vegetables, poultry, and fish
- Eating less red meat, refined grains, and sweets
Initial treatment for colorectal cancer is followed by regular doctor visits and screening to help catch the cancer if it returns.
The frequency of your follow-up visits and how often you have more tests will depend on your general health and the type of colorectal cancer you had. As part of your follow-up visits, you may have:
- Physical exams. In general, you will see a doctor every 3 to 6 months for several years, and then less often after that.
- Colonoscopy to look at the inside of your intestine for new problems.
- Carcinoembryonic antigen (CEA) blood test to check whether colorectal cancer has returned.
- Chest X-rays to find out whether cancer has returned to involve your lungs.
- Lab tests, such as a complete blood count and chemistry screen, to look for evidence of cancer.
- A computed tomography (CT) scan or magnetic resonance imaging (MRI) to look inside your body.
- A positron emission tomography (PET) scan to look for and check any signs of cancer.
Home Treatment
Home treatment may be all that is needed to help manage the side effects that often accompany metastatic or recurrent colon cancer or its treatment. Healthy habits such as eating a balanced diet and getting enough sleep and exercise may help control your symptoms. Be sure to follow any instructions your doctor has given you.
- Home treatment for nausea or vomiting includes watching for and treating early signs of dehydration, such as a dry mouth, sticky saliva, having smaller than usual amounts of urine, or having urine that is dark yellow. Your doctor also may prescribe medicines to control nausea and vomiting. For more information on how to deal with these side effects, see:
- Home treatment for pain can range from cold packs and over-the-counter medicines to massage and meditation. For more information, see the topic Cancer Pain.
- Home treatment for diarrhea includes resting your stomach by not eating for several hours or until you feel better, and watching for signs of dehydration. Check with your doctor before using any medicines for your diarrhea.
- Home treatment for constipation includes getting gentle exercise, drinking plenty of fluids, and eating lots of fruits, vegetables, and foods that contain fiber. Check with your doctor before using a laxative.
- Treatment for fatigue includes getting extra rest while you are having chemotherapy or radiation therapy. Let your symptoms be your guide. You may be able to keep your usual routine and just get some extra sleep. Fatigue is often worse at the end of treatment or just after treatment is over. If you find you have trouble sleeping, some tips to relieve sleep problems may be helpful.
Managing stress
Learning that you have colorectal cancer and being treated for it can be very stressful. There are steps you can take to reduce your stress. You may want to talk with family or friends. Some people find that spending time alone is what they need.
If your emotions interfere with your ability to make decisions, it is important to talk to your doctor about them. Your cancer treatment center may offer counseling services, support groups, and classes such as yoga.
Your feelings about your body may change after treatment. Dealing with your body image may involve talking openly about your worries with your partner and discussing your feelings with a doctor.
Contact your local chapter of the American Cancer Society to find a support group. Talking with other people who have had similar experiences can be very helpful.
Chemotherapy is the use of medicines to control cancer's growth or relieve symptoms. The medicines may be given through a needle in your vein, as pills you can swallow, or as a shot (injection).
For colorectal cancer that has spread to the liver, researchers are studying hepatic intra-arterial chemotherapy. This delivers medicines directly to the liver.
Several medicines are used to treat metastatic or recurrent colorectal cancer. Other medicines are also available to treat side effects, such as nausea.
Medication Choices
The most commonly used medicines for the treatment of colorectal cancer are:
- Bevacizumab (Avastin).
- Capecitabine (Xeloda).
- Fluorouracil (5-FU).
- Irinotecan (Camptosar).
- Leucovorin (Fusilev).
- Oxaliplatin (Eloxatin).
Cancer medicines are often used in combination. For example, a treatment called FOLFOX4 uses oxaliplatin, leucovorin, and fluorouracil, while the treatment called FOLFIRI uses folic acid, fluorouracil, and irinotecan. There are several of these specific combinations.
Cetuximab (Erbitux) and panitumumab (Vectibix) may be used for colorectal cancer that has spread and has not improved during or after treatment with other drugs. These kinds of medicines, called monoclonal antibodies, may not work for some people. So before you have this treatment, your tumor tissue will be checked for certain gene changes (mutations).
Your doctor may prescribe medicines to control nausea and vomiting. These medicines include:
- Aprepitant (Emend), which is used in combination with other medicines to prevent nausea and vomiting.
- Metoclopramide (Reglan).
- Phenothiazines, such as promethazine and prochlorperazine.
- Serotonin antagonists, such as ondansetron (Zofran), granisetron (Kytril), or dolasetron (Anzemet). These medicines prevent nausea and vomiting caused by chemotherapy more effectively when they are combined with corticosteroids, such as dexamethasone.
Clinical trials that test new drugs are ongoing. Talk with your doctor about participating in a clinical trial.
What To Think About
Medicines may not cure metastatic or recurrent colorectal cancer. But they can help you feel better and live longer by slowing the cancer's growth.
Talk to your doctor about medicines to help you manage pain and other symptoms that may accompany cancer. For more information, see the topic Cancer Pain.
Surgery to remove cancer may be used to treat metastatic or recurrent colorectal cancer. The type of surgery chosen depends upon the stage of the cancer. Surgery may be used to remove cancer that is in the colon or rectum. Or surgery may be done to remove cancer that has spread to other organs in the body.
Surgery Choices
Surgical options include:
- Bowel resection. This operation involves cutting into the abdomen to reach the area of the colon or rectum that is affected by the cancer. The surgeon cuts out the cancer as well as the parts of the colon or rectum that are next to it. Then the two healthy ends of the colon or rectum are sewn back together.
- Liver resection. In this operation the surgeon cuts out cancer that has spread to the liver and also cuts out parts of the liver that are next to the cancer. Up to half of your liver can be removed as long as the rest is healthy. If the cancer in your liver is too large to remove with surgery, you may be given chemotherapy to shrink the tumor. If the tumor becomes small enough, it can be removed with surgery.
- Lung, adrenal, or ovarian resection, depending on where the cancer has spread and whether you are a good candidate for this surgery.
If cancer that has returned to your intestine is large, more of your colon or rectum may have to be removed. The ends of your colon or rectum are rejoined during surgery. If they can't be rejoined, you may need a colostomy. Most people do not need a permanent colostomy.
For more information, see:
When cancer has spread to other parts of the body, the kind of surgery you will need depends on where the cancer is and how big the tumor is. Sometimes surgery is used not to cure your cancer but to make your life more comfortable. If a tumor is blocking your colon, for example, the surgeon may remove it to allow your intestine to work normally. If advanced cancer is blocking your rectum, your doctor may place an expandable tube, called a stent, in the rectum to unblock it.
What To Think About
Surgery does not usually cure metastatic or recurrent colorectal cancer. But it may relieve pain and discomfort, slow the spread of the disease, and help you live longer.
Other Treatment
Radiation treatment
Radiation therapy uses X-rays to destroy colorectal cancer cells. It is often combined with surgery or chemotherapy. Radiation therapy may also be used to reduce the cancer's size when it is blocking the colon or rectum or to relieve pain from cancer that has spread to other organs.
Radiation treatments are not likely to cure metastatic or recurrent colorectal cancer. But they may ease pain and discomfort, slow the spread of the disease, and help you live longer.
Treatment for cancer that has spread to the liver
Sometimes colorectal cancer that has spread to the liver can be removed by surgery. But usually other treatments are needed, such as:
- Radiofrequency ablation. A small wire that emits radio waves is inserted into the tumor. The radio waves destroy the cancer that has spread to the liver without harming healthy tissue.
- Cryosurgery. This may be done in surgery for cancer that has spread to the liver. Liquid nitrogen is used to freeze and destroy cancer cells.
- Embolization. Tumor embolization shrinks a cancer that has spread to the liver by cutting off its blood supply.
- Interstitial radiation therapy. In this type of internal radiation therapy, radioactive material sealed in needles, wires, seeds, or catheters is placed directly into the tumor or body tissue.
- Intra-arterial hepatic chemotherapy. The surgeon implants a small pump in the belly that delivers chemotherapy right into the tumor. The pump can be left in place as long as needed.
Complementary therapies
People sometimes use complementary therapies along with medical treatment to help relieve symptoms and side effects of cancer treatments. Some of the complementary therapies that may be helpful include:
- Acupuncture to relieve pain.
- Meditation or yoga to relieve stress.
- Massage and biofeedback to reduce pain and ease tension.
- Breathing exercises for relaxation.
Mind-body treatments like those mentioned above may help you feel better. They can make it easier to cope with cancer treatments. They also may reduce chronic low back pain, joint pain, headaches, and pain from treatments.
Before you try a complementary therapy, talk to your doctor about the possible value and potential side effects. Let your doctor know if you are already using any such therapies. Complementary therapies are not meant to take the place of standard medical treatment. But they may improve your quality of life and help you deal with the stress and side effects of cancer treatment.
What to think about
Clinical trials are studies designed to find better ways to treat people and are based on the most up-to-date information. There are a number of clinical trials involving the treatment for metastatic or advanced colorectal cancer. If you match the guidelines, you may be able to enroll in one. If you are interested, ask your doctor whether there are trials in which you can participate. The National Cancer Institute or your local chapter of the American Cancer Society can also help you find clinical trials.
Other Places To Get Help
|American College of Gastroenterology
|P.O. Box 342260
|Bethesda, MD 20827-2260
|(301) 263-9000
|Web Address:
The American College of Gastroenterology is an organization of digestive disease specialists. The Web site contains information about common gastrointestinal problems.
|American Cancer Society (ACS)
|1-866-228-4327 toll-free
|Web Address:
The American Cancer Society (ACS) conducts educational programs and offers many services to people with cancer and to their families. Staff at the toll-free numbers have information about services and activities in local areas and can provide referrals to local ACS divisions.
|American Society of Colon and Rectal Surgeons
|85 West Algonquin Road
|Suite 550
|Arlington Heights, IL 60005
|(847) 290-9184
|(847) 290-9203
|Web Address:
The American Society of Colon and Rectal Surgeons is the leading professional society representing more than 1,000 board-certified colon and rectal surgeons and other surgeons dedicated to treating people with diseases and disorders affecting the colon, rectum, and anus.
(571) 483-1300
|(571) 366-9537
|Web Address:
Cancer.Net is the information website of the American Society of Clinical Oncology (ASCO) for people living with cancer and for those who care for them. ASCO is the world's leading professional organization representing physicians of all oncology subspecialties. Cancer.Net provides current oncologist-approved information on living with cancer.
|National Cancer Institute (NCI)
|6116 Executive Boulevard
|Suite 300
|Bethesda, MD 20892-8322
|Web Address:
|www.cancer.gov (or https://cissecure.nci.nih.gov/livehelp/welcome.asp# for live help online)
The National Cancer Institute (NCI) is a U.S. government agency that provides up-to-date information about the prevention, detection, and treatment of cancer. NCI also offers supportive care to people who have cancer and to their families. NCI information is also available to doctors, nurses, and other health professionals. NCI provides the latest information about clinical trials. The Cancer Information Service, a service of NCI, has trained staff members available to answer questions and send free publications. Spanish-speaking staff members are also available.
|National Institutes of Health: Health Information
|9000 Rockville Pike
|Bethesda, MD 20892
|(301) 496-4000
|(301) 402-9612
|Web Address:
The U.S. National Institutes of Health (NIH) conducts and supports medical research to improve people's health and save lives. NIH provides access to health and wellness information, free newsletters, current research, health databases, fact sheets, and many other resources.
Related Information
- American Cancer Society (2009). Cancer Facts and Figures 2009. Atlanta: American Cancer Society. Available online: http://www.cancer.org/acs/groups/content/@nho/documents/document/500809webpdf.pdf.
- Lewis C (2007). Colorectal cancer screening, search date November 2006. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
- National Comprehensive Cancer Network (2010). Colon cancer. NCCN Clinical Practice Guidelines in Oncology, version 2. Available online: http://www.nccn.org/professionals/physician_gls/f_guidelines.asp#site.
Other Works Consulted
- Levin B (2006). Colorectal cancer. In DC Dale, DD Federman, eds., ACP Medicine, section 12, chap. 5. New York: WebMD.
- Libutti SK, et al. (2008). Rectal cancer. In VT DeVita Jr et al., eds., DeVita, Hellman, and Rosenberg's Cancer: Principles and Practice of Oncology, 8th ed., vol. 1, pp. 1285–1301. Philadelphia: Lippincott Williams and Wilkins.
|Healthwise Staff
|Primary Medical Reviewer
|Kathleen Romito, MD - Family Medicine
|Specialist Medical Reviewer
|Arvydas D. Vanagunas, MD - Gastroenterology
|Last Revised
|September 13, 2010
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Last Revised: September 13, 2010
Author: Healthwise Staff
Medical Review: Kathleen Romito, MD - Family Medicine & Arvydas D. Vanagunas, MD - Gastroenterology
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Q: How much money is available?
A: NYSERDA will invest over $100 million through 2011 for studies and installations at Manufacturing and Data Center facilities who pay the System Benefits Charge (SBC).
Q: How much money is available per facility?
A: NYSERDA will invest up to $5 million per facility per year. Incentives are paid based on annualized energy savings and are currently capped at 50% of project cost.
Q: Is there a due date I need to respond to?
A: No. The incentives are provided on a first-come, first-served basis. Current funding will last through 2011.
Q: I've heard that the Investor-Owned Utilities (IOUs) offer programs. Is NYSERDA working with the gas and electric Transmission and Distribution (T&D) utilities?
A: NYSERDA is working with the IOUs on customer meetings, coordination of program offerings, and to ensure the best energy services possible are available to the State's SBC paying customers.
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Q: How are the incentives calculated?
A: Incentives are paid based on one full year of energy savings. For productivity improvements the energy savings will be calculated by determining energy use per unit of production or workload before and after the improvement, and multiplying the difference by the new output.
Q: When are the incentives paid?
A: NYSERDA will pay a minimum of 60% of the incentive when installation is complete. Progress payments also are available on this installation payment for costs incurred to support installation (design, equipment purchase, etc.).
The remaining 40% of the incentive generally is paid when the project's electricity savings have been measured and verified (M&V). M&V periods are generally one to two years. However, if you or your management is concerned about cash flow, NYSERDA will work with you to accelerate performance payments.
Q: Are incentives available for electric efficiency projects?
A: Yes. NYSERDA has approximately $93 million in electric efficiency funding for manufacturers and data centers. NYSERDA will pay $0.12/kWh upstate and $0.16/kWh in Con Edison territory..
Q: Are incentives available for natural gas efficiency projects?
A: Yes. NYSERDA has approximately $10 million in natural gas efficiency funding for manufacturers and data centers throughout New York State. NYSERDA will pay $15/MMBTU upstate and $20/MMBTU in the Con Edison, KEDNY and KEDLI territories.
Q: Are operational and maintenance incentives available?
A: Yes. Incentives are available for process improvements based on operational changes. Incentives are $.05/kWh and $6/mmBTU up to 50% of the project cost to implement the operational improvement. Eligible measures can include, but are not limited to:
Q: Are pre-qualified incentives available?
A: Yes. However, performance-based incentives are far more lucrative. The pre-qualified incentives only should be used for unplanned, one-off equipment replacements. Projects that require planning, design, or that are system or process based should be submitted through the performance-based Industrial and Process Efficiency module of the program.
Q: Are there incentives available for non-manufacturing companies?
A: Yes, NYSERDA has incentives for commercial customers as well. Performance-based electrical incentives are available for Lighting, Motors, Commercial Kitchens, VFD, HVAC, and other projects that reduce electrical use. Download the application.
Q: How do I get started?
A: Send an email to email@example.com. Call the Manufacturing (585-232-5610 ext. 290) or Data Centers (212-785-0292). A representative will then contact you to discuss your needs, schedule a meeting with your team and assist with the application process.
Q: Will my incentives be reduced if I only pay SBC on a portion of my bill?
A: Yes. Incentives are pro-rated for customers who pay SBC on less than 50% of their usage.
Q: Does the program require me to share information about the project with others?
A: No. Although that is generally a requirement of NYSERDA's R&D programs, the goal of this program is to pay for energy savings. NYSERDA will develop case studies of successful projects and leaders in manufacturing and data center energy productivity. However, participation in case studies, awards, or press events is completely voluntary, and any materials published or used by NYSERDA will be reviewed by you before they are used.
Q: Does my project need to be innovative?
A: No. This program is for custom, site, and process-specific solutions that used commercially available systems and technologies..
Q: Why should you participate?
A: This is your money at work. It is the goal of NYSERDA's IPE team to return in energy-efficiency improvements as much of your SBC contribution as possible..
Q: Is my facility eligible to participate in NYSERDA programs?
A: To qualify for participation in NYSERDA programs you must be a customer of one of the following utilities and pay into the SBC.
NYSERDA offers capital incentives amd sets incentive caps across all of New York State. These incentives exist for utility (gas & electric) companies. This table will help you determine whether you're eligible for them.
Q: What projects are eligible?
A: Generally, projects that save electricity are eligible; however, NYSERDA's focus is on projects that improve manufacturing process productivity. For example, projects that increase throughput, reduce scrap, and improve productivity all have an energy component and may be eligible for a NYSERDA incentive. NYSERDA also provides incentives for improvements to support system efficiency for motors, VFDs, process cooling, and compressed air.
Q: Are projects that result in an increase in overall electricity consumption eligible?
A: Yes. One of the goals of this program is to invest in smart, energy-efficient manufacturing growth in New York. To accomplish this, NYSERDA incentives are based on improvements in electricity use per unit of production.
Q: What baseline is used to determine energy savings and incentives?
A: Industrial and data center operations are complex systems and there are no codes or standards that govern how they are to be run. This means that no two projects will be exactly the same and we can not use a standard baseline to compare all projects. To accommodate this, the IPE incentive is a custom measure program and NYSERDA's staff and consulting team will work with the customer to establish an appropriate baseline for each project.
A manufacturing company in central New York was considering adding a new piece of production equipment when they contacted NYSERDA. They currently had two machines and they needed additional capacity. The company had a strategy to purchase a new piece of equipment that ran at a higher rate, rather than buying more of the equipment they had already. In addition to making more pieces per hour, the new machine produced a vacuum more efficiently than the existing equipment. As an additional benefit, the company was able to downsize their air compressor and save an additional 135,200 kWh/year. The NYSERDA Industrial & Process Efficiency incentive for this company is $55,340 of the $262,000 project cost.
A materials process plant in upstate New York was looking for energy and operations cost reductions. Through a FlexTech study it analyzed a savings opportunity for a large bag house with two large fans that runs 24 hours a day seven days a week. The process it supports runs periodically. The study identified that by adding a variable speed drive to each of the fans, the company can save 2,469,300 kWh/year and with a potential NYSERDA IPE incentive of $296,316, the payback for this project goes from 2.7 years to 1.2 years.
The work load type for the project is high performance computing (HPC) in a scientific research setting. The customer has developed a plan to replace existing HPC servers with new high efficiency models that will increase computing capacity, within the same physical data center space. The operations measures computing performance in FLOPS (Floating Operations per Second). The energy consumption of the data center remains the same, however the amount of computing work increases, thereby improving the efficiency of kWh required per FLOP. See the project summary table below:
The customer has established an energy and operational cost reduction strategy. Through the FlexTech program, an engineering study evaluated options for cooling, disk storage upgrades, server harvesting/elimination, and server virtualization. The recommendations from the study were implemented, resulting in a demand reduction of 262 kW and annual consumption reduction of 2,131,389 kWh. See the project summary table below:
Q: Is an engineering study required?
A: Yes. Incentives are based on a site/process specific engineering analysis. However, NYSERDA's Technical Reviewers are available to assist with the required engineering analysis at no cost to the customer.
Q: Will NYSERDA pay for Measurement and Verification?
A: Yes. NYSERDA will use metering and other M&V tools at the Applicant's facility. In addition to the installation incentives described above, any incremental M&V costs will be performed by NYSERDA's technical reviewer at no additional cost to the applicant.
Q: Can NYSERDA help identify or determine the technical and economic feasibility of potential projects?
A: Yes. Through its FlexTech program, NYSERDA can help identify and determine the feasibility of potential projects. Engineering feasibility studies are performed on a cost-shared (50/50) basis using one of NYSERDA's pre-qualified consultants or an independent approved consultant of your choice. A primary goal of the feasibility study is to develop the objective analysis required to support the approval of the project by the customer's management.
Q: Is there an extensive proposal or application required?
A: No. To get started, all you need to do is submit a brief application.
Q: Do customers have to apply through a third party?
A: Industrial customers can apply to the program and receive incentives directly from NYSERDA or use a third party if desired.
Q: How long will it take to get NYSERDA approval?
A: Project approval is in the form of a purchase order issued to the Applicant by NYSERDA. Generally, the purchase order is issued as soon as a reasonably accurate estimate of the energy savings is available.
For straightforward projects, a purchase order should be issued within a few weeks of application.
For more complex projects, a site visit by NYSERDA staff and/or a NYSERDA technical reviewer may be required to develop a clear understanding of the project and to estimate energy savings. In either case, the goal is to approve projects as quickly as possible.
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Latest update : 2011-12-12
Tarak Ben Ammar, international movie producer and distributor
Tarak Ben Ammar worked as a producer on Jean-Jacques Annaud's epic "Black Gold", a movie that kicked off this year's Doha Tribeca Fim Festival. It traces the seeds of the oil war in the 1930s Gulf between American companies, Arabs and the nomadic Bedouins. "Black Gold" was filmed in Tunisia during the Jasmine Revolution.


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X-mess version of sift with shorty, shoot your enemies!
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