Vitamin D, Aspirin, Exercise, and Low Saturated Fat Foods for the Treatment of Colorectal Cancer Patients with Minimal Residual Disease, DAILY Study

Inclusion Criteria

• Age >= 18 years at the time of study entry
• Eastern Cooperative Oncology Group (ECOG) 0-1
• Histologically documented high-risk stage II, stage III, or stage IV colorectal adenocarcinoma with no evidence of disease following definitive local therapy (including surgical resection or ablation)
• No radiographic evidence of disease by contrast enhanced computed tomography (CT) chest/abdomen/pelvis
• Presence of detectable ctDNA mutation that matches mutations found in tumor tissue
• Completion of all standard of care adjuvant therapy
• Ability to give informed consent
• Ability to complete all questionnaires involved in study

Exclusion Criteria

• Concurrent malignancy under active treatment
• Known active gastrointestinal bleeding or peptic ulcer disease
• Known hypersensitivity to vitamin D or aspirin
• Creatinine clearance (CrCl) < 30 mL/min within 30 days of starting the intervention
• Current usage of therapeutic anticoagulation (warfarin, Eliquis, Xarelto)
• Inability to safely participate in physical activity in the opinion of the treating oncologist
• Pregnant or nursing women
• Persistent hypercalcemia or conditions predisposing to hypercalcemia (i.e., hyperparathyroidism)
• Known symptomatic genitourinary stones