A Double Blind Placebo-Controlled Trial of Eflornithine and Sulindac to Prevent Recurrence of High Risk Adenomas and Second Primary Colorectal Cancers in Patients With Stage 0-III Colon or Rectal Cancer, Phase III - Preventing Adenomas of the Colon With Eflornithine and Sulindac (PACES)

• History of Stage 0-III colon or rectal cancer with primary resection 1 year previously

• Post-operative colonoscopy and CT scans of chest, abdomen \& pelvis showing no evidence of disease

• Must not have cardiovascular risk factors including unstable angina, history of myocardial infarction, or cerebrovascular accident, coronary artery bypass surgery, or NY Heart Assoc Class III or IV heart failure.

• Patients must not have known uncontrolled hyperlipidemia (defined as LDL-C \>/= 190 mg/dL or triglycerides \>/= 500 mg/dL within the past 3 years or uncontrolled high blood pressure (systolic blood pressure \> 150 mm Hg) within 28 days prior to registration

• At least 30 days from completion of adjuvant chemo and RT.

• Presence of gastroesophageal reflux disease acceptable if controlled with medications

• Not receiving or planning to receive concomitant intravenous corticosteroids on a regular basis,nonsteroidal anti-inflammatory drugs (NSAIDs), nor anticoagulants on a regular predictable intermittent basis. NSAID use must not exceed 10 days per month; Maximum aspirin dose

⁃ 100 mg per day or ≤ two 325 mg tablets per week. Inhaled steroids (i.e. for asthma or related conditions) are allowed.

• Able to swallow oral medications

• Laboratory: WBC ≥ 4.0 x 1000/mcL, platelets ≥ 100,000/mcL and hemoglobin \> 11.0 g/dL. (A total WBC ≥ 3.1 x 1000/mcL is allowed for non-Hispanic black males and total WBC ≥ 3.4 x 1000/mcL for non-Hispanic black females. Serum bilirubin ≤ 2.0 mg/dL and AST (SGOT) or ALT(SGPT) ≤ 2 x IULN. Serum creatinine ≤ 1.5 x IULN

• Zubrod PS 0-1, 18 years of age or older

• Will not participate in any other clinical trial for the treatment or prevention of cancer unless off protocol treatment, on follow-up phase only

• Offered opportunity to participate in blood specimen banking