Colon cancer is a serious illness. It is important to get help from experts.
The chance of recovering from colon cancer depends on the stage of the tumor. The stage is based on how far the cancer has spread.
Your family history can also affect your risk of colorectal cancer. Your doctor can check your risk for genetic disorders like a BRCA mutation.
A risk factor is anything that increases your chances of getting a disease, such as cancer. There are many things that increase your risk, including diet, lifestyle and health conditions. Some of these factors can be modified, such as eating a healthy diet and exercising regularly. Others, such as age and family history, cannot be changed.
People over 50 are at the greatest risk for colorectal cancer. Having more than one first-degree relative (parent, sibling or child) with colon or rectal cancer doubles your risk.
Your risk is also higher if you have a family history of hereditary cancer syndromes, such as Lynch syndrome or familial adenomatous polyposis (FAP). These are genetic diseases that cause a number of polyps in the bowel. People with hereditary cancer syndromes who get colon or rectal cancer often develop the disease at a younger age than other people do.
Eating a high-fat diet, especially one that is rich in red meat and processed meat, increases your risk for colorectal cancer. So does smoking and not getting enough exercise. Drinking too much alcohol may also lead to colorectal cancer.
Being overweight (obese) increases your risk for colorectal cancer. This is because a person with a higher body mass index has more fat stored around the abdomen, which can increase the chance of developing tumors.
Other factors that can increase your risk for colorectal cancer include a sedentary lifestyle and being over 45. Some medications can increase your chance of developing colorectal cancer, such as birth control pills and hormone therapy. If you have a family history of hereditary colon cancer, your doctor may recommend screening through stool tests to look for polyps before they become cancer.
If you have a family history of colorectal cancer, talk to your doctor about starting screening at age 45 and how often you should be screened. Remember, however, that having a family history of hereditary cancer doesn’t necessarily mean you will get cancer, and not everyone with a family history of colorectal disease has a risk factor. A screening test can find polyps, which can be easily treated before they turn into cancer.
Colorectal cancer usually starts in the lining of the colon, called the mucosa. Over time, this lining can develop abnormal growths called polyps. Polyps may be asymptomatic, but left untreated they can become cancerous. Cancer cells can spread to other parts of the body through lymph nodes and blood vessels.
A health care provider can often diagnose colorectal cancer by asking about symptoms and doing a physical exam. The doctor can also order tests to check for the presence of cancer or other health problems. The most common test used to diagnose colon cancer is a colonoscopy, which involves passing a thin, tube-like instrument with a light and lens on the end (called an endoscope) down through the rectum. The doctor can then retrieve polyps or other tissue for laboratory testing. A colonoscopy can also be used to find out if cancer has spread within the colon or to other parts of the body.
Other diagnostic tests include a digital rectal exam (DRE) and blood work to look for markers of cancer, such as carcinoembryonic antigen (CEA). A stool sample can be tested for hidden blood using a guaiac-based fecal occult blood test or fecal immunochemical test.
Many people with colorectal cancer have no known risk factors. However, having a number of risk factors increases the chance that a person will develop the condition. For this reason, health care providers recommend that everyone over age 50 get regular screening with a sigmoidoscopy and a stool test for occult blood.
It is important that the tissue samples collected for diagnosis be intact and free of any disease, such as cancer or inflammation. This ensures that the pathologist can provide a complete and accurate diagnosis, which is critical for treatment planning. Ideally, these specimens should be preserved in a formalin fixative to allow for optimal histologic evaluation, including characterization of the cellular morphology and subtype (e.g., cribriform, serrated, micropapillary, medullary, or signet-ring cells). The histologic type helps determine the best treatment approach and prognosis. Staging is the process of finding out how much cancer has spread, which can help doctors plan your treatment.
Colorectal cancer treatment options depend on the stage of the disease, the type of tumor and other factors. At MD Anderson, our multidisciplinary teams include colon cancer surgeons, medical oncologists and radiation oncologists who review your case to recommend the best treatment plan for you.
Surgery is the mainstay of treatment for most patients with colorectal cancer, especially early stage disease. Our doctors use minimally invasive surgical techniques that are often performed through small incisions and offer a faster recovery time.
During surgery, our doctors remove the tumor and nearby lymph nodes. They also examine the tissue for signs of cancer spread (metastasis). When colon cancer has spread to other parts of the body, we use systemic therapy, which treats the cancer cells throughout the body with chemotherapy or other drugs.
Your doctor may also use other tests to find out if your cancer has spread. For example, a flexible sigmoidoscopy may be used to look for any unusual tissue in the abdomen and lower colon. A CT scan or magnetic resonance imaging (MRI) scan may also be done to make detailed pictures of your body and see the extent of any tumors. A positron emission tomography (PET) scan uses a radioactive substance, such as glucose, to detect cancer cells that show up brighter in the picture.
For some advanced colon cancers, your doctor may prescribe chemotherapy before surgery to kill any cancer cells that can’t be seen or removed during surgery. This is called neoadjuvant chemotherapy.
Some of these treatments can make you feel sick, so your doctor will give you medicine to help keep you comfortable. These medicines may include pain medicines, nausea reducers and laxatives. You might also receive antibiotics to prevent infection while you’re receiving these treatments.
After your treatment, you will need regular follow-up exams. Your doctor will check for any new signs or symptoms of disease, such as pain or a change in bowel habits. Your doctor will also do blood work to check your general health and to check for side effects of treatment. Your doctor will also test your blood to see how well your colon cancer is responding to treatment.
Most colorectal cancers develop from precancerous polyps (abnormal growths) in the inner lining of the colon and rectum. Screening tests can find these and other abnormal growths and remove them before they turn into cancer. This is one of the reasons why colorectal cancer death rates have dropped over the past few decades. Screening also can find cancer that has spread to other parts of the body, so it can be treated more easily.
Although a lot of people are at risk for colorectal cancer, most cases can be prevented with regular screening tests and healthy lifestyle changes. A diet rich in fruits, vegetables and whole grains, limiting red meats like steak, hamburger and pork, and avoiding processed meats such as bologna, hot dogs and sausage can help lower the risk of developing colorectal cancer. Moderate to high levels of physical activity and not smoking can also decrease the risk of developing cancers of the colon and rectum.
Almost all cancers start in the lining of the colon or rectum, so effective prevention is important. Unfortunately, too many people don’t discuss their prevention and screening options with a doctor because of embarrassment or a lack of good information. As a result, they may not get the recommended screening tests and may miss out on early detection. This can lead to a diagnosis of a much more serious and difficult-to-treat cancer, which could have been prevented.
Talk to your doctor about when you should begin screening for colorectal cancer and which test is right for you. Your doctor can also recommend ways to reduce your risk by avoiding cancer-causing risk factors and increasing protective factors.
Most people should begin getting screened for colorectal cancer starting at age 50. If you have a family history of colon cancer or adenomatous colon polyps, you should be screened earlier and more often. Your doctor may also recommend screening if you have a health condition such as inflammatory bowel disease, a previous colon polyp or a genetic syndrome that raises your risk for colorectal cancer, such as familial adenomatous polyposis or Lynch syndrome.
Many colorectal cancers start in the large intestine (colon) or rectum. They may spread to nearby lymph nodes or distant sites in the body.
Cells lining the colon and rectum are constantly growing, dividing, and dying. Sometimes changes in these cells lead to non-cancerous growths, called polyps, that can develop into cancer over time.
Pain is an important colorectal cancer symptom and may be the first sign of disease. It can happen at any time and may come and go. Pain can also be very severe and last a long time.
Abdominal pain is discomfort or other unpleasant sensations you feel in your belly area (abdomen). Most causes of abdominal pain aren’t serious, such as indigestion, gas, stomach flu and food poisoning. But sudden or continuous pain can indicate a more serious condition that needs immediate medical treatment, such as an intestinal blockage.
Your upper abdomen contains your liver, gallbladder and the bile ducts. The lower abdomen houses most of your large intestine and the rectum, which is the final 6 inches (15 cm) of your digestive system. The rectum holds waste matter until ring-shaped muscles relax during a bowel movement, allowing it to leave your body.
Describe the location and type of abdominal pain you are experiencing to your healthcare provider. It will help them figure out what could be causing it.
If your doctor suspects that you have colon cancer, they’ll start with a physical examination. This includes gently pressing on different areas of your belly. They’ll ask when it started, how long it has lasted and where the pain is most intense. Then they’ll use a camera to examine your colon and rectum for signs of cancer or pre-cancerous growths.
All the cells in your body are constantly growing, dividing and dying. But cancerous cells continue to grow out of control and form a mass known as a tumor. These cancerous cells can also break off and spread to other parts of the body. This is called metastasis.
A waning appetite is a common colon cancer symptom. It’s usually accompanied by fatigue. Your doctor can prescribe medication to help stimulate your appetite and prevent weight loss. They may recommend a high-protein diet that includes meat, eggs and dairy products. They’ll also suggest avoiding processed foods, such as bacon sausage and lunchmeat.
Bowel cancer usually develops from the inner lining of your colon and rectum, and it can be preceded by noncancerous growths such as polyps. Some types of polyps — such as adenomatous polyps, which resemble the lining of the colon and rectum but appear different under a microscope — are at risk of becoming cancerous.
Regular colon screenings are one of the most important ways to detect and treat colorectal cancer early. In recent years, more people have been getting screened, and that’s helped improve survival rates. When cancer is caught early, doctors can often save lives by treating it before it gets out of hand.
Diarrhea is loose, watery stools. It can be caused by something that’s infecting your gut, like a stomach bug or food poisoning. It can also be a sign that your colon is not working properly.
Normally, your colon receives liquefied food waste from your small intestine and then slowly condenses it into solid poop. But if your colon is cancerous, it can’t do this properly, which leads to diarrhea.
Colon cancer can grow into the wall of your colon or rectum (the last part of your large bowel that sticks out from your anus). The wall is made up of many layers. Colorectal cancer starts in the innermost layer, or mucosa. Then, it can grow through the other layers.
When the cancer reaches the next layer, it can spread into blood vessels and lymph vessels (tiny channels that carry away waste and fluid). Then, it can reach other parts of your body. This is called metastasis.
If you have chronic, persistent diarrhea, it’s important to see your doctor. You may need a colonoscopy or sigmoidoscopy to look inside your colon, or other tests to find out what’s causing the diarrhea. These include a physical exam, a history of your symptoms, and laboratory tests to check your colon’s health.
The most common cause of vomiting is a stomach or intestinal infection. But if it continues for several hours and occurs along with other symptoms, it could be a sign of colon cancer. Medications called antiemetics can help ease nausea and vomiting. They include metoclopramide, domperidone and ondansetron.
Bowel cancer develops from the inner lining of your colon and can spread to other parts of your body through blood or lymph. It usually starts with growths called polyps, which can become invasive cancer if they go untreated. Polyps are sometimes found in the colon during routine screenings with a stool test or colonoscopy.
Symptoms vary by stage of the cancer. In stage 0 cancer, tumors are limited to the innermost layer of the colon, so they are easy to treat. In stage 1 colon cancer, tumors have grown into the next layer of tissue and are harder to treat.
Stage 2 cancer has grown into the muscle or fat layers of the colon. In stage 3 colon cancer, tumors have grown into the blood vessels and nerves that line the colon. In stage 4 colon cancer, tumors have spread to other parts of the body.
When you have a possible symptom of colon cancer, it is important to call your doctor or visit an emergency room. If you are unsure whether to call, consider how long the symptom has gone on and other symptoms that may be present.
Often, people who have colon cancer do not develop symptoms until it is in the later stages. Regular screenings can help doctors catch the disease at an early stage, when it is easier to treat. Ideally, people should receive a combination of fecal tests and colonoscopies every 10 years plus a sigmoidoscopy every two years, beginning at age 50.
Colon cancer starts in the inner lining of the large intestine (colon). It usually begins as polyps, growths that are not cancer but can become invasive tumors if not treated. People who have a history of colon polyps or colon cancer in their family are at higher risk for developing the disease than others. Other risk factors include a family history of other types of cancer, inflammatory bowel diseases such as Crohn’s disease or ulcerative colitis, and certain DNA changes that increase the chance of getting colon cancer, such as familial adenomatous polyposis and Lynch syndrome.
Bowel cancer (colon or rectal) most commonly affects people over age 50. However, it can also occur in younger people. It is more common in men than women and people assigned male at birth (AMAB) than in those assigned female at birth (AFAB). A person’s ethnicity and race also play a role in whether they are at risk of the condition.
The goal of colorectal cancer treatment is to destroy the tumor and stop it from spreading. You might need surgery, chemotherapy, radiation therapy, or other treatments.
The type of surgery you have depends on where the cancer is and how much it has spread. Your age, overall health, and other factors also affect your outlook.
A colonoscopy is an outpatient procedure that allows the doctor to examine the inside of the colon. The doctor can see if the lining is abnormal and remove polyps (abnormal growths). People with a family history of colorectal cancer should undergo a colonoscopy screening every 10 years, or more often if they have other risk factors.
The person lies on their back and the endoscopist inserts a long tube called a colonoscope into the rectum. The colonoscope has a light and video camera that transmits real-time images to a monitor so the doctor can see the lining of the colon. It also has a tube that pumps in air to help inflate the colon for a better view. The doctor can also use a tool in the tube to take small samples of tissue for testing, which is called a biopsy. The doctor can also remove any enlarged polyps that are found.
Before the procedure, the person will wear a hospital gown and may receive a painkiller or sedative. The sedative can be taken as a pill or injected directly into the bloodstream (intravenously). The painkiller will reduce discomfort during the test.
After the procedure, the doctor will discuss the results. The person will need to stay in the recovery room for an hour or so to make sure there are no immediate complications. The person will need someone to drive him or her home because the sedative may affect judgment and reflexes. Some people experience stomach cramping, bloating and gas pains after a colonoscopy. This is caused by the air introduced into the colon during the exam and will disappear when the person passes gas.
Colon cancer is most treatable when it’s localized to the large intestine (colon) or back passage (rectum). Surgery alone can cure it, but it may be combined with chemotherapy. If the colon cancer has spread to other organs or lymph nodes, treatment is different.
Doctors can use a procedure called a colonoscopy to examine the colon and rectum for signs of cancer. During this test, doctors use a long, flexible and slender tube that is attached to a video camera and monitor to see the entire area. They can also pass surgical tools through the tube to take tissue samples and remove polyps. The procedure is usually painless. But there is always some risk of complications, such as infection, too much bleeding or reaction to anesthesia.
The tissue samples are examined in a lab to find out if the cells are cancerous and how quickly they’re growing. The results help your health care team create a treatment plan.
If the colon cancer is at an early stage, doctors may remove it completely during surgery, called surgical resection. They may also remove nearby lymph nodes to check for cancer cells. This helps to reduce the chance of cancer recurrence.
For patients with advanced colon cancer, surgery may be used in combination with other treatments, such as chemotherapy or radiation therapy. In addition, a surgery called cytoreductive or debulking surgery and hyperthermic intraperitoneal chemotherapy can be beneficial for some patients with gastrointestinal stromal tumors (including mucinous, serrated and cribriform colon adenocarcinomas).
The five-year survival rate for people with colorectal cancer depends on the stage of the disease at the time of diagnosis. For example, 73% of people with colon cancer that hasn’t spread beyond the colon and its nearby lymph nodes were alive five years after being diagnosed. But that rate drops to 17% when the cancer has spread to distant organs or lymph nodes.
The use of chemotherapy drugs is often part of treatment for colon cancer. It is used to treat the tumor and reduce the chances of the cancer recurring after surgery or spreading to other parts of the body.
Chemotherapy for colorectal cancer may be given before or after surgery, or both. It can be given through a tube (catheter) that goes to your bloodstream in the abdomen or chest, a needle, or directly into the intestines. Sometimes, it is delivered into the cerebrospinal fluid through the spinal cord in a procedure called intrathecal chemotherapy. It may also be given in pill form, or injected under the skin in a process called intravenous (IV) chemotherapy.
In stage III colon cancer, the cancer has spread through the outer layer of the colon wall (the serosa) to the tissue that lines the organs in the abdomen (visceral peritoneum). It can also have spread to four or more nearby lymph nodes. It is possible to cure these stages of colon cancer with surgery plus chemotherapy.
Doctors can choose from 9 different antineoplastic classes and dozens of drug combinations to treat metastatic colorectal cancer. Several newer medicines that improve outcomes include fluorouracil, capecitabine, oxaliplatin, S-1, irinotecan, the tyrosine kinase inhibitors regorafenib and ramucirumab, the anti-EGFR drugs cetuximab and panitumumab, and others.
Several factors affect the results of chemotherapy for colon cancer, including your age, overall health, and other treatments you’ve had. You also have a chance of having side effects from the chemotherapy, such as nausea and vomiting. To help reduce the risk of side effects, doctors monitor patients closely during treatment with regular blood work and CT scans to measure their response to therapy. The doctors can then adjust your doses or medications as needed.
Radiation therapy uses high-energy radiation from x-rays, gamma rays, neutrons or protons to kill cancer cells and shrink tumors. It may come from a machine outside your body (external beam radiation therapy) or from a radioactive substance placed inside your colon near the cancer cells (brachytherapy). This treatment is usually given in addition to chemotherapy.
A doctor who specializes in treating cancer, called a radiation oncologist, performs this treatment. Before you have radiation, the team of doctors will study your medical records and scans to make sure it is the best option for you.
Colon cancer is a growth of abnormal cells in the large intestine, which is the last part of the digestive system that makes up most of the bowel. It starts as small clumps of cells, called polyps, that can develop into cancer over time. Most of the time, polyps aren’t cancerous and don’t cause any symptoms. However, some can become cancerous and start to grow and spread. Regular screening tests can find and remove polyps, which often can prevent colon cancer from getting worse.
Cancer that has spread beyond the colon to other organs or tissues is called metastatic colon cancer. In stage IV colon cancer, chemo and/or radiation therapy may be recommended to help reduce the chance of the cancer coming back after surgery.
The most common type of metastatic colon cancer is adenocarcinoma. It’s also possible to have squamous cell carcinoma, rectum cancer or undifferentiated colon cancer. Your doctor will recommend a treatment plan that is right for you based on the results of your scans, biopsy and other test results. They may also suggest other treatments, like a targeted therapy or immunotherapy.
With advances in treatment, most cancers are now found and treated when they are very early, before symptoms develop. Supportive care helps to reduce the effects of a serious illness and its treatment on patients and their families. It is offered at various points in the cancer journey and can be given alongside curative and life-prolonging treatment.
The goal of supportive care is to improve quality of life, reduce side effects and improve comfort. It is important for people with colorectal cancer and their family members. It may include preventing and managing problems like pain, nausea and vomiting, fatigue, anxiety and depression. It can also be helpful in helping people come to terms with a diagnosis and plan for the future.
Most people with stage 0 colon cancer are asymptomatic (have no symptoms). If they have symptomatic disease, they usually get surgery and chemotherapy to treat their colon cancer. Chemotherapy is used to prevent the cancer from recurring after surgery and to decrease symptoms such as rectal bleeding and abdominal pain.
In some cases, the doctor may decide to take out only part of the colon (partial colectomy). This can be done if the colon cancer is not too large and there are no signs of spreading. In other cases, the doctor might need to remove more of the colon (full colectomy) if the colon cancer is larger or spread to the surrounding tissues.
To help with the planning of the next steps in your treatment, a test called a carcinoembryonic antigen (CEA) assay might be used. This test measures the amount of CEA in the blood, which is released by both healthy cells and cancer cells. If the level of CEA is high, this can be a sign that the cancer has spread to nearby lymph nodes or other organs.
