Colorectal cancer

Colorectal cancer is one of the most common cancers in the United States. While there is no single cause of the disease, it typically originates in either the large intestine (colon) or the rectum (end of the colon). Most cases begin as polyps, which are small noncancerous growths inside the colon or rectum. Over time, some polyps can slowly turn into cancer.

You may have an increased risk of developing colorectal cancer if you:

• Are an active tobacco user
• Are Black or of Eastern European descent
• Are older than 60 years old
• Are overweight or obese
• Drink more than one drink a day
• Eat a diet high in red meat and low in fiber
• Get less than 30 minutes of physical activity a day
• Have a family history of colorectal cancer
• Have an inherited syndrome, such as familial adenomatous polyposis (FAP) or Lynch syndrome
• Have inflammatory bowel disease, such as ulcerative colitis or Crohn's disease
• Have Type 2 diabetes

In its early stages, colorectal cancer does not typically cause symptoms. However, as the disease progresses, some symptoms may begin to occur, including:

• Any major change in bowel habits
• Constipation
• Diarrhea
• Feeling bowels do not totally empty
• Frequent gas pain or bloating
• General abdominal discomfort
• Loss of appetite
• Nausea or vomiting
• New onset anemia
• Persistent fatigue or weakness
• Red, black or tarry blood in stool
• Stools that are narrower than usual
• Unexplained weight loss

As symptoms often do not show up until the cancer is advanced, regular colon cancer screening is important for early detection, when it is most treatable. The American Cancer Society recommends you start regular screening for colorectal cancer at age 45, but your doctor may recommend getting tested at a younger age if you have a higher colon cancer risk. Some of the diagnostic procedures we use include:

• Biopsy — This is a procedure in which a sample of tissue is taken and examined under a microscope by a pathologist to determine if it contains cancer.
• Colonoscopy screening — If you have an increased risk of colorectal cancer, this is the recommended screening test. During a colonoscopy, your doctor uses a lighted scope to view the inside of your colon. Polyps may be removed during this test and tissue samples may also be taken at the same time.
• Digital rectal exam — This exam checks the rectum for lumps or abnormalities. About half of colon cancers can be detected in this way.
• Fecal occult blood test — This test is used because blood in the stool can be an indicator of colorectal cancer. Your stool may also contain blood for other reasons not connected to colorectal cancer. If you experience blood in your stool, contact your healthcare provider.
• Flexible sigmoidoscopy — During this procedure, your doctor uses a lighted scope to view the lower part of the intestine. Your doctor may also remove polyps during this test.

If it is determined that you have colorectal cancer, your doctor may order other tests, including:

• Blood chemistry panel
• Chest X-ray
• Complete blood count (CBC) panel
• Computerized tomography (CT) scan
• Magnetic resonance imaging (MRI)
• Positron emission tomography (PET) scan
• Ultrasound

Chemotherapy is a type of cancer treatment that uses drugs to destroy cancer cells. When used effectively, it may be used in combination with radiation therapy and surgery to achieve the most positive outcomes. Throughout our hospitals, the oncologists in our cancer programs are skilled in attacking tumors and harmful cancer cells, with a host of leading-edge treatments and research at their disposal. In turn, these treatments and research are now available to you.

Colorectal surgery

Typically, surgery is the best option for colorectal cancer treatment. Our surgical staff includes the region's only team of fellowship-trained colon and rectal surgeons. They partner with gastroenterologists, medical oncologists and imaging specialists to provide you with the best possible surgical experience. We also use the most advanced minimally invasive robotic surgical procedures whenever possible. These techniques allow our surgeons to perform complex surgeries that potentially offer less scarring, a faster recovery and shorter hospital stay.

Radiation therapy

Radiation therapy is a treatment that uses X-rays to destroy cancerous cells and shrink tumors. More commonly used to treat rectal cancer than colon cancer, radiation is typically combined with surgery. Radiation therapy at our hospitals involves the latest technologies and treatments. We coordinate care with your surgeon, medical oncologist and primary care physician to ensure personalized treatment.

We provide access to a dedicated nurse navigator who guides you through each step of your treatment and recovery journey. Our specialized colorectal cancer nurse navigators will initiate and facilitate timely communication with each member of your care team, as well as provide education, resources, emotional support and access to support groups and community resources.