Advanced Cancer Care
Colorectal cancer is a type of cancer that starts in the colon (the longest part of the large intestine) or the rectum (the last part of the large intestine that connects the colon to the anus). Colon and rectal cancers are caused by cancerous cells that grow in the tissues and muscles of your colon.
If you have colon or rectal cancer, or if your doctor suspects that you do, you need comprehensive care from a team of cancer experts. That’s what you’ll find at St. Luke’s Center for Cancer Care.
Our center is accredited by the Commission on Cancer for our care quality and patient outcomes. We follow the same treatment guidelines as large academic medical centers, but we often can see you weeks sooner than other providers. We take part in a wide range of clinical trials so patients can access treatments not available elsewhere. Our providers collaborate in our regularly meeting tumor boards to ensure our patients receive the best possible care options. And we work to coordinate your care appointments to help you get the care you need and get on with your day.
What Is Colorectal Cancer?
Colon and rectal cancers both start as an abnormal growth, called a polyp, that grows on the wall of your large intestine. Most polyps are harmless, but some have cells that can grow into cancerous tumors and spread. The colon and rectum are both part of the large intestine. Cancer of the colon and cancer of the rectum are often called colorectal cancer.
Adenocarcinoma is by far the most common type of colorectal cancer. It makes up about 95% of colorectal cancer diagnoses. Adenocarcinoma starts in cells that make mucus that lubricates the inside of the colon and rectum. Rarer types of colorectal cancers include:
- Carcinoid tumors: This type starts in the hormone-producing cells in your intestines.
- Gastrointestinal stromal tumors: This is a type of soft-tissue tumor (sarcoma) that’s found anywhere in your gastrointestinal (GI) tract. It’s rare to find this type of sarcoma in your colon.
- Lymphoma: This type of immune system cancer more commonly starts in your lymph nodes but can start in your colon.
How We Diagnose Colorectal Cancer
If your doctor suspects you have colorectal cancer, they’ll recommend one or more of the following tests.
- Digital rectal exam (DRE): During a DRE, your doctor will examine your rectum to feel for abnormal tissue.
- Blood tests: Your doctor will collect blood samples to look for tumor markers. This can also provide information we can use if targeted gene therapy is a good treatment option for you.
- Colonoscopy: A colonoscopy uses a small camera to examine your colon for polyps. Your doctor will insert the camera with a small tube through your anus.
- Biopsy: Your doctor will collect a tissue sample from a polyp or other abnormal finding during your colonoscopy. They’ll send the tissue sample to our pathologists so they can examine it under a microscope for signs of cancer.
- Stool tests: Stool tests check your poop for signs of hidden blood, which can be a sign of colorectal cancer. Stool tests are often done at home.
- Imaging tests: Your doctor may recommend a magnetic resonance imaging (MRI) scan, computed tomography (CT) scan or other imaging to see if cancer has spread to other parts of your body.
There are five stages of colon and rectal cancer. Assigning your cancer a stage helps you and your doctors better understand the disease and design the right treatment plan for you.
- Stage 0: In this stage, cancer is only found in the innermost lining of the colon.
- Stage 1: The tumor has spread outside the inner lining, in this stage, but is still inside the colon and hasn’t spread to your lymph nodes.
- Stage 2: In this stage, the cancer has spread through the thicker outer muscle layer of your colon but isn’t in the lymph nodes.
- Stage 3: This stage indicates the cancer has spread outside your colon to one or more lymph nodes.
- Stage 4: The cancer has spread to other parts of the body, most commonly the liver or lungs. The cancer may also be in your lymph nodes.
How We Treat Colorectal Cancer
We can treat colon and rectal cancers in several ways depending on the stage and location of the disease. Our experts typically use a combination of these methods, including:
- Surgery: Colon cancer surgery is also called a segmental colectomy. Your surgeon removes the part of the intestine that has cancer cells and reconnects the two remaining ends to reconstruct your colon. For rectal cancer, your surgeon can perform a polypectomy (a procedure to remove a polyp) or a local excision (a procedure to remove cancer from the rectum’s inside lining, along with a small amount of healthy tissue)
- Chemotherapy: We use chemotherapy to kill or shrink cancer cells. We can use chemotherapy to treat colon and rectal cancer before, during, after or instead of surgery.
- Radiation therapy: Radiation uses high-energy rays to shrink or kill cancer cells. Though radiation therapy isn’t typically part of treatment for colon cancer, we may use it to treat more advanced colon cancer that has spread elsewhere. For rectal cancer, your care plan may involve external-beam radiation therapy (EBRT), which involves beams of radiation delivered to the tumor, or brachytherapy (also known as internal radiation therapy, in which we place radioactive material directly next to or into the tumor).
- Targeted gene therapy: This therapy can attack genetic weaknesses in cancer cells while sparing healthy cells.
- Immunotherapy: Immunotherapy is a process to help your body use its own immune system to fight the cancer.
Symptoms and Risk Factors of Colorectal Cancer
Colorectal cancer is the third most common cancer diagnosis in the United States. Colon cancer is slightly more likely to affect men and people over the age of 50. However, the rate of colorectal cancer in people between the ages of 20 and 49 has been rising in recent years. Researchers aren’t sure why, but more young people are being diagnosed with colon cancer each year, even without symptoms or a history of the disease.
It’s important to get screened for colon and rectal cancer every year starting at age 45 if you’re at regular risk. Your doctor may recommend more frequent screening if you’re at a higher risk. You can have colon or rectal cancer with no symptoms or symptoms that are hard to recognize as serious. Colon and rectal cancers are more treatable if we catch them early. Symptoms of colon or rectal cancer can include:
- A persistent urge to have a bowel movement that doesn’t go away after you have one
- Blood in your stool or rectal bleeding
- Changes in your bathroom habits, such as constipation, diarrhea or narrow stools that last for more than a few days
- Unexplained cramping or stomach pain that lasts more than a few days
- Unexplained fatigue or weakness
- Unintentional weight loss
Don’t ignore these symptoms, even if you’re under the age of 45. Your risk for developing colon or rectal cancer depends on many factors. Some risk factors are genetic, and some include lifestyle choices. Risk factors for developing colon or rectal cancer include:
- A family history of colorectal or other kinds of cancer
- Smoking: Quitting smoking lowers your risk of colon and other kinds of cancer
- Heavy alcohol use (more than two drinks a day for men and one drink a day for women)
- A diet high in red meat, fatty or processed foods
- A personal history of polyps or inflammatory bowel disease (including ulcerative colitis and Crohn’s disease)