Colon or colorectal cancer is a type of cancer found in the bowels or colon. In most cases, it forms from adenomatous polyps (excess tissue growth) in the colon. Familial adenomatous polyposis (FAP) and hereditary nonpolyposis colorectal cancer (HNPCC) are two genetic types of colon cancer that make up just five percent of all bowel cancer cases.
While colorectal cancer can be life-threatening if not detected early it is treatable, especially if caught early. Doctors are beginning to see younger patients with this disease, but the good news is that colorectal cancer progresses slowly, and early diagnosis can lead to improved colon cancer treatment outcomes. From lifestyle changes to colon cancer screening, there are precautionary measures you can take to reduce the likelihood of developing colorectal cancer.
The process for determining the severity of colon cancer is called staging. Stages range from zero to four, with Stage 0 being the least advanced. Determined by the size of the tumor and dependent on the extent of cancer spread, staging helps determine the prognosis and treatment plan for each patient based on the severity of their condition.
Stage 0: In this stage, the cancer has not spread within the layers of the colonic wall. Cancerous tissue is normally removed using local excision during a colonoscopy. A procedure called a partial colectomy will be performed if the tumor cannot be completely removed and it must be removed in multiple pieces, or if the tumor is too large and a section of the colon needs to be removed.
Stage I: For cancers that have developed from polyps and have invaded the colonic wall but have not spread outside of it, no treatment may be required beyond a partial colectomy (which includes the removal of lymph nodes).
Stage II: These cancers are larger, have extended through the colonic wall and sometimes into surrounding tissues. These cancers can usually be removed via partial colectomy with the removal of lymph nodes. Chemotherapy is considered for those at high risk of having the cancer return. Many factors affect the level of chemotherapy prescribed, and medical opinions vary widely about when it should be used for treating Stage II colon cancer.
Stage III: At this stage, the cancer has spread to the lymph nodes but not to the organs or other parts of the body. Partial colectomy and removal of the lymph nodes are generally followed by chemotherapy. Patients unable to tolerate surgery undergo chemotherapy, radiation or both.
Stage IV: Cancers in this most serious stage have progressed beyond nearby lymph nodes and the colon and have spread to distant tissues and organs. The disease often spreads to the liver but may also metastasize in other organs. In some cases, the cancer is contained in small enough areas for surgical removal. Surgery is then followed by chemotherapy to extend life expectancy. Surgery, however, is often not a viable option for Stage IV patients. Chemotherapy is the standard treatment for those with extensive metastasis.
For patients whose cancer has spread to the liver, local therapies such as ablation, which destroys cancer cells in the liver, or embolization, which stops blood flow to cancer cells in the liver via injection can be considered. These procedures require a team of specialists (interventional radiologists, radiologists and medical oncologists) to work together, providing the most advanced and comprehensive care possible.
There are a number of factors that can put you at higher risk of developing colon cancer. If you associate with some or all of the risk factors listed below, we strongly urge you to consider a colon cancer screening.
In the early stages of colon cancer, many patients don’t experience symptoms. As the disease slowly progresses, however, the following symptoms often appear:
Although these symptoms may not be a direct result of colon cancer, if you are experiencing any of the symptoms listed above, it's best to see a doctor.
While some risk factors may be out of your control, taking the following measures may help reduce your risk of bowel cancer:
The American Cancer Society recommends that patients at average risk for colon cancer undergo colon cancer screening by the age of 45. The organization lowered its recommendation from the age of 50 after seeing the average age of colorectal cancer patients decrease.
Colonoscopies allow doctors to view the colon from the inside. A scope containing a light and a tube (with a tiny camera attached to the end) is used to look for precancerous polyps. Any abnormal growths are removed, and biopsies may be performed on tissue samples to determine if cancer or another issue exists.
The fecal immunochemical test (FIT) is used to detect early signs of colon cancer. FIT, which poses no health or safety risks, searches for otherwise undetectable blood from the lower intestines in your stool. This take-home medical test is accurate, at least in part because food and medicine do not affect the results. A colonoscopy may be ordered if blood is detected.
The fecal occult blood test (FOBT) also looks for blood in a patient’s stool. Although colonoscopies are often ordered after occult (hidden) blood is found, this does not necessarily mean that cancer is present. Polyps and ulcers may also cause blood in the stool. However, polyps and tumors do not always bleed, so further investigation may still be required.
Scheduling a colon cancer screening is the first step in preventing a late-stage colon cancer diagnosis. At Memorial Hermann, you can schedule a screening colonoscopy online if you meet the following criteria*:
Due to recent changes in screening recommendations, please consult your insurance provider to confirm coverage if you are under the age of 50.
Colon cancer treatments vary depending on the stage of the disease and other factors unique to each patient, and can include the following (individually or combined):
At Memorial Hermann, multiple healthcare specialists affiliated with the cancer treatment program will work together to provide you with the most advanced treatments based upon your individual needs. We understand this is a difficult and often confusing time for you and your loved ones. And it’s our responsibility to guide you through this process, clearly communicating with you every step of the way.
At Memorial Hermann,we are committed to staying apprised of the latest technology and treatment options. At Memorial Hermann facilities across the Greater Houston area, you will receive highly personalized colorectal cancer treatment at the location that is most convenient for you. Our Nurse Navigators can also help you with coordinating and scheduling of your colon cancer treatments, so you can focus on what matters most – healing.
Memorial Hermann Cancer Centers are accredited by the American College of Surgeons’ (ACoS) Commission on Cancer (CoC). This rare distinction is given to cancer programs that uphold the highest standard of care for patients. When you choose Memorial Hermann Cancer Centers for your cancer treatment, you can rest assured you will receive the best possible care delivered by a compassionate team of caregivers in a calm, healing environment.