Colorectal Cancer
Colorectal cancer is a malignancy that begins in the colon (large intestine) or rectum. It typically starts as noncancerous growths called polyps that, over time, can develop into cancer. When detected early, colorectal cancer is highly treatable and often curable. At Blume Health, our multidisciplinary team of gastroenterologists, colorectal surgeons, oncologists, and radiation specialists provides comprehensive care for colorectal cancer, from screening and diagnosis to treatment and survivorship support.
Causes
- Age (risk increases significantly after age 50)
- Personal history of colorectal polyps, especially adenomas
- Personal history of inflammatory bowel disease (ulcerative colitis or Crohn's disease)
- Family history of colorectal cancer or polyps
- Inherited genetic syndromes such as Lynch syndrome (HNPCC) or familial adenomatous polyposis (FAP)
- African American or Ashkenazi Jewish ethnicity
- Lifestyle factors including low-fiber, high-fat diet
- Diet high in processed meats and red meat
- Sedentary lifestyle and physical inactivity
- Obesity
- Smoking
- Heavy alcohol consumption
- Type 2 diabetes
- Previous radiation therapy to the abdomen or pelvis
Signs and Symptoms
- Change in bowel habits, including diarrhea, constipation, or narrowing of stool that lasts for more than a few days
- Rectal bleeding or blood in the stool (which may appear dark)
- Persistent abdominal discomfort, such as cramps, gas, or pain
- A feeling that the bowel doesn't empty completely
- Weakness or fatigue
- Unexplained weight loss
- Iron deficiency anemia (particularly in right-sided colon cancers)
- Tenesmus (persistent feeling of needing to have a bowel movement)
- Pelvic pain (particularly with rectal cancer)
- Many colorectal cancers produce no symptoms in early stages, highlighting the importance of screening
Diagnosis
Colonoscopy
The gold standard for colorectal cancer screening and diagnosis, allowing direct visualization of the entire colon and rectum. During the procedure, suspicious areas can be biopsied, and polyps can be removed completely. Tissue samples are sent for pathological examination to determine if cancer is present.
CT Colonography (Virtual Colonoscopy)
A less invasive imaging procedure using CT scanning to create detailed images of the colon. While it doesn't allow for biopsy or polyp removal, it can detect larger polyps and masses. If abnormalities are found, a traditional colonoscopy will still be needed.
Sigmoidoscopy
A procedure similar to colonoscopy but examining only the rectum and lower part of the colon. It may be used as a screening tool or to evaluate symptoms affecting the lower colon and rectum.
Stool-Based Tests
Including fecal immunochemical tests (FIT), guaiac-based fecal occult blood tests (gFOBT), and stool DNA tests. These non-invasive options can detect blood or abnormal DNA in stool. Positive results require follow-up with colonoscopy.
Staging Workup
Once cancer is diagnosed, additional tests like CT scans, MRI, PET scans, and endorectal ultrasound may be performed to determine the extent of the cancer (staging), which guides treatment decisions.
Treatment Options
Surgical Treatment
The primary treatment for most colorectal cancers. The type of surgery depends on cancer location, size, and stage. Options range from minimally invasive procedures for early-stage disease to more extensive surgeries for advanced cases. Our surgical team specializes in both traditional and laparoscopic/robotic approaches to colorectal surgery.
Chemotherapy
May be used before surgery (neoadjuvant) to shrink tumors, after surgery (adjuvant) to eliminate remaining cancer cells, or as the main treatment for metastatic disease. The specific drugs, combinations, and scheduling are tailored to each patient's case.
Radiation Therapy
Often used for rectal cancer, either before surgery to shrink tumors or after surgery to kill remaining cancer cells. It may be combined with chemotherapy (chemoradiation) for enhanced effectiveness. Advanced techniques minimize damage to surrounding healthy tissues.
Targeted Therapy and Immunotherapy
Newer treatments that target specific genetic mutations or proteins involved in cancer growth or harness the body's immune system to fight cancer. Molecular testing of the tumor can identify patients most likely to benefit from these approaches.
Home Remedies
Nutritional Support During Treatment
Maintaining good nutrition during cancer treatment is crucial. Focus on a balanced diet rich in fruits, vegetables, lean proteins, and whole grains. Small, frequent meals may be easier to tolerate during treatment. Our dietitians provide personalized nutritional guidance for cancer patients.
Managing Treatment Side Effects
Various strategies can help manage side effects like fatigue, nausea, or diarrhea. These may include adequate rest, staying hydrated, anti-nausea strategies, and specific dietary modifications based on your symptoms.
Physical Activity
Gentle exercise, as approved by your healthcare team, can help maintain strength, reduce fatigue, and improve mood during treatment. Post-treatment, regular physical activity plays an important role in recovery and reducing recurrence risk.
Stress Reduction Techniques
Practices like deep breathing, meditation, yoga, or guided imagery can help manage the emotional impact of cancer diagnosis and treatment. Our supportive care team can provide resources for stress management.
Support Groups
Connecting with others who understand the colorectal cancer journey can provide emotional support and practical advice. Both in-person and online support groups are available through our cancer support services.
Preventive Care
- Regular colorectal cancer screening according to guidelines (typically starting at age 45 for average-risk individuals)
- Maintain a healthy weight through balanced diet and regular exercise
- Consume a diet high in fruits, vegetables, and whole grains
- Limit consumption of red meat and processed meats
- Get regular physical activity (aim for at least 150 minutes of moderate activity per week)
- Limit alcohol consumption
- Avoid tobacco in all forms
- Consider aspirin use for prevention (discuss with your doctor, as it's not recommended for everyone)
- Know your family history and discuss any colorectal cancer or polyp history with your doctor
- For those with inflammatory bowel disease, maintain regular surveillance as recommended by your gastroenterologist
Surgical Options
Polypectomy and Local Excision
For early-stage cancers or precancerous polyps, removal during colonoscopy or through local excision may be sufficient. These minimally invasive approaches are used when cancer is limited to a polyp or small area without evidence of spread.
Learn More About This ProcedureColectomy (Colon Resection)
Surgical removal of the affected portion of the colon along with nearby lymph nodes, followed by reconnection of the healthy segments (anastomosis). This can be performed as open surgery or using minimally invasive techniques (laparoscopic or robotic). The extent of colon removed depends on tumor location and characteristics.
Learn More About This ProcedureRectal Cancer Surgery
Procedures for rectal cancer include low anterior resection (preserving the anal sphincter) or abdominoperineal resection (removing the rectum and anus, requiring a permanent colostomy). The approach depends on tumor location, size, and proximity to the sphincter muscles. Specialized techniques help preserve function whenever possible.
Learn More About This ProcedureSchedule a Consultation
If you're experiencing symptoms of colorectal cancer, our expert team is here to help you find the right treatment approach for your specific needs.