Colorectal Cancer

Nearly all colon cancers begin as benign polyps that slowly develop into cancer. In many cases, colorectal cancer symptoms do not appear until the tumor is large. That is why screening colonoscopy is so critical in detecting polyps before they have turned into cancer. The symptoms of colorectal cancer include:

• Pain and tenderness in the abdomen

• Diarrhea, constipation or changes in bowel movements

• Blood in the stool, or narrow stools

• Weight loss for unknown reasons Download this helpful screening guide for Colorectal Cancer and other prevalent cancer screenings.

Individuals at risk for colorectal cancer

Research has shown that some risk factors are present for developing colorectal cancer. These colorectal cancer risk factors include:

• Age – More than 90 percent of people with this disease are diagnosed after age 50. The average age of diagnosis is mid 60’s.

• Colorectal polyps – Most polyps are benign, but some can be cancerous. Consistently finding and removing polyps can reduce the risk of colorectal cancer. Oftentimes, polyps are what become cancer.

• A family history – individuals who have close relatives with a history of colorectal cancer are more likely to develop the disease themselves.

• Behavioral risk factors – Including tobacco and alcohol, physical inactivity and obesity

Hereditary Colon Cancer

As mentioned above, a risk for colorectal cancer could be family history. About 10% of colon cancer cases are due to an inherited genetic susceptibility. Hereditary colon cancer can be divided into two broad categories: polyposis (many polyps) and nonpolyposis syndromes (few or no polyps). Familial adenomatous polyposis (FAP) and MYH-associated polyposis (MAP) are the most prevalent of the former category, and Lynch syndrome (LS) is the most common of the latter. Features of hereditary colon cancer susceptibility in a family include one or more of the following: individuals with multiple colorectal polyps, multiple relatives on the same side of the family with colon or other LS-related cancers (rectal, uterine, ovarian, renal, or other gastrointestinal cancers), individuals with more than one primary tumor, and colon cancer diagnosed under age 50.

Early detection is key to survival

Colorectal cancer can be avoided if routine proper screening takes place. Hoag Family Cancer Institute recommends routine screening colonoscopies for men and women beginning at age 50, with subsequent intervals for retesting as determined by a physician.

What is a colonoscopy?

The gold standard in colorectal cancer screening is colonoscopy. A traditional screening colonoscopy is a short outpatient procedure that uses a flexible endoscope to travel through the colon to most accurately visualize abnormalities or polyps, and look for early signs of colorectal cancer. During the procedure, suspicious polyps can be removed, substantially reducing the risk of colorectal cancer over a patient’s lifetime.

While there are other screening options, such as a virtual screening colonoscopy – which utilizes CT scanning to detect polyps – non are superior to a conventional colonoscopy. Individuals receive a virtual colonoscopy for special circumstances, such as being too sick or weak for the more invasive conventional colonoscopy or being on blood thinners. However, if during a virtual colonoscopy a polyp or suspicious mass is detected, that individual will still need to go through a conventional colonoscopy to remove the polyp.

A conventional screening colonoscopy also acts as a means of colorectal cancer diagnosis. The polyps removed during a screening colonoscopy are biopsied to ensure that there are no signs of precancerous or cancerous changes.

Download Colorectal Cancer Facts

Hoag Family Cancer Institute offers a variety of innovative and progressive treatment options to colorectal cancer patients. Our goal is to tailor treatment plans to each individual, to accurately and effectively treat your disease. Hoag’s colorectal cancer experts specialize in surgical and radiation therapies for colorectal cancer.

Treating Colon Cancer

If colon cancer is detected during a colonoscopy, additional tests will be performed to determine if the cancer has spread. CT or PETscans may be utilized to help stage the cancer, and help determine the treatment path.

Surgery is the main treatment option for colon cancer. During surgery, the section of the colon that contains the cancerous tumor along with the adjacent lymph nodes will be removed,. Hoag’s skilled surgeons utilize two minimally invasive techniques for colon cancer surgery. These include:

• Laparoscopic surgery

• Robotic-assisted surgery

Both are excellent, effective surgical techniques for safely removing cancer cells. The surgical technique will be selected depending on the patient, their stage of cancer and location.

Once the cancer is surgically removed from the colon, a pathology report will determine if other treatment options are needed, such as chemotherapy. This is called adjuvant therapy – a secondary therapy that follows the primary treatment to improve results.

Treating Rectal Cancer

If rectal cancer is detected during a screening colonoscopy, additional tests may be completed to determine if the cancer has spread outside the rectum. Utilizing CT, PET, or MRI imaging, your physician can determine the best treatment path for your rectal cancer.

Rectal cancer is traditionally treated using a mix of therapies – surgery, radiation therapy and chemotherapy. Due to the location of the rectum, treatment often begins with less invasive options such as radiation therapy and chemotherapy to shrink the size of the tumor and allow for preservation of the anal sphincter. This treatment before surgery is referred to as neoadjuvant therapy. A skilled Hoag surgeon will then surgically remove the remaining concerning areas of the rectal cancer.

Hoag’s skilled surgical team offers minimally invasive treatment options for rectal cancer, including:

• Laparoscopic surgery

• Robotic-assisted surgery

Hoag’s Precision Medicine Program combines genomics and genetics to diagnose, treat, and prevent diseases. Using the latest advances in genomic technologies, targeted therapies and research, our precision medicine program brings together a multidisciplinary team, including a robust genetic counseling group of experts, to provide patients with the latest in innovation and technology.

Meet the Precision Medicine Team.

Hoag Family Cancer Institute provides a dedicated team of genetic counselors that offer hereditary cancer assessment, offering risk assessment and genetic cancer testing to those with a personal or family history of cancer.

Learn more and meet the team.

Being diagnosed with cancer can feel overwhelming at times. Many patients and their families need help with coping and can benefit from supportive counseling. Oncology Clinical Social Workers are available to provide emotional and practical support during all stages of cancer including diagnosis, treatment and post-treatment survivorship.

Find out more and meet our team.

Hoag Family Cancer Institute dietitians work closely with patients’ physicians, nurses, therapists, and social workers to ensure complete care.

Find out more and meet our team.

Cancer Support Services

Cancer Support Services offers a variety of classes to support and educate patients during and after cancer. These classes and workshops are all free of charge:

• Gastrointestinal Cancer Support Group – Designed to meet the educational and emotional needs of gastrointestinal cancer patients and their families. The group meets the fourth Thursday of each month from 2-3:30 p.m. in the Hoag Cancer Center Conference Room A.

• One-On-One Counseling with an oncology social worker

• Fitter Image Exercise Programs, including yoga, pilates and energizing cardio and toning

• Workshops for Well-Being, including free flow writing, meditation, reiki and creative art classes

Other Support Programs/Teams include:

• CARES Program – For patients experiencing high pain or symptom burden during treatment, the Hoag CARES Team can help. Board-certified Palliative Care physicians, nurses and social workers are available to help manage physical and emotional symptoms alongside your cancer care team.

• Oncology Dietitians – Hoag Family Cancer Institute provides two dedicated Registered Dietitians who are available to advise patients on nutrition and provide resources for a healthier diet before, during and after cancer treatment.

• Hereditary Cancer Program – Hoag offers both genetic counseling and genetic testing for individuals concerned about hereditary cancer.

• Spiritual Care – provides spiritual support & counseling services to patients, families, and the community.