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What is Colorectal Cancer? Diagnosis, Treatment, and Support at Stormont Vail Health

Finding out that you or a loved one has colorectal cancer can be one of the scariest moments of your life — but finding out that it’s a very treatable form of cancer can be a big relief.

Colorectal cancer affects the digestive system. The digestive system is responsible for breaking down what you eat and drink into nutrients, absorbing nutrients into your blood, and getting rid the waste. This process is what makes you have to use the bathroom.

Colorectal cancer affects one of two parts of the digestive system:

  • Large intestine: This is also known as the colon. It absorbs nutrients and water, and turns waste into stool.
  • Rectum: This is the lower part of the colon that holds stool. It’s connected to the anus, which is where you push stool out of during a bowel movement.

A cancer diagnosis can be very scary, but there is some good news about colorectal cancer: Because of screening technology, it is one of the most preventable cancers.

    5 Fast Facts About Colorectal Cancer

  1. When found in its earliest stages, colorectal cancer has a very high 5-year survival rate — more than 90% of people are alive 5 years after their diagnosis, and many live much longer.
  2. The number of new cases and the rate of death from colorectal cancer has dropped by over 30% among US adults ages 50 and older in the last 15 years.
  3. There are over 1 million colorectal cancer survivors in the US.
  4. Colorectal cancer is the fourth most common cancer and the fourth leading cause of cancer deaths in Kansas. But with screening, that number could go down — 60% of colorectal cancer deaths could be prevented with screening.
  5. Among Topeka adults ages 50 to 75, about 64% had gotten screened for colorectal cancer within the past 10 years.

What’s Happening to My Body During Colorectal Cancer?

Most cases of colorectal cancer begin with polyps — small, non-cancerous clumps of cells — in the lining of the colon. Polyps are very common — in fact, about 20% to 30% of American adults will have non-cancerous polyps at some point. Polyps are generally harmless. However, some can eventually turn into cancerous tumors.

If the cancerous tumors are found in your colon, they are colon cancer. But if they’re found in your rectum, they are rectal cancer.

Diagnosing Colorectal Cancer: Testing

With the right screening, it’s easy to detect colorectal cancer in its early stages, when it’s easiest to treat. Often, polyps are found before they even turn into cancer in the first place.

There are a few ways to look for both polyps and signs of cancer.

  • Colonoscopy

    One of the most common tests is a quick, painless procedure called a colonoscopy.

    Before the colonoscopy, your physician will prescribe a strong laxative to empty your colon. The laxative will be in either pill or liquid form, and you may be instructed to take it the night before the procedure, the morning of, or both.

    During the colonoscopy, your physician will look inside your colon and rectum using a scope, which is a tiny camera attached to a long, thin tube. Don’t let that scare you — you will be sedated beforehand so you won’t feel pain or remember the procedure.

    A colonoscopy can detect both polyps and cancer. If the colonoscopy finds polyps, they can usually be taken out right there. Your provider may also take samples of tissue if they think there might be cancer. These samples can be sent to a lab to check for cancer.

    Learn more about colonoscopy.

  • Flexoid Sigmoidoscopy

    Sometimes, a flexoid sigmoidoscopy is used instead of a colonoscopy. This test uses a flexible, narrow tube with an attached light and camera to look inside the lower colon and rectum. It’s similar to a colonoscopy, but there are a few key differences:

    • It only looks at the lower colon and rectum, rather than the entire colon.
    • Tissue can be removed — but polyps cannot. If polyps are found, you will need a colonoscopy to have them removed.
    • The preparation is easier.
    • You probably won’t need sedation or pain medication.

    Flexoid sigmoidoscopies are typically only used if you aren’t at high risk for colorectal cancer.

  • Fecal Occult Blood Test

    Blood in the stool can be a sign of both polyps and existing colorectal cancer. If it can’t be seen by the naked eye, it’s called occult blood. A fecal occult blood test checks a sample of your stool for occult blood.

Who Should Get Screened?

Getting screened regularly is very important, especially because polyps and colorectal cancer rarely cause symptoms in their early stages.

Stormont Vail Health recommends regular colorectal cancer screenings for:

  • Patients over age 50
  • Patients with a family history of colorectal cancer
  • Patients whose health care providers believe, for any reason, that an annual colonoscopy is indicated.

You don’t need a referral for a colonoscopy. Call (785) 270-4800 to make an appointment.

Diagnosing Colorectal Cancer: Staging

Once it has been detected, colorectal cancer, can be classified into one of five stages. The classification is based on the cancer’s location, if and where it’s spread, and whether or not it is affecting other parts of the body.

Stage What’s Happening in Your Body
Stage 0 This is the earliest stage where the cancer hasn’t spread from where it started. It’s also called cancer in situ, which means cancer in place.
Stage I The cancer is still in the lining, but it has just started to spread to nearby tissues. It has not spread to lymph nodes or other parts of the body. Usually, it’s called early-stage cancer.
Stages II and III The cancer has grown more deeply into nearby tissues, and may have spread to the lymph nodes. However, it has not spread to other parts of the body.
Stage IV The cancer has spread to other parts of the body (metastasized). This may be called “metastatic cancer” or “advanced cancer.”

Treatment

Treatment for colorectal cancer depends on how advanced it is. In general, there are three major types of treatment: surgery, radiation, or medication (including chemotherapy). You may receive just one of these or a combination.

Surgery

Surgery can be used for cancers in all five stages and it’s the most common treatment for early-stage cancers.

  • Polypectomy

    When polyps are not yet cancerous, or you have cancer that’s in stage 0, they can usually be removed by colonoscopy. If for some reason that isn’t an option, they can be removed through minimally invasive surgery. Minimally invasive means the surgeon make a few small cuts, rather than large incisions. It generally means quicker recovery, less post-op pain, and less scarring.
  • Colectomy

    If cancer has spread into or through the colon, you may need a colectomy — a procedure to remove part or all of the colon, as well as nearby lymph nodes that need to be checked for cancer. This can be done for cancer at stages 1 through 4.

    Usually, this involves removing the diseased part of the colon and then reattaching the healthy parts to one another. In rare cases, you may need a total colectomy, where the entire colon is removed.

    A total colectomy is typically only needed if there are other, non-cancerous problems of the colon, such as inflammatory bowel disease.

  • Colostomy

    Colostomy is used for cancer that has spread to other parts of the body, or when tumors are blocking off the colon. This involves making a surgical opening (stoma), which connects to the colon and provides a new way for waste to exit the body. You will wear a pouch, which collects the waste.

    Colostomies can be permanent, but many are temporary, and are just there while your rectum heals.

Radiation

Radiation uses high-energy rays (such as X-rays) or particles to destroy cancer cells. Most often, it’s used to treat cancers in the rectum, rather than those in the colon. It usually is not given until cancer is at stage 3.

Often, radiation is used in combination with chemotherapy — drugs that destroy cancer cells.

For rectal cancer, radiation is used to:

  • Shrink a tumor before surgery so it’s easier to remove
  • Destroy remaining cancer cells
  • Help keep the cancer from coming back (along with chemotherapy)
  • Control cancer growth if you’re not healthy enough for surgery
  • Ease symptoms if the cancer is advanced and causing a blockage in the colon, pain, or bleeding
  • Treat tumors that have come back in the pelvis after previous radiation
  • Treat cancer that’s spread to other parts of the body, such as your brain or bones

When radiation is used for colon cancer, it’s for many of the same purposes. It can also be used after surgery if the cancer has attached to the lining of the belly (abdomen) or an internal organ.

Medication

There are several types of drugs that can be used to destroy cancer cells. For colorectal cancer, there are three main forms of drug treatment:

  • Chemotherapy

    Chemotherapy drugs end a cancer cell’s ability to grow and divide, stopping it from getting worse or spreading. During chemotherapy, you may receive just one drug or a combination of a few different ones.

    If you are having surgery, your provider may prescribe it to eliminate any remaining cancer cells. If you have rectal cancer, you may need to use chemotherapy along with radiation before a procedure to shrink the tumor and reduce the chance of the cancer coming back.

  • Targeted Therapies

    There are certain genes, proteins, and tissues that cause a cancer cell to grow. With targeted therapy, drugs can target those areas and stop them from working, ending cells’ ability to grow and divide.

    In many cases, targeted therapy is used alongside chemotherapy. For people who have advanced colorectal cancer that can’t be cured, the combination of targeted therapy and chemotherapy can often help them live longer.

  • Immunotherapy

    Immunotherapy doesn’t specifically target cancer cells. Instead, it boosts the immune system’s natural ability to fight disease. It trains your system to recognize and attack cancer cells.

    In general, immunotherapy is used for patients who have:

    • Colorectal cancers cells that have tested positive for certain types of gene changes
    • Had treatment with chemotherapy, but their cancer is still growing
    • Cancer that can’t be removed with surgery, has spread to other body parts (metastasized), or has returned after treatment

In addition to these treatments, you may receive palliative care. Palliative care aims to reduce symptoms, ease side effects of treatments, and improve overall quality of life. There are many methods of palliative care, such as medications, relaxation techniques, diet changes, or emotional support therapy. Your palliative care specialist will help you develop a care plan that meets your individual needs.

Your Treatment Team

At Stormont Vail, your treatment team will include several types of specialists, such as:

  • Oncologists: Physicians who specialize in treating cancer
  • Gastroenterologists: Physicians who specialize in treating gastrointestinal (digestive system) disorders and diseases
  • Radiologists: Physicians who diagnose and treat cancer using imaging techniques, such as X-rays
  • Radiation oncologists: Physicians who prescribe and oversee radiation treatments for people with cancer
  • Radiation technicians: Specialists who set up and run imaging tests, and bring results to radiologists for interpretation
  • Oncology nurses: Nurses who have specific training in working with patients with cancer
  • Palliative care providers: Specialists who help relieve pain and side effects caused by cancer or its treatments
  • Behavioral health providers: Physicians, nurses, social workers, and therapists who help you manage the emotional and social concerns you may have during diagnosis and treatment
  • Primary care providers: Physicians who manage your overall, everyday health needs so that your body stays strong enough to fight cancer

Why Choose Stormont

Located in Topeka, Kansas, Stormont Vail Health is a community-driven organization. It offers close to home care and with limited travel requirements, it will be easier for you to get the colorectal cancer care you need in a community you trust.

In 2018, Stormont Vail achieved Magnet designation for a third time. Magnet designation is one of the highest awards in nursing excellence and high-quality patient care. Only 9% of US hospitals have earned this recognition. The Joint Commission — with more than 50 years of accrediting hospitals in high quality standards — has also accredited Stormont Vail Hospital.

With a team of digestive health and cancer physicians and nurses that’s been recognized for excellence with the prestigious Magnet designation, Stormont Vail Health has an experienced and skilled medical team to help you manage your colorectal cancer care.


Next Steps

Make an Appointment

  • Treatment for colorectal cancer involves specialists from both the Digestive Health and Cancer departments.
  • Call (785) 270-4800 to schedule a colonoscopy. You do not need a referral.

See a Primary Care Provider

  • Call (785) 270-4440 to schedule an appointment with your Stormont Vail primary care provider.
  • Not a Stormont Vail patient? Call (785) 270-4440 to set up your first appointment with one of our primary care providers.