Colorectal Cancer

Colorectal cancer is the third most common type of cancer in both men and women.

The colon and rectum are parts of the large intestine in the digestive system. They work together to remove waste from the body. After food is digested and nutrients are absorbed in the small intestine, the remaining material moves into the colon. Here, water and salts are absorbed, and the remaining waste is stored in the rectum until it is expelled through the anus.

Colorectal cancer occurs when cells in the colon or rectum develop genetic abnormalities and multiply quickly, resulting in a tumor forming. Depending on where the tumor forms, it may be colon cancer or rectal cancer.

Our surgeons work with a team of other specialists to detect and treat colorectal cancer. Colorectal cancer experts at WashU Medicine offer the latest advances in treatment, which have been shown to improve outcomes for people with colon or rectal cancer.

Risk factors for colorectal cancer

Studies have found that certain factors may increase the risk of getting colorectal cancer. Understanding the risk factors is crucial for prevention and early detection.

Colorectal cancer risk factors include:

• Age 50 or older
• History of colon polyps
• Family history of colon cancer
• High-fat, low-fiber diet
• Inflammatory bowel disease (ulcerative colitis or Crohn’s disease)
• Drinking alcoholic beverages daily
• Inactive lifestyle

There are steps you can take to actively reduce your colorectal cancer risk.

Signs & symptoms of colorectal cancer

Recognizing the signs and symptoms of colorectal cancer can lead to early diagnosis and more effective treatment.

Possible colorectal cancer symptoms include:

• Changes in bowel habits, such as more frequent bowel movements
• Blood in the stool, which may be dark or bright red
• Fatigue
• Stools that are narrower than usual
• Abdominal pain, gas pains, cramping, or bloating
• Diarrhea or constipation lasting more than two weeks
• A feeling that the bowel is never fully emptied

Screening tests for colorectal cancer

There are five screening tests for colorectal cancer. Screening can help detect colorectal cancer at an early stage, when it is most treatable. In some cases, screening tests can even prevent colorectal cancer before it begins.

Talk with your doctor about which tests are right for you.

Screening tests include:

• Digital rectal exam: The doctor gently inserts a gloved, lubricated finger into the rectum and feels for abnormal areas.
• Fecal occult blood test: Samples of stool are tested for blood that is not visible to the eye. Blood can be a sign of polyps, other benign conditions or cancer.
• Sigmoidoscopy: The doctor inserts a small, flexible, lighted tube into the rectum and lower colon to inspect up to 25 inches of the lower bowel. Polyps can be easily removed during this exam.
• Colonoscopy: The doctor inspects the entire colon with an instrument similar to a sigmoidoscope, but longer. Any polyps or suspicious growths can be removed during this exam.
• Barium enema with air contrast examination: For this exam, barium sulfate, a chalky substance that shows up on X-rays, is given in enema form. X-rays are then taken of the colon. To make small tumors easier to see, the doctor may carefully pump in air to expand the colon.

Colorectal cancer is most treatable when caught early, but there are treatments for the different stages of colorectal cancer.

Colorectal cancer treatment

Treatment plans for colorectal cancer depend on the stage and location of the cancer, as well as the overall health of the patient. Common treatments include:

• Surgery: The most common treatment for colorectal cancer is surgery to remove the cancerous part of the colon or rectum. Surgeons at WashU Medicine are experts in minimally invasive laparoscopic colectomy.
• Chemotherapy: Uses drugs to destroy cancer cells, often used when the cancer has spread.
• Radiation therapy: Uses high-energy rays to target and kill cancer cells. Typically used in rectal cancer.
• Targeted therapy: Involves drugs that specifically target cancer cell mechanisms with minimal damage to normal cells.

If you have any symptoms, concerns, or questions, it is important to speak with a doctor to find the care you need. Colorectal cancers are often very treatable in their early stages, and recent advances have improved outcomes for people with even more advanced forms of cancer.