New drugs and combinations of drugs are more effective, surgical treatments have been refined and improved, and most patients are candidates for minimally invasive surgical techniques that have less pain and faster recovery. Stephen Sentovich, M.D. Chief of Colon and Rectal Surgery
At City of Hope, our approach to treating colon and rectal cancers starts with personalized care — not just for your cancer, but the kind that makes you feel supported throughout your treatment. Our world-class colorectal team combines a multidisciplinary team approach with the newest, leading-edge colorectal genetic screening to provide you with the most accurate diagnosis and treatment path.
City of Hope is one of only a few cancer centers in the country that provides comprehensive treatment. That means you have a team that is working together to combine innovative, genetically-targeted therapies with leading-edge surgical techniques — all with the goal of making you whole again.
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City of Hope’s world renowned colorectal care team use the latest technology and innovation to treat colon and rectal cancer while providing compassionate care. Call 800-826-HOPE or request an appointment online.
City of Hope is internationally-recognized for its research and breakthrough treatments, has been named one of America’s top cancer hospitals by U.S. News & World Report for more than 10 years running and is a National Cancer Institute-designated comprehensive cancer center.
Our commitment to providing the best care for you includes:
At City of Hope we see complicated colon and rectal cancer cases every day, so we are experts at treating advanced and recurrent disease. That treatment happens just steps away from groundbreaking research and clinical trials — happening right on City of Hope’s campus — that could directly impact how we treat your cancer.
When we care for you at City of Hope, we are not just focused on leading-edge care and innovation — we are working to make you whole again.
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We have made great advancements in the field and the majority of colon cancers are curable. Kurt Melstrom, M.D. Colorectal Surgeon
Colon and rectal cancers combined are the fourth most diagnosed cancer in the United States, behind breast, lung and prostate. Since they are so similar the two often are lumped into one category and called colorectal cancer. More than 134,000 people will get colorectal cancer in the United States this year. That means about one in 20 people will get the disease during their lifetimes.
Although colorectal cancer is the third leading cause of cancer death, that rate has been dropping steadily, most likely because of better screening and treatment.
Types of colon cancer
There are several types of colon cancer, but most are what is called adenocarcinoma:
Other types of cancer that can start in the colon and rectum are much less common:
How Colon Cancer Develops
The colon is a five-foot-long tube, shaped like a giant question mark, stretching from the small intestine to the rectum. It is part of the large intestine. When you eat food, it travels from the stomach and through the small intestine — where it is digested and absorbed — then it goes through the colon, where any leftover water and salt are absorbed.
The last six inches of the large intestine includes the rectum, a receptacle for the waste that is left before it leaves your body — and the anus. Cancers of the colon tend to be grouped with rectal cancer, and called colorectal cancer, because they are so similar.
Getting colon cancer
Getting colorectal cancer means abnormal cells in your colon or rectum are growing and dividing at a rapid pace — so fast that cells in your immune system that fight disease cannot keep up.
Layers of tissue inside the colon and rectum form what is called the wall. The innermost layer of that wall, called the mucosa, is where colorectal cancer usually starts. When cells in the mucosa grow uncontrollably, they join together to form a small, bulb-like growth called a polyp. Most polyps are benign, which means they do not cause cancer, but some can turn into cancer over time.
There are three main types of polyps:
If it is caught early through routine screening, colorectal cancer is very treatable. In more advanced cases, cancer cells will have grown through the colon wall and eventually spread to other parts of the body — a process called metastasis. Colorectal cancer that has metastasized tends to travel through the blood or lymph system, to the liver, lung and peritoneum.
Watch: How Colon Cancer Starts
What Increases Your Risk of Colon Cancer?
Things that put you at higher risk for getting colorectal cancer are called risk factors. The links between diet, weight, and exercise and colorectal cancer are some of the strongest for any type of cancer. Your risk of getting colorectal cancer depends on a complex interaction between those lifestyle factors and your inherited risks — in other words, the ones you’re born with.
Lifestyle-related risk factors for colon cancer include:
Inherited risks for colon cancer include:
Colon Cancer Prevention
More than most other cancers, colorectal cancer is affected by things you can control, like what you eat and how much you exercise. Eating a diet that includes plenty of vegetables, fruits, and whole grains — and that is low in animal fat — has been linked with a lower risk of colorectal cancer. Other lifestyle changes like quitting smoking, drinking less and exercising regularly may help lower your risk.
And getting screened for colorectal cancer starting at age 50 (or younger if you have a family history) may help doctors to find and remove polyps before they turn into cancer.
Colon Cancer Symptoms
Most of the time during the early stages, colorectal cancer does not cause symptoms. Polyps can grow in the colon wall for months or years without causing bleeding or pain. It is usually during the later stages — once the cancer has grown or spread — that symptoms may appear:
Typical colorectal cancer symptoms include:
These symptoms could also be a result of other conditions like hemorrhoids, irritable bowel syndrome, inflammatory bowel disease or infection. Still, if you have any of these problems for more than two weeks, it’s important to see your doctor right away to pinpoint and treat the cause.
Colon Cancer Screening
Screening involves looking for cancer before you have symptoms and increases your chances of catching colorectal cancer at an early stage, when it is more likely to be cured. Colorectal cancer screening is important because polyps containing cancer cells can stay lodged in the colon wall for months or years without causing bleeding, pain or any other symptoms.
At City of Hope we are dedicated to increasing the number of lifesaving screenings, and to support that effort we offer state-of-the-art diagnostic tools including colonoscopy and stool DNA testing. And our genetic screening and counseling program for colorectal cancer allows for the most accurate diagnosis and a clearly defined treatment path.
Many people do not get screened
Colorectal cancer is one of the most curable cancers, yet research shows tens of millions of people are skipping out on potentially lifesaving screening. The biggest reason: fear.
Fear of bowel preparation. Fear of the test. Fear of the results.
But most of those concerns are unfounded — especially fear of the test. The gold standard for colorectal cancer screening – colonoscopy – is a painless exam that happens while a patient is sedated (sleeping), and usually is over in less than 30 minutes.
If people who are avoiding them got colon cancer screenings, it could prevent 60 percent of colorectal cancer deaths.
Hereditary causes of colorectal cancer
Having close relatives with colorectal cancer increases the risk of developing the disease – and being diagnosed earlier in life – and could direct or change the treatment for some patients. Up to 10% of people with colorectal cancer have an inherited genetic abnormality that associated with developing the disease. Two of the most common inherited conditions that influence your risk of disease include:
Although hereditary factors account for less than 5% of colorectal cancers, your chances of having one of these conditions is higher if several of your close family members have been diagnosed.
If your family history suggests an increased risk of colorectal cancer, City of Hope’s Division of Clinical Cancer Genetics offers genetic counseling and screening that can identify whether inherited conditions influence your risk—and guide you to the best treatments.
When should you be screened?
You should start routine colorectal cancer screening at age 50 if you:
Your screening should begin before age 50, with more frequent follow-up, if you:
Diagnosing Colon Cancer
At City of Hope, we have several ways to screen for colorectal cancer including:
Other screening tests look for signs of cancer in your stool or feces, but are less sensitive than tests like colonoscopy:
A colonoscopy is the only test that lets the provider see your entire colon and rectum, and remove polyps at the same time. If you have any of the other tests and something uncertain is found, you will likely need a colonoscopy.
The most important thing about being an oncologist is to be there for your patient all along—to have an honest and ongoing discussion of what’s going on. Marwan Fakih, M.D. Medical Oncologist
City of Hope’s approach to treating colorectal cancer is focused on precision medicine. That means we apply precise and minimally-invasive surgical techniques — and test individual cancer cells to find drug combinations that would work best for your specific cancer.
We are a leader in targeting therapy to individual patients and have many options for treating complex colorectal cancers including:
City of Hope is one of the few centers in the country that treats colorectal cancer using a comprehensive, team-based approach, by a team whose only focus is treating this type of cancer.
Your care includes regular interaction and input from a team of colorectal surgeons, oncologists, gastroenterologists, radiologists and pathologists — along with nurses, genetic counselors, nutritionists and specially-trained support staff.
That comprehensive approach to your care means better care and a strong potential for you to live longer.
I find great satisfaction in identifying a tumor, removing it and restoring the body to normal functioning. My inspiration comes from the individual challenge that each patient brings and finding the best way to treat them. Kurt Melstrom, M.D. Colorectal Surgeon
City of Hope’s surgeons are world leaders in robotically-assisted and minimally-invasive colorectal surgery that is focused on avoiding colostomy. Our surgeons work on a team to determine the best way to treat your cancer and preserve your bowel function and quality of life.
Surgeries for colon cancer
Surgeries for rectal cancer
Chemotherapy or radiation may be given before surgery to shrink the tumor; and after surgery to try and wipe out any remaining cancer cells.
Chemotherapy is a treatment that uses drugs to either kill cancer cells or stop them from growing.
Exciting advances in chemotherapy at City of Hope are allowing patients with advanced disease to get combinations of drugs to shrink tumors, making it easier to take them out later with surgery — or melt them away and avoid surgery altogether.
If you have failed all standard chemotherapy, City of Hope has several experimental approaches — including immunotherapy and targeted therapy — designed to target your specific tumor and extend your life.
And for cancer that has spread to the liver, we offer leading-edge therapies like hepatic arterial infusion: a small disc implanted under the skin that sends chemotherapy drugs directly into the artery that feeds the liver.
City of Hope uses the latest technology to spot genetic vulnerabilities in cancer cells and use medications — or combinations of medications — to stop them from growing. This allows us to create targeted therapies: drugs or drug combinations tailored to treat specific cancers.
Radiation therapy uses high-energy radiation to kill cancer cells and shrink tumors. City of Hope offers advanced radiation treatments that are highly targeted to cancer cells including:
City of Hope’s renowned physicians and researchers utilize the latest in technology and innovation to treat colorectal cancer, coupled with our enduring belief in providing unparalleled compassionate care.
Colon Cancer Research at City of Hope
Getting treated for colorectal cancer at City of Hope means you are steps away from labs where new treatments are being developed every day. That proximity means you will benefit from something unique in cancer care—“bench to bedside” treatment. Bench to bedside means exciting new research we are conducting in our labs is moved quickly to the bedside to treat our patients.
Colorectal cancer is an extremely complex disease that can act many different ways in the body. Clinical trials at City of Hope are focused on those differences — and designing therapies that affect how colorectal cancer develops, progresses and spreads:
In addition to these clinical trials, City of Hope has several others that will open soon that look at new therapies for patients with specific mutations called RAS, and will explore new immunotherapy approaches, which is a way of helping the patient’s own immune system fight cancer.
At City of Hope, we offer access to numerous clinical trials aimed at improving survival rates and enhancing quality of life. Many of these new therapies are not always available elsewhere. Our latest research covers many areas including new drug combinations that prevent colorectal cancer recurrence, profiling of cancer tissue at the molecular level to determine genetic abnormalities, and blocking a specific protein known to cause a form of the disease.
Browse through some of our clinical trials and research projects listed below:
Anne Bourque is not only a colon cancer survivor, she is also a longtime City of Hope employee who began as a registered nurse in 1980 and is now the clinical director of hematology and hematopoetic stem cell transplantation program.
When you come to City of Hope, you have access to a strong network of support services and staff to help you and your family along your colon cancer journey. That support includes everything from talk therapy to meditation to being paired up with a patient navigator. Learn more about the resources listed below at our Living with Cancer or Supportive Care Medicine sites.
Once treatment is complete, City of Hope’s support services include education and training from ostomy nurses who provide specialty care for patients with wounds resulting from colorectal surgery.