Colon Cancer

At the UofL Brown Cancer Center, your treatment for colon cancer is personalized to provide the best outcomes, while focusing on your quality of life.

Overview

At UofL Brown Cancer Center, your treatment for colon cancer is personalized to provide the best outcomes, while focusing on your quality of life. We offer leading-edge treatments for colon cancer, including minimally invasive laparoscopic and robotic surgeries that provide successful treatment with less impact on you

If chemotherapy is needed, we offer the newest options. Our Multidisciplinary Gastrointestinal Cancer Clinic directs your therapy for the most benefit, while minimizing the impact on your body.

Sometimes radiation therapy is recommended as a part of treatment for colon cancer. Our colorectal radiation oncologists specialize in treating patients with colon cancer using advanced techniques.

We have expertise in advanced colon cancer that has metastasized (spread) to other parts of the body. We offer novel chemotherapy and targeted therapy options, as well as a dedicated surgery program.

Our advanced knowledge in cancer genetics can help diagnose and treat inherited family syndromes that may increase risk of colon cancer. This expertise also helps us work with you to plan the most effective treatment for your specific condition.

As a cancer research center, we are a leader in the investigation into new methods of colon cancer diagnosis and treatment. Each patient benefits from the most advanced research.

Colorectal cancer is a cancer that starts in the colon or the rectum. These cancers can also be named colon cancer or rectal cancer, depending on where they start. Colon cancer and rectal cancer are often grouped together because they have many features in common.

Cancer starts when cells in the body begin to grow out of control. Cells in nearly any part of the body can become cancer, and can spread to other areas of the body. 

How does colorectal cancer start?

Most colorectal cancers begin as a growth called a polyp on the inner lining of the colon or rectum Some types of polyps can change into cancer over the course of several years, but not all polyps become cancer. The chance of changing into a cancer depends on the kind of polyp. The two main types of polyps are:

  • Adenomatous polyps (adenomas): These polyps sometimes change into cancer. Because of this, adenomas are called a pre-cancerous condition.
  • Hyperplastic polyps and inflammatory polyps: These polyps are more common, but in general they are not pre-cancerous.

Other polyp characteristics that can increase the chances a polyp may contain cancer or increase someone’s risk of developing colorectal cancer besides the type include the size (larger than 1 cm), the number found (more than two), and if dysplasia is seen in the polyp after it is removed. 

Dysplasia, another pre-cancerous condition, is an area in a polyp or in the lining of the colon or rectum where the cells look abnormal (but not like true cancer cells).

If cancer forms in a polyp, it can eventually begin to grow into the wall of the colon or rectum.

The wall of the colon and rectum is made up of several layers. Colorectal cancer starts in the innermost layer (the mucosa) and can grow outward through some or all of the other layers. When cancer cells are in the wall, they can then grow into blood vessels or lymph vessels (tiny channels that carry away waste and fluid). From there, they can travel to nearby lymph nodes or to distant parts of the body.

The stage (extent of spread) of a colorectal cancer depends on how deeply it grows into the wall and if it has spread outside the colon or rectum.

Signs of colon cancer include blood in the stool or a change in bowel habits.


These and other signs and symptoms may be caused by colon cancer or by other conditions. Check with your doctor if you have any of the following:

 

  • A change in bowel habits.
  • Blood (either bright red or very dark) in the stool.
  • Diarrhea, constipation, or feeling that the bowel does not empty all the way.
  • Stools that are narrower than usual.
  • Frequent gas pains, bloating, fullness, or cramps.
  • Weight loss for no known reason.
  • Feeling very tired.
  • Vomiting.

Tests that examine the colon and rectum are used to detect (find) and diagnose colon cancer. The following tests and procedures may be used:

Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.

Digital rectal exam: An exam of the rectum. The doctor or nurse inserts a lubricated, gloved finger into the rectum to feel for lumps or anything else that seems unusual.

Fecal occult blood test (FOBT): A test to check stool (solid waste) for blood that can only be seen with a microscope. A small sample of stool is placed on a special card or in a special container and returned to the doctor or laboratory for testing. Blood in the stool may be a sign of polyps, cancer, or other conditions. There are two types of FOBTs:

  • Guaiac FOBT : The sample of stool on the special card is tested with a chemical. If there is blood in the stool, the special card changes color. Enlarge A guaiac fecal occult blood test (FOBT) checks for occult (hidden) blood in the stool. Small samples of stool are placed on a special card and returned to a doctor or laboratory for testing.
  • Immunochemical FOBT: A liquid is added to the stool sample. This mixture is injected into a machine that contains antibodies that can detect blood in the stool. If there is blood in the stool, a line appears in a window in the machine. This test is also called fecal immunochemical test or FIT.Enlarge A fecal immunochemical test (FIT) checks for occult (hidden) blood in the stool. A small sample of stool is placed in a special collection tube or on special cards and returned to a doctor or laboratory for testing.

Barium enema: A series of x-rays of the lower gastrointestinal tract. A liquid that contains barium (a silver-white metallic compound) is put into the rectum. The barium coats the lower gastrointestinal tract and x-rays are taken. This procedure is also called a lower GI series.Enlarge Barium enema procedure. The patient lies on an x-ray table. Barium liquid is put into the rectum and flows through the colon. X-rays are taken to look for abnormal areas.

Sigmoidoscopy: A procedure to look inside the rectum and sigmoid (lower) colon for polyps (small areas of bulging tissue), other abnormal areas, or cancer. A sigmoidoscope is inserted through the rectum into the sigmoid colon. A sigmoidoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove polyps or tissue samples, which are checked under a microscope for signs of cancer.Enlarge Sigmoidoscopy. A thin, lighted tube is inserted through the anus and rectum and into the lower part of the colon to look for abnormal areas.

Colonoscopy: A procedure to look inside the rectum and colon for polyps, abnormal areas, or cancer. A colonoscope is inserted through the rectum into the colon. A colonoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove polyps or tissue samples, which are checked under a microscope for signs of cancer.

Enlarge Colonoscopy: A thin, lighted tube is inserted through the anus and rectum and into the colon to look for abnormal areas.

Virtual colonoscopy: A procedure that uses a series of x-rays called computed tomography to make a series of pictures of the colon. A computer puts the pictures together to create detailed images that may show polyps and anything else that seems unusual on the inside surface of the colon. This test is also called colonography or CT colonography. 

Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer.

The prognosis (chance of recovery) and treatment options depend on the following:

  • The stage of the cancer (whether the cancer is in the inner lining of the colon only or has spread through the colon wall, or has spread to lymph nodes or other places in the body).
  • Whether the cancer has blocked or made a hole in the colon.
  • Whether there are any cancer cells left after surgery.
  • Whether the cancer has recurred. 
  • The patient’s general health.


The prognosis also depends on the blood levels of carcinoembryonic antigen (CEA) before treatment begins. CEA is a substance in the blood that may be increased when cancer is present. 

Colon Cancer Staging

After colon cancer has been diagnosed, tests are done to find out if cancer cells have spread within the colon or to other parts of the body. The process used to find out if cancer has spread within the colon or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment.

The following tests and procedures may be used in the staging process:

CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, such as the abdomen or chest, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. 

MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the colon. A substance called gadolinium is injected into the patient through a vein. The gadolinium collects around the cancer cells so they show up brighter in the picture. This procedure is also called nuclear magnetic resonance imaging (NMRI).

PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.

Chest X-ray: An X-ray of the organs and bones inside the chest. An X-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.

Treatment

We offer leading-edge treatments for colon cancer, including minimally invasive laparoscopic and robotic surgeries that provide successful treatment with less impact on you

If chemotherapy is needed, we offer the newest options. Our renowned team of physicians directs your therapy for the most benefit, while minimizing the impact on your body.

Sometimes radiation therapy is recommended as a part of treatment for colon cancer. Our colorectal radiation oncologists specialize in treating patients with colon cancer using advanced techniques.

We have expertise in advanced colon cancer that has metastasized (spread) to other parts of the body. We offer novel chemotherapy and targeted therapy options, as well as a dedicated surgery program.

Our advanced knowledge in cancer genetics can help diagnose and treat inherited family syndromes that may increase risk of colon cancer. This expertise also helps us work with you to plan the most effective treatment for your specific condition.

Surgery: A procedure to remove the tumor and see how far it has spread through the colon.

Lymph node biopsy: The removal of all or part of a lymph node. A pathologist views the tissue under a microscope to look for cancer cells.

Complete blood count (CBC): A procedure in which a sample of blood is drawn and checked for the following: 

  • The number of red blood cells, white blood cells, and platelets.
  • The amount of hemoglobin (the protein that carries oxygen) in the red blood cells.
  • The portion of the blood sample made up of red blood cells.

Carcinoembryonic antigen (CEA) assay: A test that measures the level of CEA in the blood. CEA is released into the bloodstream from both cancer cells and normal cells. When found in higher than normal amounts, it can be a sign of colon cancer or other conditions.

Our doctors at UofL Brown Cancer Center are proudly part of UofL Physicians and the UofL School of Medicine.

We believe knowledge comes from questioning the status quo, discovering more about disease and using that knowledge to improve the health of our community. Our physicians are the teachers and researchers at the UofL School of Medicine, involved in the research and development of new treatments and cures for cancer. This means you receive the most advanced and appropriate treatment, even for complex or rare conditions.

To learn more about the physicians who make the academic difference in colon cancer treatment, visit the UofL Physicians web site here.