Colorectal Cancer Comprehensive Treatment Guide for Patients

Overview

Colorectal cancer is a type of cancer that begins in the colon (large intestine) or rectum, the final part of the digestive tract. It often starts as small, noncancerous clumps of cells called polyps, which can turn cancerous over time. When caught early, colorectal cancer is highly treatable, which is why routine screening is critical for at-risk adults.

Signs & Symptoms

Early-stage colorectal cancer often has no noticeable symptoms, which is why screening is so important. As the cancer grows, you may experience one or more of the following:

• Persistent changes in bowel habits (diarrhea, constipation, or narrow stools lasting more than a few days)
• Rectal bleeding or blood in the stool
• Persistent abdominal discomfort (cramping, gas, or pain)
• Unexplained weight loss
• Persistent fatigue or weakness
• A feeling that your bowel does not empty completely

Causes & Risk Factors

Most colorectal cancer cases have no obvious single cause, but several factors can increase your risk. Some risk factors are out of your control, while others can be modified to lower your risk:

• Non-modifiable risk factors: Age over 45, family history of colorectal cancer or precancerous polyps, personal history of colorectal polyps or inflammatory bowel disease (Crohn's disease or ulcerative colitis), and inherited genetic syndromes like Lynch syndrome or familial adenomatous polyposis (FAP)
• Modifiable risk factors: Diet high in red or processed meats and low in fiber, sedentary lifestyle, obesity, heavy alcohol use, and smoking tobacco

Diagnosis

If your doctor suspects colorectal cancer, they will use a combination of tests to confirm a diagnosis and determine the cancer's stage (how far it has spread), which guides treatment planning.

Treatment & Management

Your treatment plan will be tailored to your cancer's stage, location, your overall health, and your personal preferences. Common treatment options include:

• Surgery: The most common treatment for early-stage colorectal cancer, where the surgeon removes the cancerous portion of the colon or rectum, and sometimes nearby lymph nodes. Minimally invasive laparoscopic surgery is often used for smaller tumors.
• Chemotherapy: Uses powerful drugs to kill cancer cells, often used before surgery to shrink tumors or after surgery to destroy remaining cancer cells. It may be given orally or through an IV.
• Radiation therapy: Uses high-energy beams to kill cancer cells, often used for rectal cancer, sometimes before or after surgery, or to relieve symptoms of advanced cancer.
• Targeted therapy: Uses drugs that target specific abnormalities in cancer cells, often used for advanced colorectal cancer, with fewer side effects than traditional chemotherapy.
• Immunotherapy: Uses drugs that help your immune system fight cancer, used for some advanced colorectal cancers with specific genetic markers.

Living With It

After completing treatment, regular follow-up care is critical to check for cancer recurrence and manage long-term side effects. Many people live full, active lives after colorectal cancer treatment with the right care and support. Your care team may also refer you to palliative care specialists to help manage symptoms and improve quality of life at any stage of your diagnosis.