Colorectal cancer

Early detection of colorectal cancer is the key to getting the best possible outcome. That's why it's important to know if you are at risk of developing the disease.

You may have a higher risk of developing colorectal cancer if you:

• Are an active tobacco user
• Are Black or of Eastern European descent
• Are older than 60 years old
• Are overweight or obese
• Drink more than one drink a day
• Eat a diet high in red meat and low in fiber
• Get less than 30 minutes of physical activity a day
• Have a family history of colorectal cancer
• Have an inherited syndrome, such as familial adenomatous polyposis (FAP) or Lynch syndrome
• Have inflammatory bowel disease, such as ulcerative colitis or Crohn's disease
• Have Type 2 diabetes

If you have early-stage colorectal cancer, you most likely do not usually have symptoms. It's essential to be mindful of certain signs and speak to a doctor if they appear. Common symptoms of colorectal cancer include:

• Any major change in bowel habits
• Constipation
• Diarrhea
• Feeling bowels do not totally empty
• Frequent gas pain or bloating
• General abdominal discomfort
• Loss of appetite
• Nausea or vomiting
• New onset anemia
• Persistent fatigue or weakness
• Red, black or tarry blood in stool
• Stools that are narrower than usual
• Unexplained weight loss

Because early-stage colorectal cancer does not usually present symptoms, routine screenings are essential in preventing cancer and detecting the disease in its earliest and most treatable stages.

Our doctors use imaging exams and diagnostic procedures to detect and diagnose colorectal cancer, gastrointestinal (GI) cancer and related diseases. The American Cancer Society recommends screening for colorectal cancers starting at 45 years old. Evidence-based options may include colonoscopy at 10-year intervals or a fecal immunohistochemistry fest (FIT) annually.

Additionally, we offer various screening options to detect colorectal cancer, including:

• Biopsy — A tissue sample is removed and sent for an examination by a pathologist.
• Digital rectal exam — This exam checks for abnormalities and can detect almost half of colon cancers. It can usually be completed by a primary care physician (PCP).
• FIT — A stool culture test is used to detect blood in bowel movements. You will obtain a discreet sample in the privacy of your own home and send it to a lab for analysis. This test is offered through a PCP and is covered by most insurance carriers. It might be right for you if you are at an average risk for colon cancer.
• Fecal occult blood test — This lab test is used to look for blood in the stool. Talk to your doctor if you experience blood in your stool.
• Stool DNA test — In order to detect blood in stool, this lab test looks for DNA changes in cells. It can usually be performed by your PCP.
• Virtual colonoscopy – Computer software along with computerized tomography (CT) scans check the colon for polyps.
• X-ray or barium enema — These procedures take a picture of the colon to assist in identifying polyps.

If our physicians detect colon cancer, we also identify the cancer's stage. Cancer stages are determined by how much cancer is in the body. The stage can be one of the most critical factors for doctors when recommending a treatment method.

The stages of colorectal cancer are:

• Stage 0 — Also called carcinoma in situ, this extremely early stage means abnormal cells are found only on the surface layer of the colon wall.
• Stage 1 — Cancerous cells have been found in the muscular layer of the colon wall.
• Stage 2 — Cancer has spread through the muscle layer of the colon wall to the outermost layer of the colon wall.
• Stage 3 — Cancer has spread to nearby lymph nodes.
• Stage 4 — In this advanced stage, cancer has spread beyond the colon to other parts of the body, most often the liver and lungs.

In some cases, physicians can treat colorectal cancer using nonsurgical methods. This usually depends on the stage of the cancer and the location of the tumor. Nonsurgical therapies might also be used in conjunction with surgery to treat the disease effectively.

Our oncology programs offer evidence-based, nonsurgical treatments, including:

• Chemotherapy — This common treatment uses injectable drugs to destroy cancer.
• Clinical trials — Our hospitals provide you with access to new therapies that are currently under investigation.
• Cryosurgery — Here, infected tissue is destroyed using extreme cold.
• Radiation therapy — This treatment uses high-energy rays to destroy cancer cells.
• Radiofrequency ablation — Using high energy radiowaves to kill tumors, this treatment is typically chosen when the cancer has spread to other organs.
• Targeted therapy — In this treatment, chemotherapy drugs are formulated to target specific cell changes.

After you have completed treatment, you will undergo cancer rehabilitation to help you regain strength and good health.

Surgery is the most common and effective type of treatment for colorectal cancer. We use a range of minimally invasive surgical options, such as laparoscopy and robot-assisted surgery whenever possible to potentially minimize scarring and recovery times.

Robotic-assisted surgery can be potentially beneficial with rectal cancer. The robot's accuracy, visibility and maneuverability allow the surgeon to reach farther beneath the tumor than ever before. Additionally, it may eliminate the need for a permanent colostomy bag following surgery.

Renowned for our expertise in robotics, our colorectal program features some of the country's best colorectal surgeons. Many of our surgeons were early-adopters of this technology and have performed hundreds of successful robotic colorectal operations. Our surgeons educate and set expectations upfront so that they can partner with your PCP and help you make treatment decisions that are right for you.

Some of the most common surgical treatments we perform to treat colorectal cancer include:

• Local excision — Here, we remove cancer on the surface of the colon wall along with a small amount of nearby tissue. It can be done during a colonoscopy and is used for stage 0 and early stage 1 colon cancer.
• Partial colectomy — Often minimally invasive, this procedure removes the part of the colon that is infected. It can be performed with one long incision or several smaller incisions and a thin lighted tube with a camera.
• Polypectomy — This procedure is usually used for stage 0 and early stage 1 colorectal cancer. The tumor is removed as a part of the polyp during a colonoscopy.
• Total colectomy — Here, the entire colon is removed.

• A thorough genetic counseling program if you are concerned about your personal or family GI cancer history
• A wide range of invasive and noninvasive diagnostic screening options
• Advanced surgical and nonsurgical cancer treatments
• Cancer support services and educational resources
• Cancer wellness classes and survivor support groups
• Dedicated nurse navigators who support you with and guide you through stage 3 and 4 colon cancer
• High-risk GI cancer clinics at Centerpoint Medical Center, Menorah Medical Center, Overland Park Regional Medical Center and Research Medical Center
• Local access to national clinical research trials
• Over 50 GI and colon cancer specialists across our network of hospitals

HCA Healthcare Sarah Cannon Cancer Network delivers you exceptional cancer care through cutting-edge, specialized treatments, multidisciplinary collaboration and care that is tailored to you. Our teams of passionate caregivers and global oncology experts across the United States and United Kingdom offer services and expertise that extend across many types of cancer. Together with the full support of HCA Healthcare – a leading provider of cancer care and research – we’re with you and your family from diagnosis through survivorship.