Colorectal Cancer

These are the most common symptoms of colorectal cancer, but you may experience symptoms differently. If you are experiencing any of these, please contact your physician – especially if you are over 50 or have a personal or family history of colorectal cancer.

• A change in bowel habits such as diarrhea, constipation, or narrowing of the stool that lasts for more than a few days
• Rectal bleeding or blood in the stool
• Cramping or gnawing stomach pain
• Decreased appetite
• Vomiting
• Weakness and fatigue
• Jaundice (yellowing of the skin and eyes)

If you have symptoms that indicate potential colorectal cancer, your doctor will want to get a complete medical history and do a physical examination. The doctor may also do certain tests to look for cancer. Many of these tests are the same as those done to screen for colorectal cancer in people without symptoms.

• Digital Rectal Examination (DRE): A physician or health care provider inserts a gloved and lubricated finger into the rectum to feel for anything unusual or abnormal.
• Fecal Occult Blood Test: Checks for hidden (occult) blood in the stool. It involves placing a very small amount of stool on a special card, which is then tested in the physician's office or sent to a laboratory.
• Flexible Sigmoidoscopy: A diagnostic procedure that allows the physician to examine the inside of a portion of the large intestine. A short, flexible, lighted tube, called a sigmoidoscope, is inserted into the intestine through the rectum. The scope inflates the intestine, making it easier to view.
• Colonoscopy: A procedure that allows the physician to view the entire length of the large intestine. It involves inserting a long, flexible, lighted tube called a colonoscope, in through the rectum up into the colon. The colonoscope allows the physician to see the lining of the colon, remove tissue for further examination and possibly treat problems that are discovered.
• Barium Enema: A metallic, chalky, liquid called barium is used to coat the inside of organs so that they will show up on an x-ray. An abdominal x-ray reveals strictures (narrowed areas), obstructions (blockages), and other problems.
• Biopsy: A procedure in which tissue samples are removed (during a colonoscopy or surgery) from the body for examination under a microscope to determine if cancer or other abnormal cells are present.
• Blood Count: A test to check for anemia (a result of bleeding from a tumor).
• Imaging Tests: CT scans, ultrasounds, or MRIs of the abdomen may be done to look for tumors or other problems. These tests may also be done if colorectal cancer has already been diagnosed to help determine the extent (stage) of the cancer.

Specific treatment for colorectal cancer will be determined by your physician based on a variety of factors. These are your age, overall health, medical history, the stage of the disease and your tolerance for specific medications, procedures, or therapies. Your physician will also take into consideration expectations for the course of this disease and your opinion or preference. Treatment may include:

• Colon Surgery: Often, the primary treatment is an operation called a colon resection, in which the cancer and a length of normal tissue on either side of the cancer are removed, as well as the nearby lymph nodes.
• Radiation Therapy: Radiation therapy is the use of high-energy radiation to kill cancer cells and to shrink tumors. This includes internal and external radiation.
• External radiation (external beam therapy): High levels of radiation are delivered directly to the cancer cells. These are painless and usually last a few minutes.
• Internal radiation (brachytherapy, implant radiation): Substances that produce radiation, called radioisotopes, may be injected into the blood, placed inside the rectum or implanted directly into the tumor to deliver radiation as close to the cancer as possible. These may be temporary or permanent.
• Chemotherapy: Chemotherapy is the use of anticancer drugs to treat cancerous cells by interfering with the cancer cell's ability to grow or reproduce, though some groups of drugs work differently. Chemotherapy after surgery can increase the survival rate for patients with some stages of colon cancer and can also help relieve symptoms of advanced cancer.
• Targeted Therapies: Newer medications called targeted therapies may be used alone or in concert with chemotherapy. Some of these target proteins that are found more often on cancer cells than on normal cells. These medications have different (and often milder) side effects than standard chemotherapy medications and help people live longer.
• The Multidisciplinary Cancer Clinic: The INTEGRIS Cancer Institute’s Multidisciplinary Gastrointestinal clinic brings together medical oncologists, gastroenterologists, radiation oncologists and radiologists as a team to provide specific services to the patient with the aim of ensuring that the patient receives optimum care and support.

At INTEGRIS, we offer a wide variety of support programs and services along with the Troy and Dollie Smith Wellness Center to help patients with breast cancer and their loved ones manage the physical and emotional effects of a cancer diagnosis and treatment.

Support services for colon cancer include:

• Cancer screenings
• Clinical social work services
• Counseling
• Integrative medicine clinic
• Mind, body therapies including acupuncture, massage, and yoga
• Multi-disciplinary clinic coordination
• Nutrition consultations
• Pastoral care, spiritual support and relaxation techniques
• Patient and family support groups
• Patient navigation and survivor care planning
• Research and clinical trials
• Resource Room