Colorectal cancer
Our dedicated team of specialists provides comprehensive care for colorectal cancer, from early detection to advanced treatment. We offer personalized treatment plans, innovative therapies and supportive care to help you fight colorectal cancer and improve your quality of life.
Call 911 if you are seriously injured or feel you need emergency care. Emergency responders will help you decide the best course of action.
Comprehensive colorectal cancer treatment
At TMC Health Cancer Center in Tucson, colorectal surgical specialists lead our multidisciplinary approach to providing comprehensive, personalized colorectal cancer treatment. We utilize advanced diagnostic tools like colonoscopy and imaging for early detection. Our expertise encompasses a full spectrum of treatment options, including sophisticated surgical techniques, chemotherapy, and radiation therapy, all tailored to your individual needs. From initial diagnosis through every stage of treatment and into survivorship, our commitment is to provide compassionate, patient-centered care, ensuring the best possible outcomes for our Southern Arizona community.
Dr. Schluender
Risk factors for colorectal cancer
Dr. Stefanie Schluender is part of the TMC Health Cancer Center Colorectal Surgery Specialists team.
Our team works with you to provide
- Advanced diagnosis and treatment
- The latest technology and specialized techniques to improve care. Our teams are highly experienced in minimally invasive surgery as well as enhanced recovery after surgery.
- We will work with you to review all of your treatment options and choose the treatment that best suits your needs.
- Treatment may include surgery, chemotherapy (including clinical trials), radiation therapy or a combination of these.
- Palliative care
- A multidisciplinary team approach that includes the Colorectal Surgical Specialists
Information
Getting checked for colon and rectal cancer (also called colorectal cancer) is a really important way to stay healthy. It helps doctors find any problems early, even before you have symptoms. When cancer is found when it's small and hasn't spread, it's usually easier to treat and beat.
Think of it like this: regular checks can find small problems, like tiny growths called polyps. These polyps aren't cancer, but they can turn into cancer over time – sometimes as long as 10 to 15 years! Getting checked can help doctors find and remove these polyps before they become a serious problem. So, it's not just about finding cancer early; it's also about preventing it in the first place.
The American Cancer Society (ACS) now suggests that most people should start getting checked for colon cancer at age 45. They used to say age 50, but they changed it because they've seen more younger people getting this kind of cancer.
Even if you feel healthy and don't have any problems, it's still important to think about getting screened when it's time. Your doctor can help you figure out when the best time is for you to start. Things like your family's health history can also play a role in when you should begin screening. For example, if someone in your family has had colon cancer, your doctor might suggest starting earlier.
Remember to talk to your doctor about when you should start getting checked. They can help you understand your risk and make the best plan for you. Also, it's a good idea to check with your insurance company to see what screening tests they cover.
There are several ways to check for colon and rectal cancer. Here are some of the main ones:
Tests on your poop (stool): These tests look for signs of cancer or polyps in your poop.
- Fecal occult blood test (FOBT): This checks for tiny bits of blood that you can't see. You usually do this test at home and send in a sample.
- Fecal immunochemical test (FIT): This is another test that looks for hidden blood in your poop. It's often easier to do than FOBT.
- Stool DNA test (FIT-DNA), like Cologuard®: This test looks for both hidden blood and changes in the DNA in your poop that could be a sign of cancer or polyps. You do this at home and send in a sample.
Tests that look inside your colon: These tests let doctors see the lining of your colon and rectum.
- Colonoscopy: This is a common test where the doctor uses a long, flexible tube with a camera to look at your entire colon and rectum. If they see any polyps, they can usually remove them during the test. You'll need to get cleaned out before this test, and you'll get medicine to make you sleepy, so you don't feel anything.
- Sigmoidoscopy: This is like a colonoscopy, but the tube is shorter, so it only looks at the lower part of your colon (the sigmoid) and rectum.
- Virtual colonoscopy (CT colonography): This uses special X-rays to create pictures of your colon and rectum. It's less invasive than a regular colonoscopy, and you don't need to be put to sleep. However, if they find something, you might need a regular colonoscopy to remove it.
It's really important to talk to your doctor about which screening test is best for you. They will consider your age, your health, and your family history to help you decide. Getting screened is a simple step you can take to protect your health!
If a screening test finds polyps, your doctor might do a biopsy, which means taking a small piece of tissue to look at under a microscope. Often, these polyps can be removed during the colonoscopy or sigmoidoscopy. If the screening test suggests cancer or if you have symptoms, your doctor will do more tests to figure out what's going on. This might include asking about your health history and doing a physical exam. If these tests don't show cancer, you might not need any more tests or treatment, but your doctor might recommend regular checkups.
Our specialists use a staging system to describe the extent of colon and rectal cancer. This helps us determine the most appropriate treatment plan for each individual. The stages are based on how far the cancer has grown and whether it has spread to other parts of the body.
Colon Cancer Stages
- Stage 0 (Carcinoma in situ): In this earliest stage, the cancer cells are found only in the innermost lining of the colon. They have not grown beyond this layer.
- Stage I: The tumor has grown into the inner wall of the colon but has not yet grown through the entire wall. There is no spread to nearby lymph nodes or distant sites.
- Stage II: The tumor has grown more deeply, either into or through the wall of the colon. It may have invaded nearby tissues, but the cancer cells have not spread to the lymph nodes.
- Stage III: The cancer has spread to nearby lymph nodes. However, it has not yet spread to other distant parts of the body.
- Stage IV: This stage indicates that the cancer has spread to other organs or distant lymph nodes in the body, such as the liver or lungs.
- Recurrence: Recurrent colon cancer means that the cancer has returned after a period of successful treatment when it was no longer detectable. It can reappear in the colon itself or in other areas of the body.
Rectal Cancer Stages
The staging system for rectal cancer is very similar to that of colon cancer:
- Stage 0 (Carcinoma in situ): This is the earliest stage, where the cancer cells are confined to the innermost layer of the rectum and have not grown into deeper tissues.
- Stage I: The tumor has grown into the wall of the rectum but has not extended through the entire wall and has not spread to lymph nodes or distant sites.
- Stage II: The tumor has grown more deeply into or through the wall of the rectum and may have invaded nearby tissue. Importantly, the cancer cells have not spread to the lymph nodes.
- Stage III: The cancer has spread to the nearby lymph nodes but has not spread to other parts of the body.
- Stage IV: This advanced stage means the cancer has spread to other organs or distant lymph nodes, such as the liver, lungs, or distant lymph nodes.
- Recurrence: Recurrent rectal cancer is cancer that has come back after a period of time when it could not be detected following treatment. It may reappear in the rectum or in other areas of the body.
Understanding the stage of colon or rectal cancer is a crucial step in planning your personalized treatment at TMC Health Cancer Center. Our multidisciplinary team will carefully evaluate your individual situation to provide you with the most effective and compassionate care.
Anal cancer is a growth in the anal canal the short tube at the end of the rectum. Symptoms can include rectal bleeding blood in stool and anal pain sometimes mistaken for hemorrhoids.
Most anal cancer treatment now involves chemotherapy and radiation possibly avoiding surgery which was more common in the past. The anal canal is a short tube surrounded by muscles that control waste leaving the body.
Symptoms can also include a growth anal itching and more frequent bathroom trips. See a doctor for any worrying symptoms.
Anal cancer happens when anal canal cells change their DNA telling them to grow and multiply quickly forming a tumor that can invade healthy tissue and spread. Human papillomavirus or HPV a common sexually transmitted virus is thought to cause most anal cancers.
Risk factors include HPV exposure more sexual partners receptive anal sex smoking and a history of cervical vulvar or vaginal cancer or a weak immune system. Anal cancer rarely spreads but when it does it's harder to treat often affecting the liver and lungs. For more information about treatment, prevention and more visit our health library.
Colon cancer starts in the large intestine and often affects older adults though it can occur at any age. It typically begins as noncancerous polyps that can develop into cancer over time. Early colon cancer may not cause symptoms making regular screening important for polyp detection and removal.
Symptoms of colon cancer can include changes in bowel habits rectal bleeding abdominal discomfort weakness unexplained weight loss and the feeling that the bowel doesn't empty completely. If you experience persistent and concerning symptoms consult a health care professional.
While the exact cause of most colon cancers is unknown it occurs when colon cells develop DNA changes causing them to multiply rapidly and form tumors. Factors that may increase risk include older age, ancestory, personal or family history of colorectal cancer or polyps, inflammatory bowel diseases, inherited syndromes, a low-fiber high-fat diet, lack of exercise, diabetes, obesity, smoking and excessive alcohol consumption. Treatment options include surgery radiation therapy chemotherapy targeted therapy and immunotherapy including minimally invasive surgical techniques. For more details and information about colon cancer visit our health library.
If you've been diagnosed with familial adenomatous polyposis or FAP know that it's a rare inherited condition. FAP is caused by a problem with a gene and leads to many polyps in your colon and rectum. These polyps can become cancerous often in your 40s.
The main sign of FAP is many polyps in the colon and rectum usually starting in the teens. Because these polyps almost always become cancer surgery to remove the large intestine is often needed. Polyps can also grow in the upper small intestine but these can usually be managed with regular checks and removal.
Some people have a milder form called attenuated FAP with fewer polyps and a later cancer risk.
FAP is caused by a gene defect often inherited from a parent. Having a family member with FAP increases your risk.
Besides colon cancer FAP can lead to polyps in the small intestine stomach and around bile and pancreas ducts. Noncancerous growths called desmoids skin tumors bone growths eye changes dental issues and low red blood cell counts are also possible.
While you can't prevent FAP genetic testing and counseling are important if you have a family history. If you have FAP regular screening and surgery can help prevent colorectal cancer and other problems.
Diagnosis involves checking your colon and rectum with flexible tubes like sigmoidoscopy and colonoscopy. Doctors may also use upper endoscopy and imaging like CT or MRI. A blood test can check for the FAP gene.
Treatment often starts with removing polyps during colonoscopy. However, surgery to remove part or all of the colon is usually needed to prevent cancer. This can sometimes be done with minimally invasive surgery. Even after surgery regular screening of the remaining colon small intestine and other areas is important to check for more polyps or other complications like desmoid tumors. Treatments for these issues can include more surgery medication or other therapies. Researchers are also looking into new treatments. To find out more about treatment, diagnosis and more go to our health library.
Rectal cancer starts in the rectum the last part of the large intestine. 1 Often grouped with colon cancer as colorectal cancer rectal cancer treatment differs due to the rectum's tight space near other organs. Symptoms like changes in bowel habits rectal bleeding or abdominal pain may appear as the disease advances. While the exact cause is often unknown it involves DNA changes in rectal cells leading to tumor growth. Risk factors mirror those of colon cancer including a history of polyps, race, diabetes, heavy alcohol use, a low-vegetable/high-red-meat diet, family history of colorectal cancer, inflammatory bowel disease, inherited syndromes, obesity, older age prior radiation and smoking. Treatment typically involves surgery possibly with chemotherapy radiation-targeted therapy or immunotherapy. Learn more about rectal cancer symptoms causes prevention and treatment options. Read more about treatment, prevention and more in our health library.
Small bowel cancer starts in the small intestine which digests food and absorbs nutrients. Symptoms can include abdominal pain, jaundice, weakness, nausea, vomiting, unexplained weight loss, blood in stool, diarrhea and skin flushing. The cause isn't known but it involves DNA changes in small bowel cells causing them to multiply and potentially spread. Types include adenocarcinoma, neuroendocrine tumors, lymphoma and soft tissue sarcoma. Risk factors include inherited DNA changes other bowel diseases weakened immune systems and possibly diet. Treatment often involves surgery and may include chemotherapy-targeted therapy or radiation. Complications can include increased risk of other cancers and the cancer spreading. For more information about small bowel cancer, including about diagnosis and treatment please visit our health library.
Facing a diagnosis of colorectal cancer can feel overwhelming, but please know that you're not alone. At our center, we believe in a team approach to your care. This means that a group of dedicated specialists will work together to create a treatment plan that's tailored just for you. This team may include surgeons, cancer doctors (oncologists), radiation oncologists, radiologists, pathologists, and many other supportive professionals like nurses, dietitians, and counselors. We all come together to share our expertise and make sure you receive the best possible care every step of the way. We'll be here to explain everything clearly and answer all your questions. You can find out more about the colorectal specialists team here
The good news is that there are several effective ways to treat colorectal cancer. The main things that help us decide which treatments are best for you are where the tumor is located in your colon or rectum and how far the cancer has grown (the stage). You might have one type of treatment or a combination of them. Cancer treatments can be grouped into two main types:
- Local therapy: These treatments focus on the cancer in or near your colon or rectum. Surgery and radiation therapy are local therapies. Surgery aims to remove the cancer, while radiation uses high-energy rays to destroy cancer cells in a specific area. Even if the cancer has spread to other parts of your body, local therapy might be used to help control it in those specific spots.
- Systemic therapy: These treatments use medications that travel through your bloodstream to reach and attack cancer cells throughout your entire body. Chemotherapy and biologic therapy are systemic treatments.
Surgery is frequently the primary treatment for both colon and rectal cancers (National Cancer Institute). The specific surgical approach depends on the cancer's location and stage.
- Colonoscopy: During a colonoscopy, if a small, early-stage polyp (a growth that could become cancerous) is detected, it can often be removed immediately. In some instances, small tumors in the lower rectum can also be removed through the anus.
- Laparoscopy: For early-stage colon cancer, surgeons may use laparoscopy. This minimally invasive technique involves inserting a thin, lighted tube, called a laparoscope, through a few small incisions in your abdomen. The surgeon uses the laparoscope to visualize the inside of your abdomen, remove the tumor, part of the healthy colon and nearby lymph nodes. They will also check for any signs of cancer spread.
- Open surgery: This traditional surgical method involves a larger incision in your abdomen to remove the tumor, a section of the healthy colon or rectum, and nearby lymph nodes. During open surgery, the surgeon will also examine the surrounding tissues and organs for any evidence of cancer spread.
- Connecting the bowel and potential for a stoma: After a portion of your colon or rectum is removed, the surgeon typically attempts to reconnect the remaining healthy sections. However, in some situations, immediate reconnection is not feasible. In such cases, the surgeon may create a stoma, an opening on the surface of your abdomen, to divert waste. The upper end of the intestine is connected to the stoma and a collection bag is attached externally. For many individuals, a stoma is temporary, allowing the bowel to heal before being surgically reversed. However, patients with tumors in the lower rectum may require a permanent stoma. This possibility will be discussed with you in detail by your surgical team.
Chemotherapy involves the use of anticancer drugs to destroy cancer cells throughout the body. These medications circulate through the bloodstream and can reach cancer cells regardless of their location (National Cancer Institute). Chemotherapy is typically administered intravenously (through a vein), but may sometimes be given orally (by mouth). Treatment can occur in various settings, including the hospital, outpatient clinics or even at home.
For some patients with advanced colon or rectal cancer, biologic therapy, also known as targeted therapy, may be recommended. These drugs, including monoclonal antibodies, are designed to target specific molecules involved in cancer cell growth and spread (National Cancer Institute). Biologic agents are usually administered intravenously and may be given concurrently with chemotherapy.
Radiation therapy uses high-energy rays to destroy cancer cells within a localized area (National Cancer Institute).
- External radiation: The radiation is delivered from a machine outside the body, such as a linear accelerator. Treatments are typically administered on an outpatient basis, several days a week for a specified period.
- Internal radiation (Brachytherapy): This technique involves placing radioactive material directly into or near the tumor via thin tubes. Patients undergoing brachytherapy typically require a hospital stay for several days while the implants are in place.
- Intraoperative radiation therapy (IORT): In select cases, radiation may be delivered directly to the tumor site during surgery.
It's important to know that the way we treat colon cancer can sometimes be different from how we treat rectal cancer:
- Colon cancer: Surgery is usually the main treatment for colon cancer. Chemotherapy might be used along with surgery. Biologic therapy can be an option for advanced colon cancer. A colostomy is not usually needed for colon cancer. Radiation therapy isn't used very often for colon cancer but can sometimes help with pain or other symptoms.
- Rectal cancer: Surgery is also a common treatment for all stages of rectal cancer. However, radiation therapy and chemotherapy are often used along with surgery. Radiation might be given before surgery to shrink the tumor or after surgery to kill any remaining cancer cells. In some cases, radiation is given during surgery. About one in eight people with rectal cancer might need a permanent colostomy. Biologic therapy can also be used for advanced rectal cancer.
We will carefully explain all your treatment choices and what you can expect. Remember, we are a team, and we will work together with you to create a treatment plan that meets your individual needs and helps you on your path to recovery.
Research shows that some things can make you more likely to get colon and rectal cancer (also called colorectal cancer). Some of these things, like what you eat and how active you are, you can change. Others, like your age and family history, you can't. But knowing about these risk factors is important for everyone.
There are several risk factors for colorectal cancer that you have some control over:
- Your Weight: Being overweight or obese, especially around your middle, can increase your risk.
- How Active You Are: Not getting enough exercise can also raise your risk.
- Your Diet: Eating a lot of red meat (like beef and lamb) and processed meats (like hot dogs and lunch meat) is linked to a higher risk. Eating more fruits, vegetables, and whole grains may help lower your risk.
- Smoking: Smoking isn't just bad for your lungs; it can also increase your risk of colon cancer.
- Alcohol Use: Heavy drinking has been linked to a higher chance of getting colorectal cancer. Limiting your alcohol can lower this risk.
Some risk factors for colorectal cancer are beyond your control:
- Your Age: Colorectal cancer is much more common in people age 50 and older.
- Your Medical History: Having had certain conditions like adenomatous polyps or inflammatory bowel disease (like Crohn's or ulcerative colitis) can increase your risk.
- Your Family History: If you have family members who have had colorectal cancer or polyps, your risk might be higher. You might want to talk to your doctor about earlier screening or genetic testing.
- Your Race or Ethnicity: People of African American descent and Ashkenazi Jews have a higher risk.
- Having Diabetes: People with type 2 diabetes have an increased risk.
Having one or more of these risk factors doesn't mean you will definitely get colorectal cancer. Also, not having any of these factors doesn't mean you're completely safe. It's important to talk to your doctor about your individual risk and to start regular screening for colon cancer by age 45, even if you don't have any known risk factors.
Search our health library
This health information is provided by the
Mayo Foundation for Medical Education & Research.
