Colorectal Cancer Treatment Options

Colon polyps are small growths that develop on the inner lining of the colon or rectum. They are usually noncancerous (benign) in nature but have the potential to turn cancerous over time.

There are different types of polyps, including adenomatous polyps (which have the highest risk of becoming cancerous), hyperplastic polyps, and serrated polyps. Adenomatous polyps or adenomas are a pre-cancerous condition and sessile serrated polyps are treated like adenomas because they have a high risk of developing into cancer. Hyperplastic polyps are common but are usually not pre-cancerous.

Most polyps do not cause symptoms, but larger ones or those with an abnormal appearance may cause rectal bleeding, changes in bowel habits, abdominal pain, or anemia. Regular screening through colonoscopy is important to detect and remove polyps, as this can help prevent the development of colorectal cancer. When an adenomatous polyp grows into the colon wall it can spread to the blood vessels and lymphatics and to other parts of the body. If this happens it is called metastatic colon cancer.

The treatment of a colon or rectal polyp depends on several factors, including the type, size, number, and location of the polyps. When the polyp is detected during a colonoscopy, it is usually removed by polypectomy, a safe and simple procedure that snares and removes the polyp. Then the tissue is sent to a lab to determine if it is benign or cancerous which guides and determines the need for further treatment. 

**A note about Cologuard: Cologuard is a stool-based DNA test that analyzes specific genetic markers and biomarkers associated with colorectal cancer. Cologuard is primarily intended for average-risk individuals who are due for colorectal cancer screening but may be hesitant to undergo a colonoscopy or other invasive procedures. If Cologuard test results are positive or indicate abnormalities, further evaluation with a diagnostic colonoscopy is typically recommended. Colonoscopy remains the gold standard for detecting and removing precancerous polyps.

Colorectal cancer is a malignant tumor of the colon or rectum. It usually develops from a adenomatous polyp that transforms into cancerous cells. Colorectal cancer is one of the most common types of cancer worldwide.

Early detection is crucial for successful treatment. Screening methods like colonoscopy, fecal occult blood tests (FOBT), sigmoidoscopy, or virtual colonoscopy can help identify cancer or precancerous polyps.

Symptoms may include changes in bowel habits (such as diarrhea or constipation), rectal bleeding, blood in the stool, abdominal pain, unexplained weight loss, and fatigue.

Colon cancer is diagnosed through a combination of medical history, physical examination, and various diagnostic tests including colonoscopy and imaging studies. The combination of these diagnostic steps helps determine the presence, stage, and characteristics of colon cancer. The stage of the cancer, ranging from stage 0 to stage IV, indicates the extent of its spread and guides treatment decisions.

Treatment options for colorectal cancer include surgery, chemotherapy, radiation therapy, targeted therapy, and immunotherapy, depending on the stage and characteristics of the cancer.

Surgery is the primary treatment. It involves the removal of the cancerous tumor and nearby lymph nodes.

• Colectomy is the surgical removal of a portion of the colon or rectum containing the tumor, along with nearby lymph nodes.
• Chemotherapy uses anti-cancer drugs to destroy cancer cells or slow their growth. It may be administered before surgery (neoadjuvant chemotherapy) to shrink tumors, after surgery (adjuvant chemotherapy) to kill any remaining cancer cells, or for advanced or metastatic cancers to control the disease.
• Radiation therapy uses high-energy X-rays or other radiation sources to kill cancer cells or shrink tumors. It is typically used in combination with surgery and/or chemotherapy.

Radiation therapy may be used before surgery (neoadjuvant radiation) to shrink the tumor, after surgery (adjuvant radiation) to prevent recurrence, or for palliative purposes to relieve symptoms in advanced cases.

• Targeted therapy drugs specifically target certain molecules or pathways involved in cancer growth and progression. These drugs may be used in advanced colorectal cancer cases that have specific genetic mutations, such as KRAS or BRAF mutations. Targeted therapy is often used in combination with chemotherapy.
• Immunotherapy helps boost the body’s immune system to recognize and destroy cancer cells. It may be used in advanced colorectal cancer cases that have certain biomarkers.

At Rockford Gastroenterology Associates your treatment plan is developed by a multidisciplinary team of healthcare professionals, including surgeons, medical oncologists, radiation oncologists, and other specialists, based on your needs. The goal of treatment is to eliminate the cancer, control its growth, and improve overall survival and quality of life.