In 2022, the American Cancer Society® estimates that more than 150,000 Americans will find out that they have colon or rectal cancer. Dr. Michael Morton, a board-certified and fellowship-trained colorectal surgeon with Atlantic Surgical Associates in Portsmouth, New Hampshire, understands how difficult those words are to hear. “Learning you have cancer is a time of uncertainty and fear for most people but, what I want my patients to know is that in the vast majority of cases, colon and rectal cancers are very treatable,” advises Dr. Morton.
Personalized treatment plan
Following a diagnosis of colorectal cancer, a multidisciplinary care team will be established to develop and guide you through an individualized treatment plan for your cancer. Your team will consist of Dr. Morton and experts in gastroenterology, oncology, and palliative care. Next steps include:
The first step after diagnosis is to determine what stage the cancer is in. Staging helps establish what additional steps should be taken to develop a comprehensive treatment plan and achieve the best possible patient outcome.
Staging determines precisely where the cancer is located, how large it is, and if it has metastasized, or spread, to other parts of the body. Stages of colorectal cancer are from the earliest Stage 0 to the most advanced Stage IV, with sub-stages in between.
Surgery is a common part of treating cancer, especially if the cancer is localized and has not spread to other parts of the body. If surgery is recommended, Dr. Morton and his highly skilled team will perform an operation aimed at removing the cancerous tumor from your colon or rectum, and sometimes nearby lymph nodes, as well as reconnect any intestinal tissue. Surgery is often done using robotic, minimally-invasive procedures to help minimize your pain and maximize your recovery.
Types of surgery related to colorectal cancer are:
- Colectomy—surgery that removes all of part of the colon containing the cancer, as well as nearby lymph nodes, and reattaches the two ends of the colon.
- Colostomy—surgery that connects the top end of the colon to a stoma, or opening, in the abdomen. A surgical bag is attached to the stoma on the outside of the abdomen in order to collect stool.
- Ileostomy—surgery similar to a colostomy, but attaching the end of the small intestine, called the ileum, to the stoma.
- Proctectomy—surgery to remove all or part of the rectum
Both colostomy and ileostomy surgeries may sometimes be reversed once your health improves.
Medical and radiation oncology
Follow-up care with the oncological care team may include chemotherapy, especially if surgery was performed on the lymph nodes, radiation therapy, and certain targeted medications.
Palliative care is available at any time following your cancer diagnosis and accompanies active medical treatment for your illness. Its goal is to provide you with relief from pain, anxiety, fatigue, and other psychosocial symptoms related to your cancer. In addition, palliative caregivers help navigate the healthcare system and provide emotional support for you and your family.
When cancer does not respond to traditional treatments, immunotherapy may be employed to use your own immune system to fight your cancer.
Understand your risk
While there is a higher risk of getting colorectal cancer if you have a first degree relative (parent or sibling) who had it, the vast majority of cases are random. Risk factors that increase your chances of developing colorectal cancer are:
- Eating a high fat diet
- Not eating enough fiber
Likewise, limiting red meat, increasing dietary fiber, and quitting smoking are ways to decrease your risk of colorectal cancer.
Other risk factors for colorectal cancer include:
- A family history of colorectal cancer or polyps
- A family history of hereditary syndromes, such as Lynch syndrome or familial adenomatous polyposis (FAP)
- A personal history of colorectal cancer or polyps
- A personal history of inflammatory bowel disease, such as Crohn’s disease or ulcerative colitis
- A personal history of radiation to the abdominal or pelvic region to treat other forms of cancer
Signs of colorectal cancer
In addition to living a healthy lifestyle, it is important to know the signs of colorectal cancer. If you experience any of these symptoms, do not ignore them and schedule a consultation right away. Early detection and seeking treatment when cancer is in its earliest stages are key to having the most successful outcome.
There are several possible symptoms of colorectal cancer, including:
- Changes in bowel habits, especially constipation or diarrhea
- Fatigue, often due to anemia
- Weight loss
- Rectal bleeding
- Nausea and/or vomiting
- Persistent abdominal discomfort associated with pain, gas, or cramps
- Persistent feeling that the bowel is not empty
Screening for colorectal cancer
Unfortunately, symptoms of colorectal cancer are not always apparent, highlighting the importance of early screening. The American Cancer Society’s recommended guidelines suggest that people at average risk of colorectal cancer receive a highly-sensitive stool test, a visual colonoscopy, or similar examination starting at age 45. If discovered early, pre-cancerous polyps in the colon can be removed before they become cancerous.
Patients at higher risk of developing colorectal cancer should consult their physician about testing before age 45.
All patients should check with their insurance provider for coverage details.