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Colon Cancer

Colon cancer is cancer that develops in the tissues of the large intestine, also called the large bowel or colon. According to the American Cancer Society, over 95,000 new cases of colon cancer are diagnosed in the United States each year. The exact cause of colon cancer is unknown, but most of these cancers begin as non-cancerous growths or polyps. Over time, polyps can become colon cancer. The most common type of colon cancer is adenocarcinoma.

Not everyone experiences colon cancer symptoms, so it is important that men and women over age 50 have screening tests such as a colonoscopy. Colon polyps can be identified and removed during colonoscopy (polypectomy), preventing polyps from becoming colon cancer. Surgery to remove cancerous tissue is the preferred treatment for all stages of colon cancer and can usually cure colon cancer when found early. Some patients increase their chances of being cured by receiving additional therapy, such as chemotherapy.

Colon and rectal surgeons at Brigham and Women’s Hospital (BWH) are the surgical team for the Gastrointestinal Cancer Treatment Center at Dana-Farber Brigham Cancer Center, a unique center uniting the world’s best gastrointestinal cancer experts. Our board certified surgeons are leaders in colon cancer surgery, performing a large volume of colonoscopies as well as traditional and minimally invasive surgical techniques, including colectomy and colostomy.

Learn more about colon cancer from Dana-Farber Brigham Cancer Center.

Colon Cancer Topics

Risk Factors for Colon Cancer

Factors that contribute to an increased risk for colon cancer include:

  • Older than age 50
  • Diet high in fat
  • Obesity
  • Sedentary lifestyle
  • Family history of cancer of the colon or rectum
  • Certain hereditary conditions, such as familial adenomatous polyposis and hereditary nonpolyposis colon cancer (HNPCC; Lynch Syndrome)
  • History of colon polyps
  • History of inflammatory bowel disease (ulcerative colitis and Crohn’s disease)
  • History of cancer of the colon, rectum, ovary, endometrium or breast

Learn if you are at risk for colon cancer.

Read this article about vitamin D and colorectal cancer.

Symptoms of Colon Cancer

Colon cancer often is in a more advanced stage when symptoms present. Common symptoms are:

  • Change in bowel habits
  • Blood in stool
  • Diarrhea
  • Constipation
  • Stools narrower than usual
  • Frequent gas pains
  • Bloating
  • Cramps
  • Weight loss
  • Tiredness
  • Vomiting

Learn more about symptoms of colon cancer.

Screening for Colon Cancer

Beginning at age 50, men and women should follow one of these examination schedules:

  • Fecal occult blood test or fecal immunochemical test every year
  • Flexible sigmoidoscopy every five years
  • Double-contrast barium enema every five years
  • Colonoscopy every 10 years
  • Virtual colonoscopy, a computer-assisted approach that is less invasive than traditional colonoscopy every five years

People with colorectal cancer risk factors should begin screening procedures at an earlier age and/or be screened more often.

Learn more about colon cancer screening.

Learn about the Center for Community Health and Health Equity (CCHHE) colorectal screening program.

Diagnosis of Colon Cancer

If you are having symptoms of colon cancer, your surgeon will ask about your health history, your family’s history of cancer and risk factors. Diagnostic test include many of the same exams done for people without symptoms:

  • Digital rectal examination
  • Fecal occult blood test
  • Sigmoidoscopy
  • Colonoscopy
  • Barium enema
  • Biopsy
  • Blood count
  • Imaging tests. Tests, such as a CT scan, PET scan, ultrasound, or MRI 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.

Learn more about diagnostic tests and procedures for colon cancer.

Stages of Colon Cancer

After colon cancer has been diagnosed, tests are performed to find out if cancer cells have spread within the colon or to other parts of the body.

Learn more about the stages of colon cancer.

Treatment for Colon Cancer

Surgical Treatment

The segment of colon that contains cancer is surgically removed and the remaining ends of the bowel are reattached so that bowel integrity is maintained. Our colon and rectal surgeons may use one of the following surgical procedures:

  • Polypectomy This is the removal of the polyp, typically done during a colonoscopy. It does not require an incision.
  • Local excision If cancer is found at an early stage, your surgeon may remove it without cutting through the abdominal wall. Instead, the doctor puts a tube through the rectum into the colon and cuts out the cancer.
  • Resection with anastomosis For larger cancers, your surgeon will perform a partial colectomy (removing the cancer and a small amount of healthy tissue around it) and then will sew the remaining healthy portions of the colon together (anastomosis). Lymph nodes near the colon will be removed to determine whether they contain cancer.
  • Resection of the colon with colostomy If your doctor is unable to sew the ends of the colon back together, a stoma (an opening) is made on the outside of the body for waste to pass through. This procedure is called a colostomy. A bag is placed around the stoma to collect the waste. Sometimes the colostomy is needed only until the lower colon has healed, and then it can be reversed. If the doctor needs to remove the entire lower colon, however, the colostomy may be permanent.
  • Laparoscopically-assisted right colectomy Our surgeons offer laparoscopic (minimally invasive) colectomy procedures. During this procedure, slender surgical instruments are introduced through small surgical incisions in the abdomen. Problems of the right colon and of the sigmoid colon are the best areas for the laparoscopy.

Non-Surgical Treatment

Learn more about the above non-surgical treatments for colon cancer.

What You Should Expect

You will receive a thorough diagnostic examination to evaluate if you have colon cancer and determine what course of treatment is needed. Careful monitoring and the involvement of an experienced colon and rectal surgeon are important to the successful outcome for patients with colon cancer.

If you are having surgery or a procedure, you will likely be scheduled for a visit to the Weiner Center for Preoperative Evaluation for pre-operative information and tests.

The day of surgery, you will be cared for in the operating room by surgeons, anesthesiologists and nurses who specialize in surgery for patients with colon cancer. After surgery, you will recover in the post-surgical care unit where you will receive comprehensive care by an experienced surgical and nursing staff.

Learn more about your hospital stay and returning home.

Multidisciplinary Care

The Gastrointestinal Cancer Treatment Center, at Dana-Farber Brigham Cancer Center provides the world’s most advanced and innovative multidisciplinary care for patients with gastrointestinal diseases, including colon cancer. Our treatment team includes colon and rectal surgeons, medical and radiation oncologists, nutritionists, pathologists, anesthesiologists and gastroenterologists. In addition, patients have full access to BWH’s world-renowned academic medical community with its diverse specialists and state-of-the-art facilities.

Cancer Surgery Appointments and Locations

Contact one of our cancer surgeons in the list at the top of the page to make an appointment.

Cancer Surgery Locations

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