Signs of Precancerous Colon Conditions
Adenomatous polyps are a precancerous condition. They are not cancerous by themselves and are often largely harmless. Their presence, however, indicates abnormal changes to colon
Understanding Colon Cancer Symptoms, Screening, Stages, and Treatment Near You at RCCA
Colon cancer is one of the most commonly diagnosed cancers, and incidence rates in adults under age 50 are rising. It is more important than ever for people to understand the signs of colon cancer and the treatment options available. Regional Cancer Care Associates offers advanced cancer care in New Jersey, Connecticut, Massachusetts, and the Washington, D.C., area. We are committed to cancer education and advocacy to help our communities learn more about colon cancer symptoms, types, stages, and treatment options.
Key Takeaways
- Colon cancer symptoms include changes in bowel habits, black or bloody stools, persistent gas or cramps, persistently full-feeling bowels, fatigue, weight loss, and nausea.
- Routine colonoscopies and other screening methods are vital tools to detect colon cancer before it begins causing symptoms, giving patients the opportunity for better treatment outcomes.
- The best treatment for colon cancer depends on the cancer type and stage. RCCA oncologists use advanced diagnostics to plan a personalized treatment approach for each patient.
- Treatment options for colon cancer include surgery, chemotherapy, targeted therapy, and immunotherapy, with clinical trials available to evaluate new therapies.
What Is Colon Cancer?
Colon cancer is a type of cancer that starts in the colon, or the large intestine. It starts as a growth, called a polyp, in the lining of the colon. There are two primary types of polyps:
- Adenomatous polyps: Also called adenomas, these kinds of polyps may change into cancer. They account for 70% of all colon polyps.
- Hyperplastic and inflammatory polyps: These kinds of polyps usually do not change into cancer, although they should still be monitored.
Over several years, the polyp cells mutate and start to reproduce rapidly. These fast-reproducing cells are cancer. Colon cancer usually starts in the innermost layer of the colon lining and grows outward. The cancer grows through the colon wall into nearby blood vessels, lymph nodes, and other organs in the body. The more a cancer spreads, the more difficult it is to treat. That’s why early detection through colon cancer screenings is essential to promoting a positive prognosis.
How Common Is Colon Cancer?
Colon cancer is among the most commonly diagnosed cancers. It is the third most common cancer in men and women in the United States and affects about 108,860 new patients every year.
learn more:
What Are Colon Cancer Symptoms?
Colon cancer symptoms develop gradually. At first, patients may not have any noticeable symptoms. As the cancer progresses and the tumor grows, it begins to interfere with digestive processes, and patients may detect signs of something wrong. Not all digestive or bowel changes mean that the person has cancer. However, non-cancerous bowel conditions can still be serious, so patients should always seek medical attention for new symptoms or complications.
Common Early Signs of Colon Cancer
The first signs of colon cancer are changes in digestion. As the tumor gets larger, it affects how the colon absorbs nutrients and may block the movement of stool through the colon. Patients may notice the following signs:
Changes in Bowel Habits
Most people experience diarrhea (loose or watery stool) or constipation (slow or difficult bowel movements) a few times per year. Usually, diarrhea and constipation go away within a few days or weeks. If the change lasts for more than two weeks, it may indicate a serious condition, such as cancer.
Blood In Stool
Polyps and cancer masses are delicate and can be prone to bleeding. Cancer in the lower half of the colon will leave bright red streaks of blood on the stool. Cancer in the upper half of the colon will create black, tarry-looking stool as the blood is partially digested.
Persistent Cramps or Gas
Stomach cramps, pain, or gas are common occurrences that often have benign causes such as poor diet, food intolerances, stress, and bacterial infections. If the discomfort develops without a clear cause, is severe, does not go away after a few days, or gets significantly worse over time, it could indicate colon cancer.
Feeling of Full Bowels
Large colon tumors can partially or fully block off the colon, preventing the bowels from fully evacuating. Stool is held in the body because its pathway out has been blocked. This leaves patients feeling full even after a bowel movement. Patients may also experience constant urges to have a bowel movement.
Nausea or Vomiting
When stool cannot move through the colon, the whole digestive tract becomes backed up. Food has nowhere to go and gets trapped in the stomach. Eventually, the body will seek other ways to get rid of food. This can lead to intense and persistent nausea and vomiting.
Unexplained Fatigue and Weight Loss
Cancer needs enormous amounts of energy to fuel its rapid cell growth. To obtain this energy, it steals from the patient’s energy reserves. This hijacking causes fatigue or persistent tiredness that does not get better with rest. It also can cause sudden and unintentional weight loss.
Colon Cancer Symptoms in Men vs. Women
While men and women experience similar symptoms of colon cancer, women are more likely to overlook them. This is because hormonal and menstrual changes can mimic or mask colon cancer symptoms. Menstruation often causes bowel-habit changes, gas, nausea, and cramping, leading many women to dismiss their persistent or recurring symptoms as menstrual complaints. Women may also assume that colon cancer symptoms are caused by irritable bowel syndrome (IBS), which is twice as common in women as in men.
Women can increase their chances of early detection by paying attention to their normal menstrual or IBS symptoms. If they experience any new changes or symptoms, they should contact a physician for evaluation to determine the cause.
Symptoms of Advanced Colon Cancer
Advanced colon cancer is cancer that has spread beyond the colon. At this stage, the cancer begins to affect other parts of the body, often resulting in new symptoms. Metastatic colon cancer most often affects the bones, liver, or lungs, where it causes complications such as bone pain, jaundice, coughing, or shortness of breath.
Symptom | Stage It Appears | Urgency of Seeking Medical Evaluation |
Constipation | Early | Low |
Diarrhea | Early | Low |
Bloody stool | Early | High |
Abdominal cramping | Early | Low |
Bloated bowels | Mid | High |
Weight loss | Mid to late | High |
Fatigue | Mid to late | High |
Nausea | Mid to late | High |
Bone pain | Late | High |
Jaundice | Late | High |
Coughing | Late | High |
What Is Colon Cancer Screening?
While awareness of colon cancer symptoms can help patients know when to seek medical evaluation, symptoms can be overlooked or dismissed, or may not appear until cancer is in its later stages. This is why colon cancer screening is so important. Screening tests can detect colon cancer even before symptoms develop, enabling patients to begin treatment early.
Who Should Get Screened?
Current screening guidelines recommend that people with an average risk of colon cancer start routine screenings at age 45. People with a higher-than-average risk of colon cancer should start earlier, at age 40 to 45.
What Types of Colon Cancer Screening Are Available?
Colon cancer is one of the easiest types of cancer to screen for, with a wide variety of tests available. While some are more effective than others, the following methods are all reliable options:
Colonoscopy
A colonoscopy is considered the gold standard for colon cancer detection. A colonoscope is a thin, lighted tube with an attached camera. The doctor uses it to examine the entire length of the colon for polyps, tumors, or anything abnormal. Colonoscopies should be repeated every ten years in most people, although the recommended interval will vary based on a person’s specific risk factors for colon cancer.
Flexible Sigmoidoscopy
A flexible sigmoidoscopy can be thought of as a partial colonoscopy. A sigmoidoscope looks similar to a colonoscope, but is slightly smaller. The doctor uses it to visually examine the lower portion of the colon, where colon cancer is most likely to develop. Sigmoidoscopies should be repeated every five years, in most cases.
FIT (Fecal Immunochemical Test)
An FIT, or fecal immunochemical test, is a lab test that patients can perform at home. Patients are given a testing kit and instructions to collect a small stool sample. The sample is sent to a laboratory, where it is examined for minute traces of blood. FITs should be repeated annually.
Stool DNA Test
A stool DNA test is another at-home screening option. Similar to an FIT, patients are given a testing kit and instructions to collect a stool sample. The sample is tested in a medical laboratory for blood traces and microscopic fragments of DNA. Stool DNA tests should be repeated every three years.
CT Colonography
A CT colonography, also called a virtual colonoscopy, uses medical imaging to look for colon cancer. The doctor employs an advanced form of computed tomography to make a 3-D model of the colon that can be examined for polyps and tumors. CT colonography should be repeated every five years.
| Screening Method | How It Works | Typical Frequency | Detects Polyps? | Requires Prep? |
| Colonoscopy | A colonoscope is inserted into the anus to examine the whole length of the colon. | 10 years | Yes | Yes |
| FIT | A stool sample is tested in a laboratory for blood traces. | 1 year | No | No |
| Stool DNA Test | A stool sample is tested in a laboratory for blood traces and DNA remnants. | 3 years | No | No |
| CT Colonoscopy | Medical imaging is used to create a three-dimensional model of the colon. | 5 years | Sometimes | Yes |
| Flexible Sigmoidoscopy | A sigmoidoscopy is inserted into the anus to examine the lower third of the colon. | 5 years | Yes | Yes |
What Happens If a Polyp Is Found?
If colon cancer screening finds a polyp, the growth will be removed. This typically is accomplished during a colonoscopy, by means of a cutting tool at the end of the colonoscope. The polyp is examined under a microscope to determine whether it is adenomatous (precancerous) or hyperplastic. If the polyp is adenomatous, the physician may recommend more frequent screening to make sure it does not return. One advantage of colonoscopy relative to CT colonoscopy is that a polyp can be removed during a screening colonoscopy, so that a person has to undergo only one procedure. If a polyp is identified on CT colonoscopy, he or she has to have a follow-up colonoscopy so the doctor can remove the growth.
What Are the Risk Factors for Colon Cancer?
Anyone can develop colon cancer, but certain individuals have a higher risk due to health or lifestyle factors. By understanding their risk factors, people can make informed choices about how early and how frequently they are screened for colon cancer.
Risk Factors You Cannot Change
Many colon cancer risk factors cannot be changed. These are related to a person’s age, medical history, or genetics and are therefore outside the patient’s control. These are called “non-modifiable” risk factors, and they include:
- Age 46 and older
- Personal history of colon cancer or polyps
- Strong family history of colon cancer
- Inflammatory bowel disease, including Crohn’s disease and ulcerative colitis
- Inherited syndromes, including Lynch syndrome and familial adenomatous polyposis (FAP)
- Type 2 diabetes
Patients with one or more health-related risk factors should consider early or frequent screening to increase the likelihood that cancer, if present, is detected early. They should also find ways to reduce those risk factors they can control.
Risk Factors You Can Change
While non-modifiable risk factors cannot be avoided, other risk factors related to a person’s lifestyle can be changed. These “modifiable” risk factors include:
- A diet high in red or processed meat
- A diet low in fiber
- Physical inactivity
- Obesity
- Excessive alcohol consumption
- Smoking
By eating a healthy diet, staying active, losing weight, reducing or stopping alcohol consumption and quitting smoking, people can cut their risk of developing colon cancer.
Why Do African Americans Face a Higher Risk of Colon Cancer?
African Americans are about 20% more likely to develop colorectal cancer than people of other racial backgrounds, and about 40% more likely to die from the disease. This difference is caused by a complex set of factors that include lifestyle, environment, genetics, and systemic health inequities. By increasing awareness and screening, RCCA hopes to reduce this disparity and improve treatment outcomes for people of all racial backgrounds and demographics.
What Are the Types of Colon Cancer?
Colon cancer is a broad term that includes any cancer that develops in the colon. Under this umbrella are multiple subtypes, which are distinguished by the type of tissue from which they form. Determining the type of colon cancer a person has is critical for selecting the best treatment approach. The types include:
Adenocarcinoma
Adenocarcinomas form in the gland cells that produce mucus, a lubricating fluid that helps stool move smoothly through the colon. Adenocarcinomas are the most common type of colon cancer, accounting for more than 95% of all cases.
Carcinoid Tumors
Carcinoid tumors form in neuroendocrine cells, which release gastric juices to break down food in the colon. They also produce hormones that tell the colon how quickly to move food along. Carcinoid tumors account for about 1% of all colon cancers.
Gastrointestinal Stromal Tumors
Gastrointestinal stromal tumors, or GISTs, form in the interstitial cells of Cajal (ICCS). These specialized cells send signals to the smooth muscles in the colon, telling them when to contract and push stool through the colon. GISTs account for less than 1% of all colon cancers.
Lymphoma of the Colon
Lymphoma of the colon is a type of lymphoma that develops in lymph nodes surrounding the colon. This type of cancer is rare and can be difficult to detect. It is also highly aggressive, with lower five-year survival rates than other cancer types.
Molecular Subtypes of Colon Cancer
Colon cancers are further classified into molecular subtypes based on the specific genetic mutations riving their development. By knowing which mutations are involved, oncologists can predict whether the cancer is likely to respond to certain types of treatment. For example, microsatellite instability (MSI)-high colon cancers are responsive to immunotherapy, while microsatellite stable (MSS) cancers are not. Cancer caused by mutations in the KRAS and NRAS genes resist inhibitor therapies that are highly effective against cancers arising from mutations in the BRAF gene.
What Are the Stages of Colon Cancer?
After identifying the colon cancer type and molecular subtype, oncologists assess the extent of its spread. This information is used to determine the cancer’s stage. Colon cancer stages range from 0 to IV based on how far the cancer has spread:
Stage 0
Stage 0 colon cancer, also called cancer in situ, is found only in the mucosa and has not spread to other areas of the colon. The mucosa is the innermost lining of the colon.
Stage I
In Stage I, the cancer has spread deeper into the colon wall, but it has not grown through the colon wall or spread to lymph nodes or other tissues.
Stage II
In Stage II, the cancer has grown through the colon wall. There are three Stage II sub-groups based on which tissues and organs are affected:
- IIA: The cancer remains only within the colon wall.
- IIB: The cancer has spread into the abdominal lining.
- IIC: The cancer has spread to other organs near the colon.
Stage III
In Stage III, the cancer has spread to nearby lymph nodes, and it may or may not have spread to nearby organs. Like Stage II, Stage III has three sub-groups:
- IIIA: The cancer has spread into nearby lymph nodes and has grown through the colon wall.
- IIIB: The cancer has spread into nearby lymph nodes and organs.
- IIIC: The cancer has spread into numerous lymph nodes and nearby organs.
Stage IV
In Stage IV, colon cancer has become metastatic. This means that the cancer has spread to distant organs, such as the liver, lungs, bones, or brain. At this stage, treatment plans focus on reducing symptoms, slowing the cancer’s spread, and extending the patient’s lifespan while maintaining quality of life.
Stage | Tumor Depth | Lymph Nodes Involved | Metastasis | 5-Year Relative Survival Rate |
0 | Inner layer | None | No | 100% |
I | Submucosa, maybe muscularis propria | None | No | 91% |
IIA | Outer layers | None | No | 74% |
IIB | Through the wall | None | No | 74% |
IIC | Nearby organs | None | No | 74% |
IIIA | Submucosa, maybe muscularis propria | Up to 6 | No | 74% |
IIIB | Outer layers | Any number | No | 74% |
IIIC | Nearby organs | Any number | No | 74% |
IV | Any | Any number | Yes | 13% |
What Are the Treatment Options for Colon Cancer?
The most effective colon cancer treatment depends on the type and stage of the cancer as well as the patient’s overall health. RCCA oncologists take all factors into account when planning treatment, including the patient’s preferences, to help each individual achieve the best possible outcome.
Surgery
Surgery is typically the main treatment for early-stage colon cancers. The standard procedure is a colectomy, which involves removal of part or all of the colon. In partial colectomy, surgeons remove the section of the colon where the cancer is located, as well as some nearby lymph nodes, and join together the two sections of colon on either side of the excised portion to restore function. In a total colectomy, the entire colon is removed, with surgeons typically then connected the small intestine to the rectum. In treating colon cancer, partial colectomy is performed far more often than total colectomy, which generally is selected only if other serious conditions are affecting the rest of the colon.
What Is a Colostomy?
A colostomy is a surgical procedure that creates a stoma, or opening, in the abdominal wall. It redirects part of the colon to the outside of the body, where waste is collected in a pouch. A colostomy may be temporary, to let part of the colon heal, or it may be permanent.
Chemotherapy
Chemotherapy uses strong drugs to kill cancer cells. It has multiple applications. For Stage III cancer, chemo is used to kill cancer cells that might remain after surgery. When chemotherapy is administered after surgery, it is known as adjuvant therapy. For Stage IV cancer, chemo is used to slow the cancer’s spread or push it back. Two main chemotherapy regimens are used to treat colon cancer:
- FOLFOX: This chemotherapy regimen derives its name from those of the three drugs it entails: folinic acid (or leucovorin), fluorouracil (or 5-FU) and oxaliplatin. The drugs attack cancer cells by damaging their DNA. This regimen is typically used as a first-line treatment to shrink tumors.
- FOLFIRI: This regimen consists of folinic acid, fluorouracil and irinotecan. The regimen prevents the DNA of cancer cells from replicating. It is often used after FOLFOX to control cancer.
Targeted Therapy
Targeted therapy is a cutting-edge innovation to control late-stage colon cancer. A type of personalized medicine, it uses drugs that precisely target cells with certain mutations. Two types of targeted therapy have been approved for colon cancer treatment:
- Anti-VEGF therapy: The drug stops cancer from spreading by blocking the formation of new blood vessels that facilitate the spread of cancer cells.
- Anti-EGFR therapy: The drug stops cancer from spreading by blocking the signals that tell cancer cells to divide. It is used for RAS wild-type tumors only.
Immunotherapy
Immunotherapy works by empowering the patient’s own immune system. Pembrolizumab is a type of immunotherapy known as a checkpoint inhibitor. These immunotherapies work by blocking the proteins that keep immune cells from recognizing cancer. This stops cancer from hiding and enables immune cells to attack cancer. Pembrolizumab is a first-line treatment for MSI-high Stage IV colon cancer.
Radiation Therapy
Radiation therapy uses beams of energy to destroy cancer cells. It is sometimes considered for colon cancer, although it is more often used for rectal cancer.
Treatment | Most-Often Used For | How It Is Given | Potential Side Effects | |
Surgery | Early-stage cancer | Surgery | Fatigue Abdominal discomfort Scar tissue Infection | |
Chemotherapy | FOLFOX | First-line, adjuvant with surgery | Oral | Peripheral neuropathy |
FOLFIRI | Second-line, palliative | Oral | Diarrhea Hair loss Nausea | |
Targeted therapy | Anti-VEGF | Late-stage cancer | Oral | High blood pressure Bleeding Delayed wound healing |
Anti-EGFR | RAS wild-type tumors | Oral | Skin rashes Dry skin Nail inflammation Diarrhea | |
Immunotherapy | MSI-high Stage IV colon cancer | Oral | Fatigue Joint pain Skin rashes Nausea Coughing | |
Find Expert Colon Cancer Care Near You in NJ, CT, MA, and the Washington, D.C., Area
If you have been diagnosed with colon cancer, obtain the latest in evidence-based treatment at Regional Cancer Care Associates. We offer cutting-edge care at more than 20 locations near you across New Jersey, Connecticut, Massachusetts, and the Washington, D.C., area, enabling you to receive care within your own community. Contact RCCA today to learn more about colon cancer or to request an appointment with a medical oncologist.
Frequently Asked Questions About Colon Cancer
What are the first symptoms of colon cancer?
The first symptoms of colon cancer can include changes in bowel movements, black or bloody stools, and persistent stomach discomfort. Keep in mind that not all patients experience symptoms when colon cancer first develops.
How is colon cancer different from rectal cancer?
Colon cancer develops in the upper portion of the large intestine. Rectal cancer, on the other hand, forms in the lowest few inches of the large intestine.
At what age should you start colon cancer screening?
People with an average risk of colon cancer should start screening at age 45. People with a higher risk should start earlier, at age 40.
Is blood in the stool always a sign of colon cancer?
While blood in the stool is not always a sign of colon cancer, it does indicate that something is wrong with the bowels. Individuals who notice blood in their stool should seek medical evaluation to determine the cause.
What is MSI-high colon cancer and why does it matter?
MSI-high, or microsatellite instability high, colon cancer occurs when cells cannot fix errors that occur when genes replicate, leading to a high rate of mutation. This type of colon cancer responds well to targeted therapy.
Can colon cancer be cured if caught early?
Yes, colon cancer can be cured if it is caught early.
Does colon cancer run in families?
Yes, colon cancer sometimes runs in families. This is because certain inherited genetic mutations can make a person more susceptible to developing cancer. However, not everyone who develops colon cancer has a strong family history of cancer.
What happens if a polyp is found during a colonoscopy?
If a polyp is found during a colonoscopy, it is removed. The removed tissue is tested in a laboratory to determine whether it is precancerous and whether any cancer cells are present.
How long does colon cancer treatment take?
Colon cancer treatment generally takes several months to be effective. Some patients are in treatment for many years. RCCA provides support at every stage of the process to help patients navigate this physically and emotionally challenging process.
Receive the Highest Standard of Care
From the moment you have you first appointment at one of RCCA’s 25+ locations, you’ll experience quality care that only our highly trained oncologists can provide. We’ll take the time to help you understand your diagnosis and your options, so you and your doctor can devise the best treatment plan for your unique situation. You’ll also have access to clinical trials, putting you at the forefront of innovations in the field of colon cancer care.
To learn more about colon cancer treatment at RCCA or to schedule an appointment, reach out to us at 844-346-7222.
Physicians SPECIALIZED IN COLON CANCER
RELATED ARTICLES
Common Symptoms of Colon Cancer
Colon cancer is among the most common cancer types diagnosed in the United States. According to colon cancer projections from the American Cancer Society, about
Immunotherapy for Colon Cancer Treatment
If you or a loved one has been diagnosed with colon cancer, identifying the treatment approach that’s best for you and your particular circumstances is
View All Cancer Trials
When standard cancer treatments aren’t providing the results you want, clinical trials may offer hope. Our physicians use clinical trials to study new treatments, helping transform cancer care for the better. You can enroll in a clinical trial to try groundbreaking treatment plans at zero cost to you.
Regional Cancer Care Associates is one of fewer than 200 medical practices in the country selected to participate in the Oncology Care Model (OCM); a recent Medicare initiative aimed at improving care coordination and access to and quality of care for Medicare beneficiaries undergoing chemotherapy treatment.