Colorectal Cancer: Symptoms, Causes, Treatment, and Prevention

Colorectal cancer is the second leading cause of cancer death in the United States and the fourth most common cancer among adults, excluding skin cancers, according to medical reports. The disease typically begins as abnormal growths called polyps in the lining of the colon or rectum, with more than 90 percent of these cancers identified as adenocarcinomas.

What are the common symptoms of colorectal cancer?

Medical experts note that symptoms of colorectal cancer often resemble other conditions, such as hemorrhoids. Common signs include a change in bowel habits—such as diarrhea, constipation, or narrowing of the stool—that lasts more than a few days.

Other indicators include rectal bleeding with bright red or dark stools and a feeling of needing a bowel movement that is not relieved by having one. Patients may also experience cramping, abdominal pain, or unexplained weight loss.

Who is at the highest risk for colorectal cancer?

Researchers state that while new cases are dropping for people over age 50, rates are rising for adults under 50. Native American, Alaska Native, and Black people experience higher death rates and more new cases compared to other groups in the U.S.

Black patients may be more likely to carry specific genetic mutations that lead to more aggressive tumors. Other non-modifiable risk factors include being assigned male at birth, a personal history of inflammatory bowel disease like Crohn’s or ulcerative colitis, and a family history of polyps.

How is colorectal cancer diagnosed and staged?

Screening is recommended for average-risk individuals between ages 45 and 75. Doctors use several tools to find suspicious growths, including Fecal Immunochemical Tests (FIT), Guaiac-based tests, and multitargeted stool DNA and RNA tests.

A colonoscopy is the primary tool for identifying and removing precancerous polyps. Doctors use a colonoscope to view the gastrointestinal tract and perform biopsies to confirm the presence of cancer cells.

Understanding the Stages

Physicians use CT scans, MRIs, PET scans, and lymph node biopsies to stage the cancer from 0 to 4. This process determines if the cancer is limited to the inner lining, has grown into the wall, or has metastasized to other organs, most commonly the liver.

What are the treatment options?

Treatment typically involves surgery, radiation therapy, medication, or a combination of all three. Surgery is often the first choice for early-stage colon cancers and most rectal cancers, sometimes requiring a temporary colostomy.

Radiation therapy is more common for rectal cancer and cases where the cancer has spread. It may be used before surgery to shrink a tumor or after surgery to eliminate remaining cells.

Medication options include chemotherapy drugs like capecitabine (Xeloda) and oxaliplatin (Eloxatin). Targeted therapies for stage 4 cancer include bevacizumab (Avastin) and cetuximab (Erbitux), while immunotherapy drugs like pembrolizumab (Keytruda) are used for patients with specific genetic changes.

How can the risk of colorectal cancer be lowered?

While not always preventable, medical experts suggest several lifestyle changes to reduce risk. These include maintaining a healthy weight, exercising regularly, and avoiding moderate to heavy alcohol use.

Dietary recommendations include minimizing red meats, such as beef and lamb, and processed meats like hot dogs. Quitting smoking and managing Type 2 diabetes are also recommended. High-risk individuals may be advised by a doctor to take daily aspirin for 5 to 10 years.

Available Support Resources

Patients can access help through the Colorectal Cancer Alliance’s BlueHQ online hub. Other resources include the patient-empowerment group Fight Colorectal Cancer and the Colon Cancer Coalition’s Faces of Blue platform.

Frequently Asked Questions

At what age should I start colorectal cancer screening?

Screening is recommended for everyone between ages 45 and 75 if they are at average risk, though doctors may suggest starting earlier for those at higher risk.

What is the difference between a polyp and cancer?

Colorectal polyps are abnormal growths in the lining of the colon or rectum; they are not cancerous themselves but can become cancerous over time.

Which organ is most commonly affected when colorectal cancer spreads?

When colorectal cancer metastasizes to other organs and tissues, it most often affects the liver.

Do you know if you fall into a high-risk category for colorectal cancer based on your family history?