Colorectal Cancer

Colorectal cancer is the third most common cancer and the second leading cause of cancer death in Iowa, but with early detection and treatment, your chances of recovery are high.

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The colon and rectum form a long, muscular tube called the large intestine or large bowel. Colon cancer begins when cells start growing out of control. Most cancers begin as growths called polyps on the inner lining of the colon or rectum.

However, not all polyps are cancerous. Cancerous tumors usually grow quickly and spread into surrounding tissues. That is why regular screening for colorectal cancer is important. Colon cancer that has been found early, before it has a chance to spread outside of the colon, can be treated successfully and your chances of recovery are high.

Comprehensive, multidisciplinary colorectal cancer care

At University of Iowa Health Care Holden Comprehensive Cancer Center, every brain cancer patient is treated by a team of experts who only treat colorectal cancer patients.

This team of fellowship-trained specialists — surgical oncologists, medical oncologists, radiation oncologists, radiologists, pathologists, pharmacists, genetics counselors, nurses, and others — works together to design a treatment plan that is tailored to you and your specific treatment needs. This can often lead to better patient outcomes.

Several studies have shown that rectal cancer patients treated by specialized surgeons who perform large volumes of rectal cancer resections have better outcomes and survival rates compared to patients treated at lower volume centers.

Causes of colorectal cancer

The cause of colorectal cancer and the reasons people get it are unknown. Research shows that genetics may play a part, along with lifestyle factors such as smoking or alcohol intake.

Other risk factors for colorectal cancer include:

Being 50 or older
A family history of colon cancer, or hereditary conditions like familial adenomatous polyposis, hereditary nonpolyposis colon cancer or Lynch Syndrome
Having certain types of cancer in the past such as ovarian, endometrial or breast cancers
Previously having colon polyps (small noncancerous growths)
Having inflammatory bowel disease, such as ulcerative colitis or Crohn’s disease
Eating a high-fat, low-fiber diet
Obesity
Smoking
Alcohol intake
An inactive lifestyle

Signs and symptoms of colon cancer

Colon cancer can cause a wide range of symptoms. Any change in your stool or bowel habits is a good reason to talk to your provider.

Signs of colorectal cancer include:

Change in usual bowel habits (for example, changing from one bowel movement a day to two or three movements a day)
Blood in the stool, either dark red or bright red
Fatigue or tiredness
Stools that are more narrow than usual
Abdominal pain or discomfort such as gas pains, cramping, bloating or a feeling of fullness.
Loose or watery bowel movements or hard, difficult-to-pass stools that continue for more than two weeks
Feeling as if the bowel does not empty completely
Weight loss for no reason

However, these symptoms may be caused by problems other than cancer. Only a doctor can find out the cause.

How colorectal cancer is diagnosed

Not all patients with colorectal cancer will have symptoms. Screening tests are the most effective way to find colon cancer early, when it is the most treatable. Several colorectal cancer screening options exist, including screening colonoscopy and fecal immunochemical tests (FIT).

If colorectal cancer is suspected, your care team may recommend one or more of the following:

Diagnostic or therapeutic colonoscopy. This colonoscopy looks for the cause of symptoms and helps test for colorectal cancer. If polyps are found, your care team has the expertise and tools to remove it during the procedure.
Magnetic resonance imaging (MRI). These scans can help your provider see the exact size and position of your tumor. Your provider can also use this to determine if the cancer has spread to other parts of the body.
Biopsy. This test involves taking a sample of your tumor and viewing it under a microscope to see if any cancer cells are present.

Cancer patient in hallway at Holden Comprehensive Cancer Center

Every cancer diagnosis is unique.

That’s why getting a second opinion matters. Our cancer experts can confirm your diagnosis and help you understand all your treatment options.

Learn more about getting a second opinion

Treatments for colorectal cancer

Treatments for colorectal cancer depend on the state of cancer when it’s diagnosed. Surgery is the most common treatment for colon cancer. However, if the cancer has grown or spread, other treatments like chemotherapy, immunotherapy and radiation therapy may be used.

A special procedure called chemoembolization is used for patients whose colon cancer has spread to the liver. Doctors block the artery that feeds the liver with blood and inject chemotherapy drugs into the artery between the blockage and the liver so the drugs will go directly to the liver. Only a small amount of the chemotherapy will reach other cells.

We also offer clinical trials, which are research studies that give you the opportunity to receive the most recent, advanced treatment options. These treatments look at new ways to treat cancer that could increase your chances for recovery and improve your quality of life. For example, one colorectal cancer clinical trial looks at whether immunotherapy can prevent you from needing surgery for colorectal cancer.

Palliative care service: Palliative care experts help you manage your cancer symptoms and minimize side effects from your treatment.
Genetic counseling: Your genetic counselor analyzes your family history for risk and will advise you on genetic testing.