Colon Cancer

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Symptoms of colon cancer

Especially in the early stages of colon cancer, it’s possible to have no symptoms at all. The symptoms of colon cancer can also mimic other digestive conditions, such as infections, hemorrhoids and inflammatory bowel disease.

That’s why it’s essential to listen to your body and talk to your doctor if you have ongoing symptoms or notice something feels off with your digestive health. Check-in with your physician if you have any of the following symptoms:

Bowel habit changes, including diarrhea or constipation
Narrow or ribbon-like stools that last for more than a few days
Rectal bleeding, visible blood in the stool or dark stools
Cramping or gnawing stomach pain
Decreased appetite
Vomiting
Unintended weight loss
Weakness and fatigue
Continuing to feel that you cannot empty your bowels

In the later stages of colon cancer, you’re more likely to have symptoms like weight loss, swelling and pain in your abdomen. If colon cancer spreads, it can also cause symptoms in other areas of your body, such as the lungs or liver. Your healthcare team can help you get to the source of your symptoms.

Colon cancer risk factors

While you can make some lifestyle choices to reduce your risk of colon cancer, other factors may not be in your control. For example, medical conditions, genetics, age and ethnicity all play a role in your personal risk.

One of the most important steps to protect yourself from colon cancer is knowing your risk factors and talking with your doctor about the right colon cancer screenings for you. If you have a high risk of colon cancer, your care team will walk you through your options so that you can take action to reduce your risk.

Lifestyle choices that are risk factors for colon cancer
- Smoking: All tobacco use, including smoking, increases your risk of colon cancer. Stopping smoking reduces your risk of colon cancer—and many other types of cancer.
- Excessive alcohol use: Heavy drinking is linked to a higher risk. Men should limit alcohol to two drinks a day, while women should only have up to one drink daily.
- Obesity: Those with obesity have a higher chance of developing colon cancer. Take steps to maintain a healthy weight to reduce your colon cancer risk.
- Low-fiber, high-fat diet: A diet low in fiber and high in fat and calories, especially red or processed meats, may increase your risk of colon cancer. To prevent colon cancer, focus on high-fiber, low-fat choices.
- Not exercising: Physical inactivity is associated with an increased risk. Regular exercise may help you reduce your risk.
Medical conditions that increase colon cancer risk
- Inflammatory bowel disease: Chronic inflammation in the colon due to inflammatory bowel disease, including ulcerative colitis and Crohn’s disease, can increase the risk of cell changes that may lead to colon cancer.
- Inherited genetic syndromes: Some genetic syndromes, such as Lynch syndrome and familial adenomatous polyposis, cause a high lifetime cancer risk. For example, the National Institutes of Health reports that Lynch syndrome is the cause of about 2-4% of all cases of colon cancer.
- Family history of colon cancer or other cancers: People with a strong family history of colon cancer or polyps in a first-degree relative, especially in a parent or sibling before age 45 or in two first-degree relatives of any age, have an increased risk for colon cancer.
- Personal or family history of polyps: If you previously had colon polyps or have a close relative with an advanced or large polyp, you’re at an increased risk.
- Diabetes: People with Type 2 diabetes risk colon cancer more than those without diabetes.
Other risk factors
- Age: Most people with colon cancer are over 45, but it can occur at any age.
- Race and ethnicity: African Americans have the highest risk for colon cancer of all racial groups in the United States. The ethnic group with the highest risk worldwide is Jews of Eastern descent (Ashkenazi Jews).

How colon cancer is diagnosed

You have several options to help screen for and diagnose colon cancer. Your care team will decide on the right option based on your symptoms, risk factors, family and medical history, and more.

Early diagnosis of colon cancer is vital to provide you with the most options for your care and the highest recovery rate. When cancer is caught in its earliest stages, the survival rate is more than 90% at five years.

Especially if you have symptoms, a colonoscopy is the most commonly used test for colon cancer. However, blood tests, stool tests and imaging tests also give your healthcare team valuable information about your colon health and help with diagnosis and treatment planning.

Colonoscopy

Colonoscopy

A colonoscopy uses a tube with a light and a small camera to let your doctor look at the inside of your entire colon. During a colonoscopy, your provider may take tissue samples or remove polyps to help diagnose cancer.
Sigmoidoscopy

Sigmoidoscopy

A sigmoidoscopy, including flexible sigmoidoscopy, uses a small tube and camera to view the inside of the colon and look for signs of cancer. While colonoscopy looks at the whole colon, sigmoidoscopy only looks at the bottom portion of the colon.
Fecal testing

Fecal testing

Fecal or stool testing allows you to take a sample—or multiple samples—of your stool at home and then send them to a lab to look for hidden blood or DNA that might signal cancer. The most common colon cancer stool tests include Guaiac-based fecal occult blood tests, fecal immunochemical tests and stool DNA tests.
Blood tests

Blood tests

Your doctor may order blood tests such as a complete blood count, comprehensive metabolic panel or CEA assay. These could help identify abnormal levels of cells or antigens in your blood or rule out other conditions.
CT colonoscopy

CT colonoscopy

Sometimes called a virtual colonoscopy, this procedure uses computed tomography (CT) to create images of your colon. These images are then reviewed to look for polyps or cancer in the colon.
X-ray

X-ray

To get a closer look at your colon and look for cancer, your doctor may use a barium enema. This moving X-ray, or fluoroscopy, procedure injects barium into the colon through the rectum to coat it and create images.

Colonoscopy

A colonoscopy uses a tube with a light and a small camera to let your doctor look at the inside of your entire colon. During a colonoscopy, your provider may take tissue samples or remove polyps to help diagnose cancer.

Sigmoidoscopy

A sigmoidoscopy, including flexible sigmoidoscopy, uses a small tube and camera to view the inside of the colon and look for signs of cancer. While colonoscopy looks at the whole colon, sigmoidoscopy only looks at the bottom portion of the colon.

Fecal testing

Fecal or stool testing allows you to take a sample—or multiple samples—of your stool at home and then send them to a lab to look for hidden blood or DNA that might signal cancer. The most common colon cancer stool tests include Guaiac-based fecal occult blood tests, fecal immunochemical tests and stool DNA tests.

Blood tests

Your doctor may order blood tests such as a complete blood count, comprehensive metabolic panel or CEA assay. These could help identify abnormal levels of cells or antigens in your blood or rule out other conditions.

CT colonoscopy

Sometimes called a virtual colonoscopy, this procedure uses computed tomography (CT) to create images of your colon. These images are then reviewed to look for polyps or cancer in the colon.

X-ray

To get a closer look at your colon and look for cancer, your doctor may use a barium enema. This moving X-ray, or fluoroscopy, procedure injects barium into the colon through the rectum to coat it and create images.

Types of colon cancer

Most of the time, colon cancer begins in the cells that make up the colon’s inner lining. But there are other types of colon cancer, too. Some rare types of colon cancer start in the blood vessels, muscles, lymph cells or hormone-producing cells.

Understanding the type of colon cancer you have is important because it will guide your care. Your healthcare team will tailor your treatment options based on the type and stage of the cancer.

Colorectal adenocarcinoma

By far, the most common type of colon cancer is colorectal adenocarcinoma. More than 95% of people with colon cancer have this type. Adenocarcinoma can start in the cells that line many different organs. In this case, it starts in the lining inside the colon. Often, adenocarcinomas begin as polyps before they turn into cancer.
Gastrointestinal carcinoid tumors

Gastrointestinal carcinoid tumors start in special hormone-producing cells in the large intestine. This type of cancer often doesn’t cause symptoms initially and may grow slowly. Carcinoid tumors account for only 1% of all colon cancer cases. They’re more common in the small intestine.
Gastrointestinal stromal tumors

Gastrointestinal stromal tumors (GIST) start in specialized cells in the wall of the digestive tract called the interstitial cells of Cajal. They can be noncancerous at first, but many turn into cancer. While more common in other parts of the digestive system, this type of cancer is rare in the colon. Only a few thousand cases of GIST are diagnosed each year.
Primary colorectal lymphomas

In rare cases, a type of non-Hodgkin's lymphoma may start in the colon. This type of lymphoma affects the lymphocytes—a white blood cell that works as part of the immune system. Primary colorectal lymphomas make up less than 1% of all colon cancers.
Leiomyosarcomas

Leiomyosarcoma is a rare type of cancer that starts in the colon—accounting for only 0.1% of cases. It begins in the smooth muscle layers of the colon. Like other types of colon cancer, leiomyosarcomas may not cause symptoms in the early stages.

Colon cancer treatment

Treatment options for colon cancer continue to improve, especially for cancers caught before they can spread to distant locations in the body. Your care team will create a colon cancer treatment plan based on your colon cancer stage, type, health history and individual needs.

Many treatment plans include some type of surgery to remove as much colon cancer as possible. But your care team may also recommend chemotherapy, radiation, targeted therapies or immunotherapy options. Sometimes, multiple treatments are used together to care for you. In some cases, you may have the option to be a part of a clinical trial as part of your colon cancer care.

Surgery
Surgery

Surgery is a common treatment in all stages of colon cancer. The goal of surgery is to remove all or part of the cancerous cells. Many of our care locations offer advanced, minimally invasive options, including laparoscopy or robotic-assisted surgery, which use smaller incisions to help speed up recovery.

Some surgical options include:
- Polypectomy, a procedure done through endoscopy (colonoscopy) to remove a cancerous polyp
- Colectomy, a surgery to remove a section of the colon affected by cancer or all of the colon
- Colectomy with colostomy, a procedure that removes all or part of the colon and connects the top of the colon to an opening in the abdomen and a bag to collect stool, which can be temporary or permanent
Chemotherapy

Chemotherapy

Chemotherapy drugs are sometimes used to treat colon cancer by shrinking or destroying cancer cells. This treatment option is often used with surgery and is most common in stage 3 and stage 4 colon cancer.
Radiation

Radiation

In some cases, radiation therapy is used to treat colon cancer. It destroys cancer with targeted high-energy rays. Radiation therapy is less common than chemotherapy or surgery in colon cancer and is often used in the later stages of the condition.
Targeted therapy

Targeted therapy

This type of treatment targets specific genes or proteins in cancer cells to prevent them from continuing to grow or multiply. One of the most common targeted therapies is monoclonal antibodies.
Immunotherapy

Immunotherapy

Immunotherapy is an innovative treatment for colon cancer that uses the body’s immune system to destroy cancer. Cells are often modified in the lab and then infused into the blood to help fight cancer better.

Surgery

Surgery is a common treatment in all stages of colon cancer. The goal of surgery is to remove all or part of the cancerous cells. Many of our care locations offer advanced, minimally invasive options, including laparoscopy or robotic-assisted surgery, which use smaller incisions to help speed up recovery.

Some surgical options include:

Polypectomy, a procedure done through endoscopy (colonoscopy) to remove a cancerous polyp
Colectomy, a surgery to remove a section of the colon affected by cancer or all of the colon
Colectomy with colostomy, a procedure that removes all or part of the colon and connects the top of the colon to an opening in the abdomen and a bag to collect stool, which can be temporary or permanent

Chemotherapy

Chemotherapy drugs are sometimes used to treat colon cancer by shrinking or destroying cancer cells. This treatment option is often used with surgery and is most common in stage 3 and stage 4 colon cancer.

Radiation

In some cases, radiation therapy is used to treat colon cancer. It destroys cancer with targeted high-energy rays. Radiation therapy is less common than chemotherapy or surgery in colon cancer and is often used in the later stages of the condition.

Targeted therapy

This type of treatment targets specific genes or proteins in cancer cells to prevent them from continuing to grow or multiply. One of the most common targeted therapies is monoclonal antibodies.

Immunotherapy

Immunotherapy is an innovative treatment for colon cancer that uses the body’s immune system to destroy cancer. Cells are often modified in the lab and then infused into the blood to help fight cancer better.

Colon cancer prevention

The best way to fight colon cancer is to stop it from developing. With today’s colon cancer screening tools, many cases of colon cancer are preventable. You can also reduce your risk through healthy lifestyle choices, knowing your family history and seeking care for digestive symptoms.

Some actions you can take to help prevent colon cancer include:

Get routine colon cancer screenings
Take proactive steps if you have a family history or conditions that increase your risk
Focus on a high-fiber, low-fat diet and reduce the amount of red and processed meats
Maintain a healthy weight
Quit smoking and tobacco products
Limit the amount of alcohol you consume
Stay physically active
Manage health conditions like diabetes

Frequently asked questions

Can colon cancer be cured?

In most cases, yes. Especially when colon cancer is found in the early stages, it is a very treatable and sometimes curable type of cancer. If colon cancer is localized, meaning it has stayed in the colon, surgery is often the only treatment needed.
Where is colon cancer pain?

The most common place to have pain or discomfort caused by colon cancer is the lower abdomen. However, colon cancer may not cause pain at all. It’s possible to have colon cancer without any symptoms.
Can colon cancer cause back pain?

It’s rare for colon cancer to cause back pain, but it’s possible. You may have back pain as a symptom of colon cancer if the tumor causes pressure on the spine or spreads to the spine. Back pain can also be a side effect of colon cancer treatment.
Where does colon cancer tend to metastasize to?

Some of the most common places colon cancer might metastasize—or spread—are the liver, lungs, brain, abdominal cavity and distant lymph nodes.
Will colon cancer show on CT scan?

Yes, CT scans can show signs of colon cancer and look for signs that the cancer may have spread to other areas of the body. A CT colonography scan is sometimes used to screen for colon cancer but may not detect smaller polyps.

What is colon cancer?

Symptoms of colon cancer

Causes of colon cancer

Colon cancer risk factors

Hereditary colon cancer