Colorectal cancer

Colorectal cancer occurs in the colon, also known as the large intestines or rectum, which connects the colon to the anus. This type of cancer almost always begins in cells that produce mucus or other fluids as tumors. These tumors generally start as adenomas, or polyps, which are small benign (non-cancerous) growths.

Colorectal cancer is often detected through screenings, such as colonoscopies or sigmoidoscopies, and can be treated with surgery or specialized cancer therapies, depending on the disease's stage and severity.

At HCA Midwest Health, our cancer programs are overseen by panels of physicians who are experts in a variety of medical specialties. One of those medical specialties is colorectal cancer. We offer comprehensive colorectal cancer care provided by multidisciplinary specialists with a wide range of services, including:

• A thorough genetic counseling program for patients who are concerned about their personal or family history of GI cancer
• A wide range of invasive and noninvasive diagnostic screening options
• Advanced surgical and nonsurgical cancer treatments
• Cancer support services and educational resources
• Cancer wellness classes and survivor support groups
• Dedicated nurse navigators who support and guide patients with stage 3 and 4 colon cancer
• High-risk GI cancer clinics at Centerpoint Medical Center, Menorah Medical Center, Overland Park Regional Medical Center and Research Medical Center
• Local access to national clinical research trials
• Over 50 GI and colon cancer specialists across our network of hospitals

Patients with early-stage colorectal cancer do not usually present symptoms. That's why it's essential to be mindful of certain symptoms and speak to a doctor if they arise. Common symptoms of colorectal cancer include:

• A change in the frequency of bowel movements
• A feeling that the bowel does not empty completely
• Abdominal discomforts, such as gas, pain, bloating, fullness or cramping
• Blood in stool
• Chronic fatigue
• Constipation
• Diarrhea
• Narrow stool
• Unexplainable weight loss

Because early-stage colorectal cancer does not usually present symptoms, routine screenings are essential to prevent cancer and/or detect the disease in its earliest and most treatable stages.

Our doctors use imaging exams and diagnostic procedures to detect and diagnose colorectal cancer, gastrointestinal cancer and related diseases. Sarah Cannon Cancer Institute recommends consulting your physician if you are 45 years old or older to determine the right screening test for you. Evidence-based options may include colonoscopy at 10-year intervals or a Fecal Immunohistochemistry Test (FIT) annually.

Additionally, we offer various screening options to detect colorectal cancer, including:

• Digital rectal exam – An exam that checks for abnormalities. It can detect almost half of colon cancers and can usually be completed by a primary care physician near you
• Fecal immunochemical test (FIT) – A stool culture test used to detect blood in the stool. You will obtain a discreet sample in the privacy of your own home and send to a lab for analysis. This test is offered through a primary care physician and is covered by most insurance with little to no cost to you. It is designed for patients at an average risk for colon cancer and should be repeated annually
• Fecal occult blood test – A lab test used to look for blood in the stool. You can talk to a primary care doctor near you about this test
• Stool DNA test – A lab test used to look for DNA changes in cells. It can also detect blood in stool. This test can usually be performed by your PCP
• X-ray of the large intestine or barium enema – Provides a picture of the colon and can assist in identifying polyps
• Biopsy – The doctor removes a tissue sample to be sent for examination
• Virtual colonoscopy – Uses computer software along with CT scan to check the colon for polyps

When a physician detects colon cancer, they also identify the cancer's stage. Cancer stages are determined by how much cancer is in the body. The stage can be one of the most critical factors for doctors when recommending a treatment method.

The information below describes what a patient can expect from each stage of colon cancer:

• Stage 0 – this extremely early stage, also called carcinoma in situ, abnormal cells are found only on the surface layer of the colon wall.
• Stage 1 – In this early stage, cancerous cells have been found in the muscular layer of the colon wall.
• Stage 2 – In this stage, cancer has spread through the muscle layer of the colon wall to the outermost layer of the colon wall.
• Stage 3 – In this stage, cancer has spread to nearby lymph nodes.
• Stage 4 – In this advanced stage, cancer has spread beyond the colon to other parts of the body, most often the liver and lungs.

In some cases, physicians can treat colorectal cancer using non-surgical methods. This usually depends on the stage of the cancer and/or the location of the tumor. Nonsurgical therapies might also be used in conjunction with surgery to treat the disease effectively.

Our oncology programs offer the following non-surgical cancer treatments:

• Radiofrequency ablation – Typically used when the cancer has spread to other organs. It uses high-energy radio waves to kill tumors
• Cryosurgery – Uses extreme cold to destroy infected tissue
• Radiation therapy – High-energy rays to destroy cancer cells
• Chemotherapy – Injectable drugs used to destroy cancer
• Targeted therapy – Chemotherapy drugs that are specifically formulated to target specific cell changes
• Clinical trials – Provides patients with access to new therapies that are currently under investigation
• Cancer Rehabilitation

Surgery is the most common and effective type of treatment for colorectal cancer. We use a range of minimally invasive surgical options, such as laparoscopy and robotic surgery, whenever possible to minimize scarring and recovery times.

Robotic surgery can be particularly beneficial to patients with rectal cancer. The robot's accuracy, visibility and maneuverability allow the surgeon to get lower beneath the tumor than ever before. Additionally, it possibly eliminates the patient's need to have a permanent colostomy bag following surgery.

Renowned for their expertise in robotics, HCA Midwest Health’s colorectal program features some of the country’s best colorectal surgeons. Many of our surgeons were early-adopters of this technology and have performed hundreds of successful robotic colorectal operations. Our surgeons educate and set expectations upfront so that they can partner with their patients and help them make the treatment decisions that work best for them.

Some of the most common surgical treatments we perform to treat colorectal cancer include:

• Polypectomy – Is usually used for stage zero and early stage one. The tumor is removed as a part of the polyp during a colonoscopy
• Local excision – Removes cancer on the surface of the colon wall along with a small amount of nearby tissue. It can be done during a colonoscopy and is used for stage zero and early stage one colon cancer
• Partial colectomy – Removes the part of the colon that is infected. Can be performed with one long incision or several smaller incisions and a thin lighted tube with a camera
• Total colectomy – Removes the entire colon