What is colorectal cancer?

Colorectal cancer is a type of cancer that begins in the lining of your colon or rectum, which are parts of the large intestine. The term colorectal cancer includes both colon cancer and rectal cancer. Together, these cancers are among the top five types of cancer diagnosed today.

Colorectal cancer starts as a polyp, an abnormal outgrowth of cells on the lining of the colon and rectum. When these polyps are found early and removed, colorectal cancer can be prevented from having the chance to develop. Beyond removing polyps, if colorectal cancer is caught in the earliest stages, the five-year survival rate is around 90%. This is why early detection and screening for colorectal cancer is so important. It is recommended for individuals to begin screening for polyps and cancer at the age of 45. This age is younger if there is a family history of cancer and polyps.

Our team of specialists will partner with you to reduce your risk of colorectal cancer and navigate your options after a diagnosis. From screenings to innovative clinical trials, we give you access to the resources you need to care for colorectal cancer.

Symptoms of colorectal cancer

One way to protect yourself from colorectal cancer is to know the symptoms and when to get checked. When colorectal cancer first develops, you may not have any noticeable signs. If you do have colorectal cancer symptoms, they might be very similar to other common digestive diseases, from infections to irritable bowel syndrome.

Early symptoms of colorectal cancer tend to be related to your digestive system. In rectal cancer, rectal bleeding or blood in the stool is one of the most common symptoms, while colon cancer may cause changes in bowel habits or abdominal cramping. As colorectal cancer reaches its later stages, you may have symptoms that affect your whole body, like fatigue or weight loss.

Colorectal cancer causes

Colorectal cancer occurs when abnormal cells in your colon or rectum multiply and grow rapidly. In most cells, specific genes control how they divide and stay functional. However, if these genes undergo mutations, they might not function properly. This could lead to the formation of cancer. Studies are ongoing to understand why this happens in some people, but researchers have found several factors that increase the risk of colorectal cancer.

Colorectal cancer risk factors

Several factors increase your risk of developing colorectal cancer. In some cases, you can take steps to control or reduce your risk factors, but some may not be within your control. By knowing your risk factors for colorectal cancer and talking with your doctor, you’ll have the information you need to make choices to protect yourself—such as lifestyle changes or routine screenings.

  • Lifestyle choices that are risk factors for colorectal cancer

    Diet, exercise and tobacco use affect your overall health and your risk of colorectal cancer.

    • Lack of regular exercise: Studies have shown a link between physical inactivity and a higher risk of colorectal cancer.
    • Food/diet choices: The foods you eat may increase your risk of cancer. A diet low in fruit, vegetables and fiber or high in processed meats and fatty foods is a contributing factor to colorectal cancer.
    • Obesity: People who are obese tend to have a higher risk of developing colorectal cancer.
    • Moderate to heavy alcohol consumption: Excessive alcohol consumption, defined as more than two drinks a day for a man or one drink for a woman, increases your risk.
    • Smoking: Smoking and tobacco use increases your likelihood of developing colorectal cancer.
  • Medical conditions that increase colorectal cancer risk

    If you have certain medical conditions, your risk of colorectal cancer can increase. It's important to talk with your doctor about managing your condition and taking preventive steps.

    • Inflammatory bowel disease: Inflammatory bowel disease causes inflammation in the intestinal tract, which puts you at risk for colorectal cancer. IBD includes ulcerative colitis and Crohn's disease and differs from irritable bowel syndrome (IBS).
    • Inherited gene mutations: People with Lynch syndrome have a higher chance of colorectal cancer in their lifetime. If the colon isn't removed, almost all people with Familial Adenomatous Polyposis (FAP) go on to develop colorectal cancer.
    • Family history of colorectal cancer: If you have a history of colorectal cancer or polyps in your family, genetic counseling can offer insight into your predisposition for colorectal cancer. Your risk of colorectal cancer may be even higher when close family members (such as parents or siblings) have been diagnosed with colorectal cancer at a young age.
    • Personal history of certain types of cancer: If you've previously had uterine cancer or ovarian cancer, your risk of colorectal cancer is higher.
    • Type 2 diabetes: Individuals with Type 2 diabetes have a higher chance of developing colorectal cancer compared to those who don't have diabetes.
  • Other risk factors
    • Age: It is possible to develop colorectal cancer at a young age, but most cases are found in those over 45.
    • Gender: Men are more at risk of colorectal cancer than women.
    • Race and ethnicity: In the United States, African Americans, Native Indians and Alaska Natives are more likely to develop colorectal cancer than other racial groups. Around the world, Ashkenazi Jews have one of the highest rates of colorectal cancer.

Colorectal cancer diagnosis

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Many tests are available today to screen, diagnose or determine the stage of colorectal cancer. While colorectal cancer screenings look for signs of cancer when you have no symptoms, diagnostic tests are used as a follow-up to a screening or when you have symptoms that need a closer look.

One of the most common tests used to diagnose colorectal cancer is a colonoscopy. It can help catch colorectal cancer in its early stages and allows your doctor to take tissue samples to diagnose the tumor. Early diagnosis is vital in treating colorectal cancer because it gives you more options, including surgical care that can preserve as much of your normal intestinal tract as possible.

Endoscopic tests

Endoscopic tests use a thin, flexible tube with a camera and a light to see the colon and rectum. This scope is inserted through the anus into the intestinal tract to look for areas of cancer or polyps.

  • Colonoscopy: A colonoscopy is an endoscopic test that lets your doctor view the entire rectum and colon. Your provider can also remove polyps and take samples of tissue to confirm the cancer diagnosis.
  • Sigmoidoscopy: Both sigmoidoscopy and flexible sigmoidoscopy use a small scope to look at the rectum and lower portion of the colon, but the upper part isn’t viewed. As a result, sigmoidoscopy can help diagnose rectum cancer, but it doesn’t catch cancers higher up in the colon.

Fecal testing

Fecal tests allow you to take stool samples at home and send them to a lab for testing. These tests look for pieces of DNA or hidden blood in the stool, which could be signs of colorectal cancer. If a fecal test is positive, it’s often followed by a colonoscopy. Unfortunately, these tests do not detect polyps.

  • Fecal immunochemical test (FIT): A FIT test looks at multiple stool samples in the lab to detect blood in the stool.
  • Guaiac-based fecal occult blood test (gFOBT): Fecal occult blood tests also look for blood in the stool and may require diet and medication changes in the days leading up to the test.
  • Fecal DNA test: A fecal DNA test looks for hidden blood in the stool and pieces of DNA that could indicate colorectal cancer.

Blood tests

Although a single blood test isn't enough to determine if someone has cancer, doctors might use a variety of blood tests to gather additional information about a person's health before or after diagnosing colorectal cancer. Some of these blood tests include red blood cell counts, tests to look at liver enzymes in your blood or tests that detect a common colorectal tumor marker called CEA.

Biopsies

A biopsy takes tissue samples from a polyp, tumor or area of concern. To diagnose cancer, these samples are viewed under a microscope or through other lab testing. In colorectal cancer, biopsies are usually taken during an endoscopic procedure like a colonoscopy.

Imaging tests

Imaging tests aren’t usually used to diagnose colorectal cancer. However, they can help your doctor look for signs that cancer has spread, determine the stage of colorectal cancer or check to see how well your treatment is working.

  • CT scan: CT imaging is a cross-sectional imaging tool that is used after a colorectal cancer diagnosis to see if cancer has spread to other areas of your body.
  • MRI: An MRI uses radio waves and strong magnets to create detailed images of soft tissue in the body. In colorectal cancer, your care team may see if cancer has spread to the liver or brain with an MRI or use a series of rectal MRI protocols to look at a tumor in more detail.
  • PET/CT scan: A PET/CT scan isn’t used as often in colorectal cancer diagnosis or monitoring, but it might be performed as a follow-up to other tests. It uses a small amount of radioactive material to highlight areas of cancer in the body.
  • Chest X-ray: In colorectal cancer, a chest X-ray is used to look for cancer that may have spread into the lungs.
  • Angiography: An angiography injects dye into your arteries to take images of the blood vessels. This type of X-ray test can show arteries that are supplying blood to a tumor.
  • Ultrasound: A few different types of ultrasound tests are used for colorectal cancer. For example, your care team may use an ultrasound of the abdomen to look for cancer that has spread, an endorectal ultrasound to view the rectum or an ultrasound during a surgical procedure to evaluate the liver.

Barium enema

A barium enema is an imaging test where barium is injected through the anus to coat the rectum and colon. This contrast substance allows a better view of the colon and rectum lining. After injecting barium, a series of X-rays are used to create images.

Treatment for colorectal cancer

Your colorectal cancer treatment plan should be tailored to your individual needs. Colorectal cancer is best treated in a multidisciplinary team setting with multiple specialists working together to tailor your treatment plan to your cancer. Our locations offer a team of specialists and many support services and resources to help guide your care. After your diagnosis, your team will work with you to plan your next steps so you feel informed and confident in your treatment choices.

In many cases, surgery is used to treat colorectal cancer. The treatments you undergo might involve more than surgery; chemotherapy or radiation could also be considered. The specific treatments depend on various factors and whether you have colon or rectal cancer. In the later stages of colorectal cancer, your care may include immunotherapy, target therapies or clinical trials.

  • Surgery

    One of the main goals of colorectal cancer surgery is to remove all or as much of the cancer as possible. The type and extent of the surgery you have depends on where your cancer is located and how far it has spread. Different surgical options are based on whether you have colon or rectal cancer, the stage and site of the tumor and the likelihood of curing the condition.

    Doctors continue to innovate new surgical options for your care. Many of our locations offer minimally invasive procedures, like laparoscopy or robotic-assisted surgery, which typically have a shorter recovery time and work to preserve your quality of life after surgery. For rectal cancer, we also offer transanal surgeries that remove early rectal tumors without an abdominal incision.

  • Chemotherapy

    Chemotherapy uses drugs to help destroy cancer cells and stop them from growing. Chemotherapy may be used in stages 2, 3 or 4 in colorectal cancer. Sometimes, you’ll have chemotherapy before surgery to help shrink the tumor. Other times, your care team may use chemotherapy after surgery to target any cancer that couldn’t be removed or reduce the risk of cancer returning.

  • Radiation

    Several types of radiation are available to fight colorectal cancer. External beam radiation is one of the most common. It delivers high-energy rays using a machine outside the body to help destroy specific cancer areas while preserving healthy tissue. Radiation therapy is generally more common in rectal cancer than colon cancer.

  • Targeted therapy

    Monoclonal antibody therapy is often used in the treatment of colorectal cancer. This therapy creates proteins that mimic the natural antibodies found in your body, helping your immune system better recognize and target cancer cells. Most of the time, monoclonal antibodies and other targeted therapies are given in advanced-stage colorectal cancer.

  • Immunotherapy

    Immunotherapy uses drugs to help your immune system better find and destroy cancer cells in the body. For treating colorectal cancer, the FDA has currently approved the use of checkpoint inhibitors, which help the immune system fight the growth of cancer cells.

Colorectal cancer prevention

You can take steps to reduce your risk of colorectal cancer. Through routine screenings, you can often stop colorectal cancer before it starts. Because of the many screening options available to suit your needs, colorectal cancer is considered one of the most preventable types today.

Many factors affect your risk for colorectal cancer and some lifestyle factors are within your control. Healthy dietary choices, regular physical activity, limiting alcohol consumption and quitting smoking are all preventive actions. If you’re ready to take charge of colorectal cancer prevention, talk with your doctor about your next steps.

Colorectal cancer screening

Following your doctor’s guidance on colorectal screening is one of the best ways to prevent colorectal cancer. If you have an average risk of colorectal cancer, the U.S. Preventive Services Task Force recommends starting colorectal screenings at 45.

From stool-based tests to endoscopic procedures like colonoscopy, the guidelines for screening include several options. How often you need screening will depend on which test you choose.

In general, the guidelines recommend the following timing for each type of screening test:

  • gFOBT stool test: Annually
  • FIT stool test: Annually
  • DNA-FIT stool test: Every three years
  • Colonoscopy: Every ten years
  • Virtual colonoscopy: Every five years
  • Flexible sigmoidoscopy: Every five years or every ten years when used with yearly FIT

If you have any factors that put you at a higher risk of colorectal cancer, you should talk with your doctor about starting screening sooner. People with risk factors often need screenings earlier and more often. They’re also more likely to need a specific screening type, usually a colonoscopy.

Our approach to colorectal cancer

With our team, you have the expert providers, innovative treatments and complete support you need to feel confident at every step of your care. And with Texas's largest network of hospital-based cancer programs, you can find nearby care that fits your life.

Many of our locations offer dedicated colorectal cancer care teams that bring together multiple specialists—all working together for you. Our hospitals include physicians on the medical staff specializing in gastroenterology, medical oncology, colon and rectal surgery, radiation oncology and more.

You also have various support services to care for you as a whole person—from nutrition to genetic counseling to psychological care. No matter where you are in your colorectal cancer journey, our team is dedicated to helping you make informed choices and providing care that maximizes your quality of life.

Advanced diagnosis and treatment

Our extensive cancer services network gives you access to advanced treatments not found at other centers. We offer numerous screening and diagnostic options so that you can work with your doctor to choose the tests that fit your needs.

Our teams focus on providing treatments that reduce recovery time and minimize the effects of treatment as much as possible, including minimally invasive surgery and procedures that preserve the normal function of your digestive tract. With a commitment to ongoing research, you also have access to clinical trials that give you even more options in the fight against colorectal cancer.

  • Early detection through screenings: We make it easy to connect with the routine care you need, including cancer screenings so that you can prevent, detect and beat colorectal cancer.
  • Latest technology: You will have access to dedicated colon and rectal surgeons on the medical staff specializing in advanced surgical care. These experts guide you through your options, including minimally invasive surgical techniques and sphincter-preserving surgeries that can protect your normal digestive function and avoid needing a colostomy bag. Enhanced recovery programs reduce complications and shorten the length of your stay, as well as reduce narcotic use.
  • Innovative research: With our robust cancer research program through the Baylor Scott & White Research Institute, our teams are involved in advancing colorectal cancer treatment. Our cancer programs offer numerous clinical trials, giving you more options and hope.

Supportive care and wellness

Whether you’re coping with a new diagnosis or navigating life after cancer, our team is by your side through it all. We’ve created an entire network of support resources across Texas that are made just for you, including cancer navigators who guide you through your care. We’ll support you through each step so you know what to expect and can confidently move forward.

Colorectal cancer affects many aspects of your life. When you partner with us for your care, we focus on supporting you as a whole person—physically, emotionally, socially, mentally and spiritually. We also have programs designed for your loved ones and caregivers so that they feel supported and informed, too.

Some of our support and wellness services include:

Our locations near you

We help you get care at a location that fits your needs. We offer several locations for your care, including colorectal cancer screening, diagnosis and treatment in North and Central Texas.