Colon Cancer

Your risk level may affect when you begin colorectal cancer screening.

Research has shown that people with certain risk factors are affected more than others. Knowing your risks will help you and your doctor make the best decisions for your health.

Risk factors may include:

• Age: Your risk increases as you age, although increasingly, we're finding younger patients being diagnosed. We recommend scheduling your first colonoscopy at the age of 45 if you have an average risk.
• Race or background: People who are African-American or Jewish with Eastern European background are at a higher risk.
• Medical history: People with ulcerative colitis, Crohn’s disease, type 2 diabetes, or previous cancers have a higher risk of developing this disease.
• Family medical history: You have an elevated risk if you have close family members diagnosed or other related conditions passed down through genetics, such as Lynch syndrome.
• Lifestyle: Your risk is more directly linked to diet and exercise than any other type of cancer. Some evidence suggests that this type of cancer may be associated with a diet high in fat and calories and low in foods with fiber, such as whole grains, fruits, and vegetables. In addition, smoking and alcohol consumption can increase your risk.

For patients who have a high risk of the disease, we take a proactive approach to managing and lowering their disease risk. Through genetic counseling services and our High-Risk Gastrointestinal Cancer program, we provide individualized plans which may include earlier and/or more frequent screenings, medications, and other strategies to reduce your risk.

If your doctor finds a polyp during a colonoscopy, they can remove it immediately, reducing your risk of cancer.

Most commonly, healthcare providers suggest screening with a colonoscopy. During a colonoscopy, a gastroenterologist uses a lighted instrument called a colonoscope to inspect the entire large intestine (colon and rectum) for abnormal growths, called polyps. A polyp is not cancer, but it can change over time into cancer. If polyps are found, they will be removed during the procedure, reducing your risk. The procedure is painless, as you will receive sedation and are asleep during the 20-minute procedure. Many patients report that prep is much easier than it used to be, especially given its potentially lifesaving benefits.

Learn More About Colonoscopy

Diagnosis

We use advanced technology to understand the specific features of your cancer.

At MedStar Health, we understand how difficult a diagnosis can be for you or your loved one. If you’ve been diagnosed, you can rely on our devoted and specialized teams, from treatment to follow-up care. Our knowledgeable doctors and nurses will answer any questions you may have during the diagnosis and be with you every step of the way.

Our goal is to complete the diagnostic phase promptly so that you can begin treatment as soon as possible. We use the most advanced diagnostic technology to diagnose and stage your cancer because we know that the more accurate your diagnosis, the more precise your treatment regimen will be.

Our doctors use a variety of tests to diagnose and determine if this type of cancer has spread (metastasized) to other parts of your body. These tests may also help your doctor determine which treatment will be most effective. In most cases, a biopsy is the only way to make a definitive diagnosis. Your MedStar Health doctor will consider several factors when deciding which diagnostic test is right for you: your age, medical history, type of cancer suspected, symptoms, and previous tests.

• Colonoscopy - A colonoscopy allows your doctor to see inside your rectum and colon to find polyps or other signs of cancer

• Biopsy - During a biopsy, your doctor will remove a small amount of tissue from your rectum or colon and examine it under a microscope to determine if cancer is present. Other tests can be used to suggest whether or not cancer is present, but only a biopsy can definitively diagnose it
• Molecular testing - Your MedStar Health doctor may use molecular testing to determine if your treatment options include targeted therapy
• Computed tomography (CT or CAT) scan - A CT scan may be used to help your doctor determine if it has spread to other parts of your body

In addition to these tests, your doctor may use a blood test, MRI, ultrasound, or other tests.

Colon cancer stages

Once your diagnostic tests are complete, your doctor will review the results. If the tests show that the cancer is present, the results of your tests will help your doctor determine the stage of cancer and which treatment options will be most effective. Staging helps us understand how far cancer has spread and ranges from zero to four:

• Stage 0: Cancer is only found in the mucosa, the innermost lining of the colon.
• Stage I: Cancer has spread beyond the inner lining but is contained to the colon. It has not spread to lymph nodes.
• Stage II: Cancer has spread to the outer layer of the colon but has not spread to the lymph nodes.
• Stage III: Cancer has spread through the colon and to one or more lymph nodes.
• Stage IV: Cancer has spread to other organs, making it an advanced, metastatic disease.

Types of cancer

We used to treat colorectal cancer universally as the same type of cancer. Now, with the help of tumor DNA profiling, we know there are significant differences in tumors that come from the right side of the colon (closer to the liver), the left side of the colon (closer to the rectum), and the rectum itself. These distinctions are important because they impact how effective treatments may be for patients with advanced disease.

Most men and women who are diagnosed with colon cancer have adenocarcinoma, which begins as a growth in the colon, called a polyp. There are other types of colorectal cancer, although extremely rare. These may include:

• Gastrointestinal carcinoid tumors, which begin in hormone-producing cells
• Colon leiomyosarcomas, in which the tumor begins in the layers of muscle in the colon
• Colorectal lymphomas, which typically develops in the lymph nodes but can begin in the colon
• Familial adenomatous polyposis (FAP), which is a hereditary condition that results in hundreds or thousands of polyps in the colon or rectum

Why choose us

Our comprehensive services provide easy access to the latest diagnostic and treatment options available at convenient locations across the Washington, D.C., and Maryland region. Our approach combines the latest treatment options with individualized care that involves:

Experts meet regularly to discuss your best treatment options. Our colorectal team brings the best of surgical and medical oncology together to deliver personalized treatment to address your unique needs. Our experts meet regularly in a tumor board to discuss each cancer case and consider every aspect of care, including physical, emotional, spiritual, and financial needs, and any others that arise. The tumor board allows specialists across several disciplines to provide input into a comprehensive treatment plan and may involve:

• Colorectal surgeons
• Medical oncologists
• Radiation oncologists
• Gastroenterologists
• Interventional radiologists
• Pathologists
• Nurse practitioners
• Physical therapists
• Genetic counselors
• And others

Excellent surgical care held to rigorous standards set by our innovative Colorectal Surgery Clinical Practice Council. With ten hospitals and dozens of outpatient facilities, we strive to deliver integrated and streamlined colorectal cancer care wherever you see us in Washington, D.C., and Maryland. Through our Colorectal Surgery Clinical Practice Council, our physicians and leaders from across MedStar Health work together to maximize patient outcomes, from increasing colorectal screening rates to protocols that reduce surgical site infections. This commitment to collaboration ensures our patients benefit from the most rigorous clinical best practices for colorectal surgery at our academic and community-based facilities.

A compassionate team who is invested in your recovery. "It's how we treat people" is not just our tagline—it's the guiding principle we live by every day. Our entire care team is dedicated to treating patients with the same respect, empathy, and kindness we'd want for our family members. You can expect us to sit with you and answer all of your questions, engage in conversation about what's meaningful to you, and be genuinely invested in your journey to and through survivorship.