Frequently Asked Questions About Colorectal Cancer

Colorectal cancer basics

• What does colorectal cancer look like?
• What does colorectal cancer feel like?
• Is colorectal cancer genetic?
• At what age do people get colorectal cancer?

Colorectal cancer screening and diagnosis

• What are polyps?
• How are polyps removed?
• How is a colonoscopy done?
• What do colonoscopy results mean?
• How is colorectal cancer diagnosed?

Colorectal cancer treatment

• What is the treatment for colorectal cancer?
• Is colorectal cancer curable?

What does colorectal cancer look like?

Nearly all colorectal cancers start as growths called polyps. Doctors try to find polyps with colonoscopies and other screening tests. Some polyps are flat, but most are either dome-shaped or have a head and a stalk. If a polyp contains cancer, the disease can grow into the colon or rectal wall as a malignant tumor.

What does colorectal cancer feel like?

Someone with colorectal cancer doesn’t “feel” the disease directly, but it can cause a number of symptoms. These signs include abdominal pain or cramping, constipation and the feeling that you still need to go to the bathroom even after a bowel movement. Colorectal cancer may not cause noticeable symptoms right away, though, so it’s important to follow screening guidelines. Learn more about colon cancer or rectal cancer.

Is colorectal cancer genetic?

Most risk factors for colorectal cancer are not genetic. But some genetic conditions do increase the chance of developing the disease or cause potentially troublesome polyps to form. These conditions are tied to genetic changes inherited from parents. Henry Ford’s Cancer Genetics Program offers testing and counseling for conditions such as:

• Lynch syndrome, also called hereditary nonpolyposis colorectal cancer (HNPCC)
• Familial adenomatous polyposis (FAP)
• Peutz-Jeghers syndrome (PJS)
• MYH-associated polyposis (MAP)

At what age do people get colorectal cancer?

Approximately four of five colorectal cancers are diagnosed in people 45 and older. Two-thirds of colorectal cancers are diagnosed in those 55 and older. While colorectal cancer in people younger than 45 remains infrequent, diagnoses have increased in recent years among those 20 to 54. Medical professionals do not yet know why colorectal cancer is on the rise in this age group.

What are polyps?

Polyps are abnormal growths in the colon or rectum. Certain types of polyps have the potential to become cancerous if left in place. Polyps can:

• Vary in size. Bigger polyps are more likely to contain cancer or lead to cancer.
• Cause rectal bleeding.
• Come in various shapes, with the majority looking like a dome. Others feature a head and stalk or lie flat on the colon or rectum.

How are polyps removed?

During colonoscopies, doctors often remove any polyps they find to reduce the risk of the polyps developing into colorectal cancer. Some large or otherwise complex polyps may require surgical removal in a separate procedure.

The techniques for polyp removal during colonoscopy include:

• Destroying them using an electrical current, called electrosurgery
• Using a wire loop to snare and remove them

How is a colonoscopy done?

Colonoscopy is the main tool for colorectal cancer screening. For this procedure, you can expect to:

• Prep a day or two beforehand: Your doctor may temporarily switch you to a liquid diet. You take strong laxatives to empty your colon, so you should be near a bathroom in case you need to go frequently. This process, called bowel prep, helps your doctor get clear images of your colon.
• Take medication: At your appointment, you receive pain medication and a sedative. These medications help you relax and avoid discomfort. Because of these medications, you can’t drive afterward. You’ll need someone to accompany you and take you home.
• Spend 30 minutes or so in the exam room: The procedure takes place in a private room and is typically performed by a gastroenterologist or a colorectal surgeon. The doctor uses a colonoscope, a thin tube about the width of a finger with a light and tiny camera on the end. The scope is eased through the rectum and into the colon, where it captures images. The doctor may remove polyps or tissue samples.
• Ease back into activities: The sedative wears off gradually. You should be able to return to your usual activities the next day.

What do colonoscopy results mean?

Your doctor will share the results of your colonoscopy with you.

• Negative results mean the doctor did not find any polyps. Your doctor will advise you on when you should have another screening.
• If polyps were found, a lab examines samples under a microscope to determine if they are completely harmless (noncancerous), could turn into cancer (precancerous), or are cancerous. Your doctor could recommend a repeat colonoscopy or screening at shorter intervals. Cancerous polyps require more treatment. Your doctor will discuss the next steps.

How is colorectal cancer diagnosed?

Doctors diagnose colorectal cancer by examining the colon and rectum. They may also order blood tests and imaging. They will also ask you about symptoms. Learn more about colorectal cancer diagnosis.

What is the treatment for colorectal cancer?

Surgery is a common treatment for both colon and rectal cancers. Your team may also recommend chemotherapy and/or radiation therapy, depending on the specifics of your case. People with rectal cancer often receive these treatments, for various stages of the disease. Chemotherapy and radiation can also treat more advanced colon cancers. Learn more about colorectal cancer treatment.

Is colorectal cancer curable?

Doctors hesitate to use the word “curable” when it comes to colorectal cancer. But colorectal cancer can be highly treatable when found early. Doctors measure the success of treatment with the five-year survival rate — the number of people alive five years after diagnosis. For colorectal cancer in 2018:

• Among those with cancer confined to the colon or rectum, nearly 90 percent were still alive.
• When cancer had spread, but only to nearby lymph nodes, just over 70 percent were still alive
• Nearly three-quarters of cases were diagnosed at these early, most treatable stages.