Colon and rectal cancer: comprehensive treatment

What it is

In most cases, this cancer does not appear overnight. It usually begins as a polyp: a small bump on the inner wall of the colon that is not cancerous at first. Over the years, some polyps can turn into cancer. That is why this type of cancer is among those that benefit most from early detection: if a polyp is found and removed in time, it often never gets the chance to become a malignant tumor (U.S. National Cancer Institute).

Found at an early stage, colon cancer usually has more treatment options and a better outlook than when it is found advanced. The problem is that in its early stages it causes almost no discomfort, so many people see a doctor once the disease has already grown. The good news: there are simple tests to find it in time, even before it causes symptoms.

Risk factors

• Being 45 or older (most cases occur after age 50, but cases in younger adults are on the rise).
• Family history of colorectal cancer or polyps (father, mother, siblings, or children).
• Having had colon polyps or inflammatory bowel disease (ulcerative colitis, Crohn's disease).
• Being overweight or obese.
• A sedentary lifestyle (little physical activity).
• A diet high in red and processed meats (cold cuts) and low in fiber, fruits, and vegetables.
• Tobacco use and excessive alcohol consumption.
• Type 2 diabetes.
• Some rare inherited syndromes (such as Lynch syndrome).

Source: American Cancer Society in Spanish.

Warning signs / common symptoms

• Changes in bowel habits that last more than a few days: diarrhea, constipation, or a feeling of not emptying completely.
• Blood in the stool (red or very dark, almost black).
• Bleeding from the rectum.
• Persistent abdominal pain, cramping, or discomfort.
• Weakness and tiredness without explanation.
• Unintended weight loss.
• Anemia found on a blood test with no apparent cause.

Important: these problems can come from many other, more common causes, such as hemorrhoids, infections, or irritable bowel. Having one of these symptoms does not mean you have cancer, but it is a reason for a doctor to evaluate it. If you have any of them, come in for an evaluation.

Source: American Cancer Society in Spanish — signs and symptoms.

How it is detected and diagnosed

Everything starts with an evaluation appointment: the oncologist listens to your symptoms, reviews your personal and family history, and performs a physical exam. From there, they may order:

• Fecal occult blood test: a simple test, done with a stool sample, that looks for traces of blood not visible to the naked eye. It is one of the most accessible ways to start screening (MedlinePlus).
• Colonoscopy: a procedure in which the inside of the colon is examined with a thin, flexible camera. It shows polyps or lesions and allows samples to be taken during the same procedure.
• Biopsy: when a suspicious lesion is found, a small piece of tissue is taken for analysis. A biopsy is the only test that confirms or rules out a cancer diagnosis.
• Laboratory and imaging studies: blood tests (including markers) and imaging studies to determine how far the disease extends and to plan treatment.

At the Unidad de Oncología Menonita you can have the evaluation appointment, the biopsies, and the tests needed to reach a diagnosis and a treatment plan.

Treatment options

Treatment depends on the stage of the disease, the location of the tumor, and each patient's overall health. No two cases are alike; the plan is always defined individually in consultation.

What the unit offers:

• Cancer surgery: in many cases of colon cancer, surgery to remove the tumor is the foundation of treatment.
• Chemotherapy: medicines that attack cancer cells; it may be given after surgery or as the main treatment, depending on the stage.
• Targeted therapy: medicines that act on specific features of the tumor, prescribed based on studies of the tumor itself.
• Immunotherapy: in certain selected cases (depending on the tumor's biological profile), it helps the immune system recognize and attack the cancer.
• Palliative care: control of pain and other symptoms to protect quality of life at any stage of the disease.

What we say honestly: some cases — especially rectal cancer — require radiation therapy as part of treatment. The unit does not have radiation therapy; when a case needs it, the patient is referred to radiation therapy centers in Chihuahua City, and the unit's team provides coordinated follow-up for the rest of the treatment.

Source for treatment options: U.S. National Cancer Institute — colon cancer treatment.

Early detection / prevention

• International guidelines (the American Cancer Society and the U.S. Preventive Services Task Force) recommend that people at average risk begin screening at age 45, even without symptoms (American Cancer Society in Spanish).
• Common options: a fecal occult blood test every year or a colonoscopy every 10 years (if the result is normal and there are no additional risk factors).
• If you have a family history of colorectal cancer or polyps, screening may start before age 45; mention it in consultation.
• To lower your risk: keep a healthy weight, stay physically active, eat more fiber, fruits, and vegetables, limit red and processed meats, avoid tobacco, and moderate alcohol.

Frequently asked questions

Does a colonoscopy hurt? It is done under sedation, so most people feel no pain during the procedure and tolerate it well. The preparation beforehand (cleansing the bowel) is the part that requires the most care, and the medical team explains how to do it step by step.

If no one in my family has had colon cancer, do I still need to get tested? Yes. Most cases occur in people with no family history. That is why the guidelines recommend starting screening at age 45 even without a family history.

I found blood in my stool — is it cancer? Not necessarily: causes such as hemorrhoids or fissures are much more common. But since bleeding can also be a sign of something more serious, do not let it go: come in for an evaluation so a doctor can determine the cause.

Related treatments