We Treat
Colorectal Cancer
Colon cancer and rectal cancer are often referred to as colorectal cancer, which is a type of gastrointestinal (GI) cancer. At SCRI Oncology Partners in Nashville, our medical oncologists who specialize in colorectal cancer use the most advanced therapies, biomarker testing, and clinical trials to personalize treatment plans for each patient.
Meet Your Colorectal Cancer Doctors
What are the signs and symptoms of colorectal cancer?
Many people with colorectal cancer don’t notice symptoms at first, especially in the early stages. That’s why screening is important for everyone starting at age 45. Screening can start earlier if you have certain risk factors, like a family history of polyps or colorectal cancer, or you have a gastrointestinal condition such as ulcerative colitis, which increases the risk of developing colon cancer.
If symptoms appear, they could be changes in bowel habits, such as consistent diarrhea, constipation, or narrower stools lasting more than a few days, rectal bleeding or blood in the stool, dark-colored stool, feeling like your bowel doesn’t empty completely, or unexplained weight loss. These can also be symptoms of other conditions, so be sure to talk with your primary care doctor to get clear answers.
Diagnosis
Staging
Treatment
Clinical Trials
How is colorectal cancer diagnosed?
Early-stage colorectal cancers are usually found during a colonoscopy. Polyps removed during the procedure are tested. If they come back positive for cancer cells, a diagnostic colonoscopy will be performed, allowing the doctor to view the entire colon and rectum to look for any other areas of concern.
Later-stage colorectal cancers are more likely to be imaged with a CT scan or MRI to see where the tumor is located and how large it is. The extent of cancer may not be fully understood until the GI cancer surgeon determines how deeply the cancer has grown into, or through, the colon wall or spread to the lymph nodes.
Biomarker testing, also called genomic testing, is performed to identify specific genetic changes, unique to the patient and not inherited, that may be causing cancer growth. The results will shape the treatment plan and the recommended therapies.
A PET-CT scan can also be used to determine if cancer has spread beyond the colon or rectum.
If you were recently diagnosed with colon or rectal cancer, schedule a consultation with our oncologists in Nashville for a personalized, precision medicine treatment plan. We are also available to provide a second opinion on a diagnosis and treatment plan if you have already met with a cancer doctor.
Staging colorectal cancer
Staging describes how far cancer has spread. It looks at tumor size and whether it has reached lymph nodes or other parts of the body.
The most common staging system for colorectal cancer is the TNM system from the American Joint Committee on Cancer (AJCC). It assesses tumor size, lymph node involvement, and whether the cancer has metastasized (spread) to other parts of the body.
These details are grouped into categories, or stages, from 0 to IV, with higher numbers meaning more advanced disease. There are subcategories for each stage that the oncologist will review with you to determine the precise stage.
- Stage 0: Cancer is only in the innermost lining of the colon or rectum. It has not grown deeper or spread.
- Stage I: The tumor has grown into the inner layers of the colon or rectum wall but has not spread to nearby lymph nodes or distant organs.
- Stage II: The cancer has grown through the wall of the colon or rectum and may reach nearby tissues, but it has not spread to lymph nodes or distant parts of the body.
- Stage III: The cancer has spread to nearby lymph nodes but has not spread to distant organs.
- Stage IV: The cancer has spread to distant parts of the body, such as the liver, lungs, or the lining of the abdomen.
Recurrent colorectal cancer
When colon or rectal cancer has returned after treatment is complete, and a period of time has passed during which it could not be detected, it is called recurrent cancer. The likelihood of recurrence depends on when the cancer was originally diagnosed. Earlier stages are less likely to recur than later stages. When colorectal cancer recurs, it can come back in the colon or rectum, or in another part of the body.
How is colorectal cancer treated?
Treatment for colorectal cancer is personalized based on the tumor’s location, stage, and your overall health. The SCRI Oncology Partners GI cancer doctors will review all of the available information to create a treatment plan that uses the most advanced treatments available. You may also qualify for a clinical research trial with an emerging therapy suitable for your specific type of cancer. Our team will discuss this with you if one is available.
GI cancer surgery
Surgery is often included in the treatment plan for colorectal cancer. The procedure type depends on the tumor’s size and location. Small, early cancers can often be removed during a colonoscopy with a polypectomy or local excision. Larger tumors in the colon may require a colectomy, which removes part or all of the colon along with nearby lymph nodes. Rectal cancers may need more complex procedures, ranging from surgeries that preserve normal bowel function to more extensive operations that remove the rectum and anus and may require a colostomy.
Some people may need a colostomy or ileostomy to remove waste from the body after surgery. This can be permanent, or it can be temporary while the colon or rectum heals. Your care team will help you understand if this is necessary and how to manage it.
Chemotherapy for colorectal cancer
Chemotherpy uses medications that travel through the bloodstream to destroy cancer cells. This treatment may be given before surgery to shrink a tumor or after surgery to eliminate any remaining colorectal cancer cells. Colorectal cancer usually uses a combination of chemotherapy drugs found to be most effective for colorectal cancera.
Immunotherapy
Immunotherapy drugs help the immune system recognize and attack cancer cells. Tests are run to determine microsatellite instability. If the results are microsatellite instability high (MSI-H), there is a change in how the tumor repairs its DNA. Cancers with high MSI often respond well to immunotherapy drugs called immune checkpoint inhibitors, which turn on the immune system so it can see the colorectal cancer cells and attack them.
Colorectal cancer targeted therapies
After biomarker testing is complete, the oncologist will know whether any genetic mutations are present that can be treated with targeted therapy. These drugs are designed to specifically block a genetic mutation or protein overgrowth to slow down cancer cell growth. Various mutations, such as KRAS, BRAF, HER2, and NTRK fusions, can be targeted with drugs.
Radiation therapy
Radiation therapy uses high-energy rays or particles to target and kill cancer cells. While it is not commonly used for colorectal cancer, radiation therapy may be given before or after surgery or to help manage symptoms.
Colorectal cancer clinical trials in Nashville
Even if you’ve started treatment at another cancer center, and you’d like to learn more about colorectal cancer trials available at SCRI Oncology Partners, you can schedule a second opinion appointment.
We’re here when you need us
If you were recently diagnosed or would like a second opinion, request an appointment with one of our experienced cancer doctors right here in Nashville.
We’re here when you need us
If you were recently diagnosed or would like a second opinion, request an appointment with one of our experienced cancer doctors right here in Nashville.
We’re here when you need us
If you were recently diagnosed or would like a second opinion, request an appointment with one of our experienced cancer doctors right here in Nashville.