Colorectal Cancer Program

As Georgia’s largest and most comprehensive cancer care provider, Northside Hospital Cancer Institute (NHCI) diagnoses and treats more new cases of colorectal cancer than any other provider in Georgia and is among the top programs in the country. We provide colon cancer and rectal cancer patients with access to interdisciplinary colon, rectal and gastrointestinal (GI) cancer care services with the most powerful combination of physician experts, facilities and resources of any cancer program in Georgia.

What Is Colorectal Cancer?

Colorectal cancer originates in the colon (large intestine), rectum (end of colon) or anus. If the cancer is in the last 6 inches of the colon (the rectum), it is considered rectal cancer. Most colorectal cancers begin as benign adenomas, or polyps, on the inner lining of the colon or rectum. These growths spread very slowly, sometimes taking from 10 to 20 years to become cancerous. Regular screening tests can identify and remove polyps before they become cancerous. Once colorectal cancer is diagnosed, the prognosis depends on how much the cancer has spread.

Colorectal cancer is the second leading cause of cancer-related deaths in the United States. Most cases of colorectal cancer occur in people over 50. Although colorectal cancer is responsible for thousands of deaths every year, it is highly treatable if caught early.

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Symptoms of Colorectal Cancer

Most people with colorectal cancer do not have any symptoms in the early stages of the disease. In general, signs and symptoms of colorectal cancer can include the following:

  • Changes in bowel habits
  • Blood in the stool
  • Problems related to blood loss (anemia, weakness, fatigue, shortness of breath, pounding or racing heart, chest pain and intolerance to exercise)
  • Abdominal discomfort (frequent gas, bloating, fullness, cramps and pain)
  • Unexplained weight loss
  • Decreased appetite
  • Pain with bowel movement
  • Feeling that your bowel does not empty completely

Learn more about symptoms related to colorectal cancer.


Colorectal Cancer Risk Factors & Prevention

Risk Factors

As the third most diagnosed cancer among men and women, colorectal cancer risk is higher in older adults as it is rarely diagnosed in people under age 50. More than half of all colorectal cancers occur without any known cause.

Some people with colorectal cancer carry specific genetic mutations or have relatives with the condition. Those with a family history of specific genetic syndromes, such as familial adenomatous polyposis, Lynch syndrome, juvenile polyposis and Peutz-Jeghers syndrome, are also at an increased risk of developing colorectal cancer.

Additional risk factors for developing colorectal cancer include:

  • Personal history of inflammatory bowel disease (such as Crohn’s disease and ulcerative colitis)
  • Personal or family history of colorectal cancer and/or polyps
  • Personal history of inflammatory bowel disease (such as Crohn’s disease and ulcerative colitis)
  • Race/ethnicity - African-American or of Eastern European (Ashkenazi Jewish) descent
  • Being overweight or obese
  • Eating a high-fat diet
  • Diet high in red or processed meats
  • Heavy alcohol use
  • Long-term smoking
  • Having type 2 diabetes

Learn more about the risk factors associated with colorectal cancer.

Prevention

The risk of developing colorectal cancer has been strongly linked to a variety of lifestyle-related factors, such as diet, weight and exercise. Knowing how closely related these lifestyle choices are with colorectal cancer, it may be possible to prevent it by making changes to diet and physical activity levels.

Eating plenty of fruits and vegetables, as well as foods rich in omega-3 fatty acids (such as salmon and halibut), folate (such as whole grains and leafy green vegetables), and calcium (such as sea vegetables and kale), can help reduce the risk of colorectal cancer. Reducing the intake of high fat and fried foods, particularly red meats, may also protect against developing colorectal cancer.

Obese people (those with a BMI over 29) have a 20 percent increased risk of developing colorectal cancer compared to those of healthy weight. Maintaining a proper weight and exercising regularly also cuts a person’s risk of developing colorectal cancer. Even small amounts of exercise on a regular basis are protective. The American Cancer Society recommends at least 30 minutes of physical activity on most days.

Smoking and drinking alcohol significantly contribute to a person’s risk of developing colorectal cancer. There is a 72 percent increased risk for people who consume more than seven alcoholic beverages a week and a 164 percent increased risk for long-term smokers.

As part of our comprehensive approach to cancer prevention and education, Northside offers Built To Quit, a smoking and tobacco cessation program offering resources to help individuals quit smoking and stop using other tobacco products. This program includes a six-week class that educates participants about the hazards of smoking and using tobacco products; the benefits of quitting; and the strategies and skills to cope with urges. The class is conducted primarily in a group setting, with face-to-face interaction that allows participants to learn from each other’s experiences. We also offer convenient web-based sessions.

For additional information call 404-780-7653 or email smokingcessation@northside.com. Register for a cessation class online.

2019 Built To Quit
Class Schedule (English)
2019 Built to Quit
Class Schedule (Spanish)

Approximately 5-10 percent of all colorectal cancer cases are inherited. A personal or family history of colorectal cancer and endometrial cancer is an indicator of the most common form of hereditary colon cancer, hereditary nonpolyposis colorectal cancer (HNPCC), and is responsible for 3-5 percent of all colorectal cancers. HNPCC is associated with an 80 percent lifetime risk of developing colorectal cancer, as well as an increased risk of developing other cancers such as endometrial, ovarian and gastric.

Our Cancer Genetics Program is available to patients interested in genetic counseling and testing due to strong personal or family histories of cancer. Our team of certified genetic counselors will help patients assess, understand and reduce the risk of developing certain types of genetically influenced cancer such as colorectal cancer. For additional information, please call 404-851-6284 or email genetics@northside.com.

People with a personal or family history of endometrial cancer, colorectal cancer or polyps, should talk to their doctor about an evaluation and risk assessment with one of our certified genetic counselors.


Colorectal Cancer Screening & Diagnosis

Screening

Colorectal cancer is highly preventable, even curable, when caught early. Regular screening for colorectal cancer detects polyps before they become cancerous. When detected early and the disease is localized, the survival rate for colorectal cancer is approximately 90 percent.

Northside Hospital Cancer Institute supports the U.S. Preventive Services Task Force (USPSTF) and the American College of Gastroenterology (ACG) recommendations that colorectal cancer screening for average-risk persons begin at age 45 for African-Americans and age 50 for other groups. Average risk for screenings is defined as those with no symptoms of colorectal cancer, no personal or family history of colon polyps or colorectal cancer, and no personal history of inflammatory bowel disease, such as ulcerative colitis or Crohn’s disease. NHCI recommends colonoscopy screenings every 10 years if the results of a person’s colonoscopy were normal and no polyps were found.

People with a personal or family history of colon polyps or colorectal cancer, or a personal history of ulcerative colitis or Crohn’s disease should talk to their doctor about early screening.

In May 2018, the American Cancer Society (ACS) released an updated guideline for colorectal cancer screening. People should speak with their doctor about what screening age and screening test option is best for them.

For a comparison of colonoscopy screening to other colorectal screening tests, click here.

Download our comparison chart
of colorectal screening tests.

Diagnosis

Colorectal cancer is the second highest cause of cancer-related deaths and the third most diagnosed cancer among men and women.

Northside Hospital Cancer Institute offers specialized care for the following colorectal and gastrointestinal cancers:

To diagnose colon or rectal cancer a gastroenterologist will take a complete medical history, perform a physical exam, and may order one or more tests to diagnose including sigmoidoscopy, colonoscopy and barium enema. During a sigmoidoscopy or a colonoscopy, the physician removes a sample of tissue (called a biopsy) from the colon or rectum and examines it under a microscope to detect abnormal growths. If cancer is evident, various test may be required such as chest X-ray, abdominal CT scan, and blood tests to check liver function) to see if the cancer has spread and to help determine the stage (or extent) of the disease.

Learm more about colorectal cancer and staging.


Team of Colorectal Cancer Specialists

Northside Hospital Cancer Institute’s Colorectal Cancer Program provides patients with access to interdisciplinary colorectal and gastrointestinal (GI) cancer care services with the most powerful combination of physicians, facilities and resources of any cancer program in Georgia.

At Northside Hospital Cancer Institute, we believe that cooperative teamwork is vital to success and survivorship. Because taking care of cancer patients is complex and challenging, our colorectal cancer patients are treated by a team of specially trained experts from a variety of disciplines. Our multidisciplinary GI cancer care team ensures patients receive integrated, evidence-based care, utilizing the most innovative, cutting-edge and scientifically supported colorectal cancer treatment options.

Our GI cancer multidisciplinary care team consists of the following physicians and clinical support team members:

  • Fellowship-trained colorectal surgeons
  • Hepatobiliary surgeons
  • Medical oncologists
  • Radiation oncologists
  • Interventional radiologists
  • Diagnostic radiologists
  • Pathologists
  • Gastroenterologists
  • Certified genetic counselors
  • Oncology nurse navigators
  • Clinical research nurses

Rollover the graphic for more information

Multidisciplinary 1 2 3 4 5 6 7 8 9 10 11

Northside Hospital’s colorectal cancer specialists participate in multidisciplinary care conferences where they discuss Colorectal Cancer Treatment Options, including clinical trial eligibility, for each colorectal cancer patient and agree upon an evidence-based treatment plan. By prospectively discussing colorectal cancer cases during conference, patients get the benefit of not just one clinical perspective, but more than a dozen expert opinions.


Colorectal Cancer Treatment Options

The primary treatment for colorectal cancer is surgery to remove the part of the colon containing the tumor. Depending on the stage of colorectal cancer, chemotherapy follows surgery. If the tumor is particularly large, the patient may need radiation before or after surgery.

Some medications or supplements may help prevent the development of polyps or colorectal cancer. Making lifestyle changes, especially eating less red meat, losing weight, quitting smoking, and getting more exercise, may help prevent the disease, even in people with a family history of the condition.

For more information about colorectal cancer treatment, please expand the content below.

Surgery is the most common form of treatment for colorectal cancer. It may be used to diagnose, treat and even prevent colorectal cancer. When surgery is used for colorectal cancer treatment, the cancer and some of the adjacent tissue are usually removed. Surgery also can be helpful in collecting information to predict whether the cancer will come back.

In addition to surgical resection, surgical options for colorectal cancer include:

When colorectal cancer has spread to other organs such as the liver, these metastases, or tumors that have spread, can sometimes be destroyed by techniques, such as ablation or embolization, which may help a person live longer.

Ablation refers to treatments that destroy tumors without removing them. Radiofrequency ablation (RFA) and cryosurgery (cryotherapy) are two ablation procedures used to treat colorectal cancer.

Embolization is most often used to treat colorectal cancer that has spread to the liver. During an embolization procedure, substances are injected to try to block or reduce the blood flow to cancer cells in the liver. Three main types of embolization procedures used to treat cancer in the liver include arterial embolization, chemoembolization and radioembolization.

Chemotherapy or “chemo” uses medication to destroy cancer cells by stopping growth. Chemotherapy may be used at different times during treatment for colorectal cancer:

  • Adjuvant chemotherapy refers to chemotherapy given after colorectal cancer surgery.
  • Neoadjuvant chemotherapy refers to chemotherapy given before surgery to try to shrink the colorectal cancer and make surgery easier. Neoadjuvant chemotherapy is often used to treat rectal cancer. In some cases, radiation therapy and neoadjuvant chemotherapy are given at the same time.
  • Chemotherapy for advanced/metastatic cancers is an option for cancers that have spread to other organs, such as the liver, to help shrink tumors and relieve symptoms. Although it is not likely to cure the cancer, it often helps people live longer.

At Northside's infusion centers, chemotherapy is provided to colon and rectal cancer patients on an outpatient basis by registered nurses who are certified in chemotherapy administration.

Click here for questions to ask your doctor about treating colorectal cancer with chemotherapy.

Radiation therapy, or radiation oncology, is a treatment option that uses high energy X-rays to kill cancer cells. Radiation therapy may be used before surgery to shrink a tumor or after surgery to kill remaining cancerous cells.

It is not common to use radiation therapy to treat colon cancer, but it may be recommended for certain rectal cancer patients depending on their specific cancer diagnosis.

Northside Hospital Cancer Institute offers several radiation therapy treatments for colorectal cancer:

  • External beam radiation therapy (EBRT)
  • Internal radiation therapy (brachytherapy)
  • Endocavitary radiation therapy
  • Interstitial brachytherapy

Learn more about our Radiation Oncology services.

Targeted therapies are designed to only treat the cancer cells and minimize damage to normal, healthy cells. In order to become cancer cells, healthy cells must go through a process called carcinogenesis. Targeted therapy disrupts this process and the cellular changes necessary for development and growth.

Immunotherapy uses the body’s immune system to treat colorectal cancer. Unlike chemotherapy, radiation or targeted therapy that fights cancer cells directly, immunotherapy helps the immune system to fight cancer cells.

Learn more about our Immunotherapy Program

Clinical trials are studies that involve people and are a critical part of oncology research. These studies test new ways to prevent, detect, diagnose or treat cancer. People who take part in cancer clinical trials have an opportunity to contribute to scientists’ knowledge about cancer and to help in the development of improved colorectal cancer treatments. They also receive state-of-the-art care from cancer experts.

Learn more about Cancer Clinical Trials and Research at Northside Hospital

Learn more about NHCI Cancer Treatment Options


Colorectal Cancer Support & Survivorship

Colorectal cancer treatment and recovery can be overwhelming, which is why we have oncology nurse navigators to guide patients through every step of their cancer journey. Northside Hospital Cancer Institute’s GI nurse navigator is a registered nurse with extensive knowledge and training in oncology, available to help guide patients after colorectal cancer diagnoses and through treatment, educating and supporting cancer patients to make informed decisions. The cancer patient navigation team works with radiologists, surgeons, oncologists and other colorectal cancer specialists to coordinate treatment.

Support provided by oncology nurse navigators includes:

  • Clinical information and education on rectal and colon cancers.
  • Answering questions about diagnosis, treatments and any side effects experienced.
  • Starting and facilitating communication between the patient and their care team.
  • Access to emotional and psychological support, including referrals to counseling services and available support groups.
  • Health monitoring and overall cancer treatment progress.

To learn more about oncology patient navigation or to speak with an oncology nurse navigator, please call 404-300-2800 or email nurse.navigator@northside.com.

Ongoing support is crucial when facing cancer and afterward. Northside Hospital Cancer Institute provides a full range of Support and Survivorship programs and services to address the unique needs of colorectal cancer patients.

For patients that need help with getting to and from their colorectal cancer treatment and doctor appointments, Northside Hospital Cancer Institute has funding available through our Colorectal Cancer Transportation Assistance Program.

Learn more about our cancer Support & Survivorship services