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Treatment: Colorectal Cancer

Colorectal Cancer Prevention, Screening and Treatment

We treat your cancer and your life.

Fighting colorectal cancer is about much more than fighting a disease. To an extent, it’s about the American lifestyle. Our diets are often high in animal products. Many of our jobs involve sitting with no exercise. And busy schedules make a regular exercise program difficult – and can lead many of us to make unhealthy food choices (like fast food). These factors and more can contribute to everyone’s risk of colon and rectal cancer. The good news is, over the last 20 years, deaths from colorectal cancer have declined, perhaps thanks to early detection and improved treatment. And here’s more good news: The Van Elslander Cancer Center is dedicated not only to treating colorectal cancer, but also to helping increase our community’s awareness of ways to minimize the risk for the disease. One of the ways we accomplish this is through providing concerned patients immediate access to a nutritionist. We also offer genetic counseling and a full range of screening services, all created to help keep you cancer-free or, if you have cancer, to begin fighting it at the earliest possible moment.

Highlights at the Van Elslander Cancer Center

The Van Elslander Cancer Center offers screening, prevention and treatment in a single, convenient location, with a staff committed to providing the fastest and most comprehensive services available. Here’s how:

  • A nutritionist is available to consult with you on dietary and lifestyle choices to help prevent colon and rectal cancer.
  • Genetic counseling enables you to assess your risk if you are concerned about a family history of colon or rectal cancer.
  • A full range of screening options provides the potential for early detection, maximizing your potential for recovery.
  • Patients have access to all national clinical trials.
  • Our multidisciplinary team of physicians work together closely to provide the optimal treatment regimen for every patient with colorectal cancer, providing important advantages for those who:
    • Have recently been diagnosed with colorectal cancer.
    • Have experienced a relapse of their disease.
    • Have certain types of polyps linked to colorectal cancer such as adenomatous polyps.
    • Have a personal history of inflammatory bowel disease, also called ulcerative colitis or Crohn's colitis.
    • Have risk factors for colorectal cancer.
    • Have had abnormal screenings or symptoms of colorectal cancer.
    • Have been referred by their family physician or another surgeon for a second opinion about their colorectal health and/or colorectal cancer.

How To Reach Us

To schedule a consultation, call (313) 647-3000 or toll free, 1-866-246-HOPE

Second Opinion

Patients who have been diagnosed with colorectal cancer may come to the Van Elslander Cancer Center for a second opinion consultation. Second opinions are strongly recommended for all cancer diagnoses, so that you and your oncologist can choose the best treatment. Patients should ask their physicians to submit pathology materials for our review; each case receives a written evaluation.

If you are a Van Elslander Cancer Center patient and would like to obtain a second opinion, we can assist you as part of the University of Michigan Cancer Center Network. Because we are affiliated with their network, Van Elslander Cancer Center patients receive priority treatment.

Who’s On Your Team?

Our multidisciplinary approach to cancer care ensures that in a single visit, each patient receives a complete team of nationally recognized experts, including:

  • Colorectal Surgeon
  • Radiation Oncologist
  • Medical Oncologist
  • Oncology Nurse

Physician Listing

Specialized Services

  • Genetic Counseling: Heredity is currently thought to play a role in each individual’s risk for colorectal cancer. The Van Elslander Cancer Center staff provides genetic counseling services to help determine your personal risk for colorectal cancer.
  • Nutritional and Lifestyle Counseling: Our staff nutritionist can work with you to create diet and exercise guidelines to minimize your risk for colorectal cancer.
  • Sigmoidoscopy: Using a lighted tube inserted into the rectum, your doctor can look at the inside of the rectum and part of the colon for cancer or polyps.
  • Colonoscopy: Similar to the sigmoidoscope, the colonoscope is a longer tube enabling your doctor to see the entire colon. If an abnormality is discovered, the doctor may perform a biopsy, removing a piece of tissue through the colonoscope.
  • Virtual Colonoscopy: This recently developed technique uses a CT scanner and computer virtual reality software to examine the colon without inserting the traditional, long colonoscopy tube.
  • Digital Rectal Exam (DRE): Using a finger, the doctor will examine the rectum to check for masses, tenderness or bleeding.
  • Fecal Occult Blood Test: This test comes in the form of a kit instructing you to take a stool sample at home. You simply provide a stool sample and return the kit to the Van Elslander Cancer Center, where we send it to diagnostics for testing to detect any traces of blood.
  • X-Ray/Double-Contrast Barium Enema: Films can be taken to detect tumors or abnormalities. An enema is given beforehand an air is inserted to expand the colon for clearer pictures.

Staging

To determine how far the cancer has spread, your cancer care team uses a process of analysis known as staging. The stage of your cancer impacts your treatment and the prognosis for recovery. A number of different staging systems can be used to classify tumors. The TNM staging system assesses tumors in three ways: size of the primary tumor (T), whether it has spread to lymph nodes (N), and whether it has spread (metastasized) to other organs (M). Once the T, N, and M are determined, a number of I, II, III, or IV is assigned, with stage I being early stage and IV being advanced. In general, the lower the number, the less the cancer has spread. A higher number, such as stage IV, denotes a more serious case. Your doctor will review your test results and tell you the stage of your cancer.

Treatment Options

The three main treatments used to treat colorectal cancer are:

  • Radiation Oncology: High-energy rays are used to kill or shrink cancer cells. For colon and rectal cancers, external radiation is most often used (as opposed to radiation implants). You will generally receive treatments five days a week for several weeks. Each treatment lasts just a few minutes and is painless. Side effects usually disappear after treatment ends and can include skin irritation, nausea, diarrhea and fatigue.
  • Chemotherapy: Anticancer drugs are injected or given by mouth. They enter the bloodstream and spread throughout your body, which helps to fight cancers that have spread. Side effects can include diarrhea, nausea, loss of hair, rashes on hands and feet, mouth sores and fatigue. Most of these side effects disappear once treatment ends.
  • Surgery: Surgery is the main treatment for colon and rectal cancer and is offered at St. John Hospital and Medical Center. Surgery is followed by chemotherapy and radiation. Chemotherapy after surgery can increase the survival rate for some stages of colorectal cancer, and it can help relieve symptoms of advanced cancer. After surgery, radiation can kill small areas of cancer that could not be seen during surgery, and it can ease symptoms of advanced cancer such as intestinal blockage, bleeding, or pain. Radiation and chemotherapy may be used before the surgery to shrink a large or hard-to-reach tumor.

Protocol

We designed the Van Elslander Cancer Center’s team and processes to help you assess your best treatment options and begin fighting your cancer quickly – usually within two weeks of your diagnosis:

  • If a screening shows an abnormality, we will contact you to return within a week to consult with a colorectal surgeon.
  • Often that same day a biopsy will be conducted, and our pathologists will determine whether the abnormality is cancer. You will generally get these results within two working days.
  • If the results determine you have cancer, you will receive a referral to our radiation oncologist.
  • The multidisciplinary team (see Who’s on Your Team, above) meets every week to review patients’ cases. This means that your case will be presented to this team at their next meeting (usually within 10 working days of the original diagnostic procedure), providing input of all the team members at once and access to information on any clinical trials for which you may be eligible.
  • Once you have met with your multidisciplinary team, you and your doctor will develop the best plan for your treatment.
  • Within two weeks of your diagnosis, your action plan for care can be developed and treatment can begin.

Follow-Up Therapy

Once you have received treatment, one member of your team will take the lead in your follow-up care. This is usually your medical oncologist, the last member of the team to treat you. He or she will follow up with you to check your healing progress and address any concerns, and keep all other members of your team informed of your progress.

If follow-up visits determine your treatment was successful (usually after six months), your medical oncologist will arrange for annual checkups through your primary care physician.

Your follow-up care can also include other services offered through the Van Elslander Center, such as occupational therapy. At the Van Elslander Cancer Center, we treat your whole person, not just your cancer, for complete healing of body, mind and spirit. Patients who have undergone abdominal surgery or who require a colostomy may need to relearn tasks they once took for granted; our therapists will be there to help you maximize your quality of life.

We also offer many routes to spiritual strengthening at our special Healing Arts Center.

Reducing Your Risk

Here are a few of the ways the Van Elslander Cancer Center can help you prevent colon and rectal cancer:

  • Screening (see Specialized Services, above): Beginning at age 50, you should follow one of these testing schedules:
    1. Yearly fecal occult blood test plus flexible sigmoidoscopy and digital rectal exam (DRE) every 5 years.
    2. Double-contrast barium enema every 5 years.
    3. Colonoscopy and digital rectal exam (DRE) every 10 years.

If you have risk factors such as a personal or family history of colorectal cancer or adenomatous polyps, or a personal history of inflammatory bowel disease, you should begin colorectal cancer screening earlier and/or undergo screening more often. The Van Elslander Cancer Center provides a full range of screening services.

Lifestyle choices

  • Diet: Lots of water, lots of fiber, and lots of fruits, vegetables and whole grains to flush the system are excellent ways to help prevent colorectal cancer. Avoid high-fat, low-fiber foods. A diet of foods that are high in fat, especially from animal sources, can increase the risk of colorectal cancer, while many fruits and vegetables can work to prevent cancer from forming. The American Cancer Society recommends eating at least five servings of fruits and vegetables every day and six servings of other food from plant sources such as breads, cereals, grain products, rice, pasta, or beans.
  • Supplements: Studies seem to indicate that taking a daily multivitamin containing folic acid or folate can lower your risk of colorectal cancer. Other studies suggest that getting more calcium with supplements or low-fat dairy products can help.
  • Exercise: Regular exercise, even small amounts, lowers your risk of colorectal cancer.
  • Smoking: Smokers are 30% to 40% more likely than nonsmokers to die of colorectal cancer.

A Van Elslander Cancer Center nutritionist can consult with you about cancer- preventing lifestyle changes, such as reducing fat intake, exercising and not smoking. For further nutritional information, click here.

  • Risk assessment: The Van Elslander Cancer Center staff can work with you to determine your personal risk for colorectal cancer. Risk factors include …
    • Family history: If you have close relatives who have had colorectal cancer or colorectal cancer syndromes such as familial adenomatous polyposis, you are at increased risk for colorectal cancer.
    • Personal history: Even if your colorectal cancer has been completely removed, new cancers may appear. In addition, some types of polyps, such as adenomatous polyps, increase your risk, as does a history of inflammatory bowel disease (also called ulcerative colitis or Crohn's colitis).
    • Your age: Most people diagnosed with colon or rectal cancer are at least 50 years old.
  • Early detection: Tell your doctor if you have any of the following symptoms; they can indicate colorectal cancer.
    • Bleeding from the rectum or blood in the stool.
    • Unusual bowel habits that last more than a few days, such as diarrhea, constipation, or narrowing of the stool.
    • Cramping or constant stomach pain.
    • Feeling that you need to have a bowel movement even after you have had one.

While these symptoms do not necessarily mean you have cancer, the Van Elslander Cancer Center will be ready with prompt screening services to put your mind at ease or to help you begin fighting the disease as early as possible.

Clinical Trials

The Van Elslander Center is one of only 13 facilities nationwide whose patients have access to all national clinical trials. In addition, qualified Van Elslander Cancer Center patients can participate in private trials sponsored by The University of Michigan Cancer Care Center Network.

Clinical trials are conducted to study promising new treatments that have shown potential value to patients. While there can be risks, these studies offer the most leading-edge treatment options and are often found to have great benefits to patients. Taking part in a clinical trial is up to you, and once you have joined the study, you are free to leave it at any time, for any reason.

A few examples of the many clinical trials for currently available to qualified colorectal cancer patients at the Van Elslander Cancer Center are:

  • Study of high-dose Folic Acid for the prevention of colorectal cancer in patients with resected adenomatous polyps.
  • A comparison of accuracy and patient experience in three diagnostic and screening methods: air contrast barium enema, virtual colonoscopy and colonoscopy.
  • Evaluation of the drug DHA-Paclitaxel in patients with colorectal cancer that has spread, or metastasized, in order to assess effects like the response of tumors, effect on progression of disease and patients’ quality of life.
  • Ask your physician about participating in clinical trials, which offer access to promising new treatments. For a list of current clinical trials, visit our Clinical Trials page, click here or call the National Cancer Institute at 1-800-4-CANCER.

Other services

At the Van Elslander Cancer Center, we believe the strength of your mind and spirit is essential to your body’s healing process. Our Healing Arts Center is available for you to use, providing services such as massage, reflexology, mediation, music and art therapies and holistic assessment.

More Information

You can find more information on colorectal cancer from these sources:

  • Colorectal Cancer Information Page
  • The National Cancer Institute (NCI)

 

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