Colon cancer develops in the colon and/or small bowel. In most cases, colon cancer begins as a benign, or non-cancerous, polyp on the bowel wall that eventually increases in size and becomes cancerous. Unfortunately, many polyps and early cancers fail to produce symptoms.⁷

Because colon cancer is curable in its early stages, the key to survival is early detection. If everyone aged 50 and older had regular colorectal cancer screening tests, more than one third of deaths from colon cancer could be avoided. When diagnosed and treated in the early stages, between 80% and 90% of colon cancer patients return to their normal health.⁷

Screening for colorectal cancer should begin soon after turning 50 and continue at regular intervals. However, testing may need to happen earlier, or more often, in some people than in others if:

• The patient or a close relative has had colorectal polyps or cancer
• The patient has inflammatory bowel disease¹

Patients should talk to their doctors about when to begin screening and how often to be tested.¹

• Both men and women are at risk.¹
• Ninety-three percent of cases occur in people aged 50 and older.¹
• The risk of developing colon cancer increases with age.⁸
• There will be approximately 145,000 new cases of colon cancer diagnosed in the United States in 2005, meaning someone will be diagnosed every four minutes.⁸
• One out of 18 people in the United States will develop colon cancer in their lifetime.¹

Colon cancer does not always cause symptoms, especially at first. But sometimes there are symptoms, such as:

• Blood in or on the stool
• Unexplained and frequent pain, aches, or cramps in the stomach
• A change in bowel habits, such as having stools that are narrower than usual
• Unexplained weight loss

If you have any of these symptoms, talk to your doctor. These symptoms also may be caused by something other than cancer, but the only way to know what is causing them is to see your doctor.¹

Risk factors for colon cancer include⁸:

• A family history of colorectal cancer
• A personal history of colorectal cancer, polyps, or bowel disease
• Age 50 or older
• A high-fat diet
• Lack of exercise
• Obesity
• Smoking
• Heavy alcohol use
• Inflammatory bowel disease

After colon cancer has been diagnosed, tests are done to find out if cancer cells have spread within the colon or to other parts of the body. The process used to find out if cancer has spread within the colon or to other parts of the body is called “staging.” The information gathered from this process determines the stage of the disease. It is important to know the stage in order to plan treatment. The following stages are used for colon cancer:

The physician will develop a treatment plan to fit your needs based on the location of the tumor and the stage of the disease. Treatment for colon cancer may involve radiation therapy or chemotherapy, but the primary treatment in nearly all cases is surgery.¹⁰

During surgery, the cancer is removed through an incision in the abdomen, along with a small length of normal colon on either side of the cancer. The nearby lymph nodes also are removed. The surgeon also checks to see if the cancer has spread. The two ends of the colon are then sewn back together.¹¹

Sometimes the surgeon cannot reconnect the colon. In this case, a new opening, or stoma, to the outside of the abdomen is created. The intestine is then connected to the stoma, where a bag is attached to collect body waste. This is called a colostomy. In most cases, a colostomy is only temporary. For most people, it is needed only until the colon or rectum heals from surgery. After healing takes place, the surgeon reconnects the colon and closes the stoma.¹¹

During traditional open surgery, the surgeon makes an incision up to 12 inches long from the upper to the lower abdomen to view the colon and remove the diseased portions. Because of the nature of this highly invasive procedure, patients often face a long and difficult healing process that results in a hospital stay of at least a week, with recovery time ranging from six to eight weeks.¹²

Advancing technology and research have transformed surgery for the treatment of colon cancer in recent years. In the past, most patients underwent open surgery for colon cancer. However, patients now have a second surgery option, laparoscopic surgery, also known as a minimally invasive procedure.¹³ 

During a minimally invasive procedure for colon cancer, the surgeon makes a series of small incisions, from a quarter of an inch to four inches, in the patient’s abdomen. A small video camera, or scope, is placed in one of the incisions, providing the surgeon with a magnified view of the patient’s internal organs on a monitor. Surgical instruments are placed in the other incisions, allowing the surgeon to work inside and remove the diseased portions of the colon.¹⁴ 

Minimally invasive procedures for colon cancer have been shown to be as effective as open surgery while offering many benefits over the open procedure, according to a study published in the New England Journal of Medicine in May 2004. These benefits include:

• Quicker recovery time
• Shorter hospital stay
• Less pain
• Less scarring¹⁴

Patients considering a minimally invasive procedure should consult with a surgeon who is experienced in minimally invasive techniques and has performed at least 20 laparoscopic colon resections for benign disease or metastatic cancer.¹⁴ 

Factors that could preclude a patient from undergoing a minimally invasive procedure include obesity, prior abdominal surgery, dense scar tissue, bleeding problems during the procedure, and/or the surgeon's inability to visualize the organs.¹⁵

*Data gathered at 3 years post-surgery⁶