Colon cancer

Starting in the large intestine or colon, colon cancer is one of the most common forms of cancer. It mainly affects people over the age of 50, and is detected best via colonoscopy.

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Educational Materials: Colon Cancer

Español: Pruebas De Laboratorio Relacionadas Con Cancer De Colon

Invasive colon cancer is present in the center of this cross section of colon showing dark blue to purple clusters of malignant glands invading down from the top of the image through multiple normal levels of the colon wall. On either side of the cancer are normal structures including four layers. Note that the cancer cells penetrate the fourth layer, a feature which is used in staging the cancer.

Rebecca's Story

It was a busy week for Rebecca, a Santa Fe-based sculptor. On a Monday in July 2009, she had a colonoscopy for mysterious stomach pains. The doctor responded almost immediately that she had colon cancer. On Tuesday she called the cancer center at the University of New Mexico. On Wednesday, she installed a sculpture she had donated to that same center in memory of her late husband, who had passed away from leukemia. By Friday, she was a patient there herself.

Rebecca was stunned by her diagnosis, and frightened about the unknown outcome. But she also had confidence in her care team at the University of New Mexico, and at the same time, her sister, a GI pathologist, sent Rebecca’s lab specimens off to one of the top colon cancer doctors in the country. That doctor confirmed with Rebecca’s University of New Mexico team that the treatment plan they’d designed was the right course of action to treat Rebecca’s cancer.

“It was unbelievably comforting to have my sister be in touch with other doctors, and following my treatment every step of the way,” Rebecca says.

She underwent radiation treatments at UNM, and took a chemotherapy drug every day to augment the treatment. She also had once a week chemotherapy treatments in Albuquerque, which required a blood draw at each visit. The laboratory, she explained, would check her levels to make sure she was able enough to have the chemotherapy treatment.

The treatments weren’t easy, but Rebecca finished her course in September 2009, and 10 weeks later, after a PET scan, was pronounced tumor-free.

Being the sister of a pathologist, Rebecca respected the work laboratory professionals and pathologists do. But now, post-treatment, she understands and respects it in a way she couldn’t have before her cancer diagnosis.

“Without lab professionals and pathologists, I think modern medicine would be in a world of hurt these days,” she says. “Laboratory professionals and pathologists help doctors make accurate diagnoses—and where would we be without that?"

Anna's Story

I was completely shocked when I received my diagnosis because I didn’t have any physical symptoms.

When Anna was 33, she worked in the lab at a primary care clinic. One day, she thought she noticed streaks of blood in her stool and her primary care provider recommended she take a fecal immunochemical test (FIT). This test checks for blood in the stool and is used to screen for colorectal cancer. Anna’s FIT test confirmed the presence of blood in her stool, so additional tests were ordered, including a colonoscopy.

Since Anna was young and blood in the stool can happen for many reasons, she never considered cancer as a possible diagnosis. She was stunned when her gastroenterologist called and told her that they had found a cancerous polyp in the lining of her large intestine.

The first step of her treatment was surgery to remove part of her large intestine. The removed section was sent to her pathology team for analysis. Her pathologist determined that Anna had stage I colon cancer. Colon cancer is often diagnosed at a later stage in people under 45 years old. This is partly due to the physical symptoms being mild and because often people under 45 years old do not receive routine screening. Anna is grateful she didn’t ignore her symptoms and that her lab team caught the cancer early.

It has now been over 5 years since she was diagnosed and her risk of recurrence is low, but Anna continues to get routine colonoscopies to monitor her health.

“I want other patients and caregivers to know that your pathology team has a huge impact on how your oncologist decides to treat you. Without lab results, it would be impossible to diagnose and treat colorectal cancer.”

Heather's Story

Heather was exhausted. She had spent years trying to find someone who would listen to her concerns about finding blood in her stool, but doctor after doctor dismissed her symptoms. “It's just hemorrhoids,” they would say, “Mothers get them after birth all the time. It’s to be expected.”

Heather was tired of bleeding, and she was tired of being dismissed. It had been five years, and she just wanted to feel like herself, spend time with her three kids, and return to half marathon training. “I was so frustrated I raised my voice at the doctor and insisted the hemorrhoids be removed.”

The doctor agreed to send her to get a series of basic blood tests. Only after the results showed that Heather had severe anemia, did they refer her to a general surgeon.

The general surgeon recommended Heather move forward with getting a colonoscopy. It was at that appointment, while coming out of anesthesia, that Heather received the news she had been dreading – she had cancer. Even though her worst fears were coming true, Heather found a sense of calm in the moment of diagnosis. The grogginess from the procedure provided a buffer to process the information without immediate panic. Once home, she embarked on a journey of research, seeking information, connecting with communities online, and reaching out to a friend who had colorectal cancer.

While Heather processed her diagnosis, her sample was sent to the laboratory so a pathologist could look at it under a microscope and make an official diagnosis. They diagnosed her with stage IIA rectal adenocarcinoma. Based on this information, Heather and her oncologist created a care plan. Her treatment included chemotherapy and radiation before surgery. During surgery, her surgeons removed the cancer and created a stoma – an opening in her abdomen to allow waste to pass directly from her colon into an ostomy bag. After the mass was removed, Heather received another round of chemotherapy followed by a second surgery to repair her colon and remove the stoma.

Heather is deeply grateful for laboratory medicine: “The information they provide gave me the best shot at treatment decisions and understanding what I was facing. It provides precision instead of just ‘cancer’”.

Throughout her treatment, Heather grappled with constant fatigue and relied on her support system, both online and in person. “My parents helped me by keeping the kids or taking me to radiation or surgeries,” she reflected, “My husband never stopped, when he wasn’t at work, he was spending time with the kids or keeping the house running.”

Heather finished her treatment over five years ago, but she still struggles with pain and fatigue and thinks about her diagnosis every day. Her experiences have motivated her to become a patient advocate, and she works with organizations across the country to raise awareness of colon cancer and help recently diagnosed patients. Her advice to others facing a similar journey is to read, learn, and absorb as much information as possible.

“The more you know about your cancer and your options, the better chance you have to not only survive but have quality of life as well.”