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About Colon Cancer

Colon cancer affects a part of the digestive system called the colon, or the large bowel. The colon consists of several segments, including its head (or cecum), the ascending colon, transverse colon, and descending colon. The final segment of the large intestine is called the rectum, which connects the colon to the anus. The upper 5-6 feet of the large intestine is the colon, and the lower 5-6 inches is the rectum.

Early symptoms of colon cancer might include blood in the stool; persistent problems in defecating (long-lasting diarrhea or constipation); feelings of cramping, distension or pain in the area of the bowel; or a persistent decrease in the size of the stool.

Treatments for colon cancer depend on a patient’s cancer stage, genetic factors, and previous treatments, among other considerations. Surgery is the most common treatment for early stage, localized cancers, while chemotherapy and other medical treatment are more commonly used for more advanced stages of cancer.. Radiation therapy is less commonly used, but it may become part of a treatment plan for colon cancers that have spread to other organs, such as the liver.

Colon Cancer: What You Need to Know

  • Colon cancer is the third most common cancer diagnosed in the United States.
  • Screening for colon cancers can include a colonoscopy, which uses a camera on the end of a long flexible tube to view the inside of the colon; a virtual colonoscopy, which uses a CT scan to view the colon; or a fecal occult blood test, which looks for signs of bleeding in the stool.
  • About 20 percent of colon cancers have some hereditary link. Colon cancer screening experts at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins offer genetic testing for these common genetic variations.
  • In general, early stage colon cancers (stage 1 and 2) are confined to the colon and have not moved outside the colon wall to affect lymph nodes. Stage 3 colon cancer has spread to organs and tissues or lymph nodes directly outside the colon wall. Stage 4 colon cancer has spread to distant lymph nodes and organs, such as the lung or liver.
  • About two-thirds of patients with colon cancer have localized cancer that can be removed surgically. Outcomes for stage 1 and stage 2 colon cancer are very good, with a 65 to 95 percent cure rate.
  • Our nutrition specialists help patients plan and follow a diet during and after treatment to ensure the best healing and recovery times.

Early Stage Disease

  • Approximately two thirds of colon cancer patients have localized cancer, which is best treated surgically.
  • Patients with stage I and II colon cancer have a cure rate of approximately 95 percent.
  • The most common treatment for early stage colon cancer is surgery. Innovative surgical techniques can also be used in conjunction with other treatments for patients whose cancer has spread.
  • Patients benefit from having surgeons who specialize in treating colorectal cancer.

Late Stage Disease - New Therapies

New, innovative therapies are being developed to give patients with advanced stage disease more options.

Other treatment options for late stage gastrointestinal cancers may include cytoreductive (debulking) surgery and hyperthermic intraperitoneal chemotherapy (HIPEC).  In certain cases, the procedures have been shown to be an effective treatment option for certain peritoneal surface malignancy cancers such as selected stage IV colon cancer and other gastrointestinal cancers including appendiceal cancers and pseudomyxoma peritonei.

Dr. Richard Burkhard, a Johns Hopkins cancer surgeon and researcher, treats colon cancer that has spread to the liver by using a team approach. Learn more.

Genetic Testing

There are some genetic mutations that have been linked to inherited forms of colorectal cancer and other mutations that can help guide a patient’s treatment when they are identified. Johns Hopkins medical oncologists recommend genetic testing for patients with rectal cancer if the patients have a close relative with colorectal cancer or a family history of colorectal cancer, or if the cancer is metastatic.

Before treatment begins, the Johns Hopkins colon cancer team screens common genetic variations that may affect which medical treatments are best suited for an individual patient.

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