Tests, Treatments & Therapies for Colorectal Cancer

At the University of Colorado Cancer Center, we use the most minimally invasive approach possible for both diagnosis and treatment of colorectal cancer. We recognize that both work-up and management requires a multidisciplinary approach with numerous specialists working closely together.

We use both standard treatments and those being tested in clinical trials. You might consider participating in a trial, which are designed to improve current treatments or get information on new treatments. If a new treatment is proven better than the standard treatment, the new treatment may become the standard treatment.

Staging and Detection Tests

Once a cancer has been diagnosed, it is very important for doctors to find out where the cancer may have spread (the “stage” of the cancer) to determine the best possible treatment plan for you. To find out, doctors use staging tests, which include:

  • Different types of scans
  • Different ways to take tissue samples to look for tumor cells microscopically (biopsy tests)

Scans and other tests may also be used:

  • In a “surveillance program” looking for any signs of relapse after treatment
  • In a “screening program” to detect cancer early in individuals at high-risk
  • To monitor responses to treatment

Tests and procedures that may be used include:

Fecal occult blood test: A test to check stool (solid waste) for blood that can only be seen with a microscope.

Digital rectal exam – The doctor or nurse inserts a lubricated, gloved finger into the lower part of the rectum to feel for lumps or anything else that seems unusual.

Colonoscopy – A procedure to look inside the rectum and colon for abnormal areas. A thin, lighted tube, called a colonoscope, is inserted through the rectum into the colon.

Sigmoidoscopy – A procedure to look inside the rectum and lower colon, called sigmoid, for abnormal areas. A thin, lighted tube, called a sigmoidoscope, is inserted through the rectum into the sigmoid colon.

Biopsy – The removal of cells or tissues so they can be viewed under a microscope to check for signs of cancer.

Types of scans include:

Barium enema (lower GI series) – A series of X-rays of the lower gastrointestinal tract. A liquid that contains barium(a silver-white metallic compound) is put into the rectum. The barium coats the lower gastrointestinal tract and X-rays are taken.

CT scan (computed tomography) – An X-ray procedure that creates detailed, highly accurate cross-sectional body images.

Virtual colonoscopy (a colonography or CTcolonography) – Uses CT scans to make a series of pictures of the colon. A computer puts the pictures together to create detailed images that may show anything that seems unusual on the inside surface of the colon.

PET scan (positron emission tomography) – An imaging test used to light up cancer in different parts of the body. You get an injection of a short-lived radioactive substance before having the scan. Cancerous tissue will build up more of the substance and appear brighter than normal tissue on the PET images. Other non-cancerous tissues, such as areas of inflammation, can also sometimes “light up.”

Treatment & Therapy for Colorectal Cancers

Both work-up and management of colorectal cancer require a multidisciplinary approach of many specialists working closely together. That’s why our treatment programs have doctors and nurses who specialize in this type of cancer and work as a team.

Surgery

Removing cancer in an operation is the most common treatment for all stages of colon cancer. A surgical oncologist-a doctor who specializes in cancer operations-may remove the cancer using one of the following types of surgery:

Cryosurgery – A treatment that uses an instrument to freeze and destroy abnormal tissue.

Local excision – If the cancer is found at a very early stage, it can be removed without cutting into the abdomen.

Radiofrequency ablation (cryotherapy) – The use of a special probe with tiny electrodes that kill cancer cells.

Resection – Surgically removing the cancer and a small amount of healthy tissue around it. The doctor will then sew together the healthy parts of the colon. The doctor also might sew the remaining colon to the rectum.

Resection and colostomy – If the doctor is not able to sew the colon or rectum back together, a stoma (an opening) is made on the outside of the body for waste to pass through. A bag is placed around the stoma to collect the waste.

Radiation Therapy (“Radiotherapy”):

Radiation therapy involves using X-rays and other types of medical radiation aimed at specific parts of the body to:

  • Kill cancer cells
  • Prevent cancer cells from developing or recurring
  • Improve many of the symptoms caused by cancer

Radiation therapy can be:

  • Used before surgery to make the operation easier (this is called “neoadjuvant” treatment)
  • Used after surgery to reduce the chances of the cancer coming back (this is called “adjuvant treatment”)
  • Almost as effective as surgery in people who are not fit enough for an operation
  • Better than surgery when used together with chemotherapy for certain cancers (this is called “chemo-radiotherapy”)

Chemotherapy and other drug-based treatments:

Anti-cancer drug treatments – Chemotherapy-and new “targeted therapies”-involve using drugs that kill, slow down or damage cancer cells. Many new drugs are being developed. View current colorectal cancer clinical trials available at UCCC.

Anti-cancer drug treatments may involve:

  • Single drugs or combinations of drugs
  • Intravenous injections or tablets/capsules
  • Taking the drugs in repeating patterns, called “cycles”, that usually last three to four weeks
  • Taking some drugs every day or only on a few days within the cycles
  • Taking other medicines to reduce or eliminate side effects associated with chemotherapy
  • Taking targeted therapies, often with very little side effects, on their own or in combination with standard chemotherapy
  • Access to new drugs or vaccines on their own, or added into standard treatments, in clinical trials

Chemotherapy and targeted therapies can:

  • Be given before surgery to make the operation easier
  • Be given in combination with radiotherapy to make both treatments more effective
  • Be given after surgery to reduce the chances of cancer coming back
  • Successfully control advanced cancer and many cancer-related symptoms

Clinical Trials

The goal of clinical research is to improve treatment outcomes and reduce treatment side effects or long-term toxicities. Clinical trials provide the latest treatments because they evaluate:

  • New drugs
  • New combinations of therapies
  • New treatment delivery methods

Because we’re the Rocky Mountain region's only National Cancer Institute (NCI)-designated Comprehensive Cancer Center-one of only 39 in the United States-your treatment will always include the latest and most comprehensive care options.

Learn more about clinical trials at UCCC.

Other types of treatments being tested in clinical trials include:

Biologic therapy (biotherapy or immunotherapy) – A treatment that uses the patient’s immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct or restore the body’s natural defenses against cancer.