Colon Cancer

Colon Cancer

MSK surgeon Julio Garcia-Aguilar and nurse Gina Occhiogross walk down a hallway

Our specialists, such as Chief of the Colorectal Service Julio Garcia-Aguilar (right) and nurse Gina Occhiogross, treat people with colon cancer using innovative approaches that preserve quality of life.

About Colon Cancer

You may be reading this because you or someone you care about has been diagnosed with colon cancer. Or you may be having symptoms that make you concerned you may have colon cancer. Learning as much as you can about the disease can help you feel better prepared to speak with a doctor about your condition and your options for screening and treatment.

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You may feel worried and overwhelmed. This is a good place to begin. From here you can visit other sections of this guide for more in-depth information. We are here to help you every step of the way.


What is colon cancer?

Diagram which points out the location of the colon (large intestine), small intestine, rectum and the anus

Colon cancer forms inside the colon, which is the first five feet of the large intestine.

Colon cancer forms inside the large intestine, which is roughly five and a half feet long. The first five feet of the large intestine is called the colon. The rectum makes up the last six inches of the large intestine. Cancers found in the two organs are often grouped together as colorectal cancer.

Colon cancer often develops slowly over several years. It typically starts as a small abnormal growth on the inner lining of the colon. This is called a polyp. Some polyps can eventually grow into cancer.

Colon cancer is often contained within the colon. But if left untreated, it can spread to other organs, most often the liver and lungs.

A small percentage of colon cancer is due to genetic causes that may be passed from parents to children.

What are the signs and symptoms of colon cancer?

Colon cancer often does not cause symptoms in the early stages. That’s why we recommend that you get regular screenings for colon cancer depending on your age, medical history, and other risk factors.

However, there are some signs of colon cancer that you should not ignore, such as:

  • rectal bleeding or blood in your stool
  • changes in your bowel habits, such as diarrhea, constipation, or narrow stools that last more than a few days
  • unexplained abdominal pain or cramping that lasts more than a few days
  • a persistent urge for a bowel movement that doesn’t go away after you have one
  • unexplained weakness and fatigue
  • unintended weight loss
  • a diagnosis of anemia

These symptoms usually do not mean you have colon cancer. Contact your doctor if any of these problems are severe or last longer than you think they should.

If you are younger than 45 and have not been screened for colon cancer, it’s particularly important that you do not ignore symptoms. The recommended age to begin colon cancer screening is now 45 years old. Recently there has been a troubling rise in colon cancer among people as young as their 20s and 30s who have no history of the disease and few if any risk factors. If you are under 45 and have worrying symptoms — especially rectal bleeding or blood in the stool — tell your doctor as soon as possible.

Learn more about colon cancer screening.

Learn more about colon cancer before 50.

Am I at risk for getting colon cancer?

Colorectal cancer is the third most common cancer diagnosed in both men and women in the United States. About 101,000 people are newly diagnosed with colon cancer each year.

Your risk of colon cancer depends on many factors. You can control some of them but others you can’t, including:

  • age — the older you are, the more likely you are to develop colon cancer
  • diet, exercise, and tobacco and alcohol use
  • a personal history of polyps and inflammatory bowel diseases, including ulcerative colitis and Crohn’s colitis
  • a family history of colon and related cancers and inherited disorders, including Lynch syndrome and familial adenomatous polyposis;
  • genetics — about 5 to 10 percent of colon cancer is due to genetic causes passed from parents to children

Learn more about the risk factors for colon cancer.

Learn more about genetic testing for colon cancer.

Should I get screened for colon cancer?

Colon cancer can usually be cured if it is found early enough.

Memorial Sloan Kettering’s guidelines recommend that you get screened for colon cancer beginning at age 45, if you have an average risk and no symptoms. If you are at a higher risk, you should have screenings more often, depending on your age as well as your personal and family medical history.

At MSK, a colonoscopy is the preferred screening method. This procedure detects polyps. These abnormal growths of tissue inside the colon lining can grow into cancer. A colonoscopy can also remove polyps before they become cancerous.

Learn more about a colonoscopy and other screening tests for colon cancer.

How is colon cancer diagnosed?

If colon cancer is suspected, a specialist will do a colonoscopy. This is a test in which a small piece of tissue is removed to look for signs of cancer. This sample is examined under a microscope by a pathologist (a doctor who specializes in diagnosing disease).

If you are diagnosed with colon cancer, the next step is determining how advanced the disease is. This is called staging. Your care team may recommend CT and MRI scans and other tests to see if the cancer has spread outside the colon to other organs.

What are the types of colon cancer?

The vast majority of colon cancer is a type called adenocarcinoma. This is a cancer of the cells that line the inside surface of the colon. Rarer tumor types include:

  • carcinoid tumors, which start in hormone-producing cells in the intestines
  • gastrointestinal stromal tumors (a type of soft tissue sarcoma that can be found anywhere in the gastrointestinal tract but is rare in the colon) or other types of sarcoma that start in the blood vessels or connective tissue of the colon
  • lymphoma, which is a cancer of the immune system that more commonly starts in the lymph nodes but can start in the colon

Learn more about the types of colon cancer.

What are the stages of colon cancer?

Stages describe how widespread the cancer is in the colon and whether it has spread (metastasized) to other organs. This is crucial information for MSK doctors when tailoring a care plan for you.

There are five stages of colon cancer.

  • Stage 0: This very early cancer is found only in the innermost lining of the colon.
  • Stage I: The tumor has spread beyond the inner lining but remains within the colon and has not spread to the lymph nodes (small organs that are part of the immune system).
  • Stage II: The cancer extends through the thick outer muscle layer of the colon but has not spread to the lymph nodes.
  • Stage III: The cancer has spread outside the colon to one or more lymph nodes.
  • Stage IV: The cancer has spread to other parts of the body, such as the liver or lungs. This is known as metastatic cancer. The cancer may be in the lymph nodes.

Learn more about the stages of colon cancer.

What are the treatments for colon cancer?

If you are diagnosed with colon cancer, your doctors will discuss treatment options with you. To make an informed choice, ask about the pros and cons of each option, potential side effects, and how effective the treatment is likely to be.

We understand how important quality of life is. We always try to preserve your ability to use the bathroom normally as well as your sexual health.

There are several ways to treat colon cancer depending on the stage and location of the disease. These methods are often used in combination, including:

  • Surgery to remove the cancer. Colon cancer is treated with a segmental colectomy, which removes part of the colon. This is usually done using a minimally invasive procedure. For most people, the surgeon joins the two remaining ends to reconstruct the colon. 
  • Chemotherapy with drugs that shrink or kill colon cancer cells. This can be done before, during, or after surgery, or for some people, instead of surgery.
  • Radiation using high-energy rays or particles to shrink or destroy cancer cells. This is more often used in advanced colon cancer that has spread and in rectal cancer.
  • Targeted therapy that attacks genetic weaknesses in cancer cells. This treatment spares normal cells.
  • Immunotherapy. This helps your body’s own immune system fight cancer.

Learn more about colon cancer treatments.

Here are some questions you might want to ask your colon cancer surgeon.

What are the treatments for colon cancer that has spread (metastatic cancer)?

If the cancer has spread (metastasized) beyond the colon to other organs, there are many options for treatment.

  • Surgery can remove tumors from the colon and other organs, such as the liver, at the same time. Doing this in a single surgery can improve the outcome, shorten recovery time, and reduce the risk of complications.
  • Chemotherapy can shrink or kill cancer cells. It may be used on its own or combined with surgery or radiation therapy.
  • Therapies are available that target portions of cancer cell DNA (targeted therapies) or boost your body’s immune system to fight cancer (immunotherapy). These are effective for a relatively small number of people.

Learn more about treatments for metastatic colon cancer.

How will colon cancer treatment affect my quality of life?

After the shock of a colon cancer diagnosis, you may have many questions about how treatment will affect your quality of life, including your ability to use the bathroom normally as well as your sexual health.

At MSK, preserving these functions is one of our key goals. Your team will focus on your quality of life from the very beginning of treatment. We will tailor a personalized plan for you.

You may be concerned about a procedure called a colostomy. That’s when the colon is cut to remove the cancer, and the top end is attached to an opening made in the skin of the belly. Waste comes out of the opening and is held in a bag stuck to the skin.

Only a small number of people with colon cancer need this procedure, depending on the stage and location of the cancer. For many people who have a colostomy, it is reversed after a short time, and normal bathroom habits can resume.

Why should I choose Memorial Sloan Kettering for colon cancer treatment? 

If you are facing colon cancer, we understand how much you want to regain a sense of control over your life. Deciding where to be treated is a crucial step.

MSK is recognized around the world as a leader in pioneering new ways to treat colon cancer, so we can tailor a treatment plan specifically for you. Each year we care for more than 1,200 people with colon and rectal cancer. We cure or control the disease for people facing every form of colorectal cancer, from the earliest stages to the rarest and most complex.

Many of the most advanced treatments available today were developed or first studied by our colon cancer team. That means the people we care for have access to clinical trials with new therapy options that may not be available at other hospitals.

We believe you should choose MSK because we offer:

  • Compassionate care from a team of experts. Our staff includes more than 70 colorectal cancer specialists from diverse fields, including surgery, chemotherapy, radiology, and pathology. Many of them are nationally or internationally recognized.
  • The most-advanced colon cancer treatments, including minimally invasive surgeries, which use smaller incisions than traditional surgeries. MSK’s surgeons are particularly skilled at methods that use a robotic system to provide greater precision and enhanced visibility. MSK doctors perform more of these kinds of surgeries than doctors at any other institution in the country. This gives us a high level of expertise that reduces recovery time and leads to fewer complications. We are also leaders in treating colon and rectal cancer with no surgery when possible.
  • A commitment to your quality of life. Our specialists take every measure to preserve your ability to use the bathroom normally as well as your sexual health. We can help you not just survive but thrive.
  • Expertise in diagnosing and treating hereditary, rare, or complex colon cancer. As the world’s largest nonprofit cancer center, we have extensive experience in curing or controlling all forms of the disease.
  • Personalized treatment. We use state-of-the-art genetic testing and other methods to predict which treatments are most likely to be effective for our patients.
  • The first clinic in the world for people under 50 with colon cancer. The Center for Young Onset Colorectal and Gastrointestinal Cancer was created to address a troubling rise in colon cancer among people as young as their 20s and 30s. The Center help younger patients with the specific challenges they face while advancing research into the causes of this disturbing new trend.
  • Personalized screening and monitoring after treatment to keep you healthy. This includes the Hereditary Colorectal Cancer Family Registry for families who are affected by genetic colon cancer syndromes and may be at an elevated risk.
  • A dedication to giving you the best outcome possible and ensuring you are happy with your care. We track patient satisfaction and use your feedback to continually improve.
  • Flexibility in how and where to receive treatment. Our specialists are conveniently located in Manhattan and at our regional outpatient locations in New Jersey, on Long Island, and in Westchester County. This provides our patients with the same outstanding care from MSK doctors closer to home.
  • Emotional support at MSK’s Counseling Center and wellness therapies from integrative medicine specialists if you need help relieving symptoms after treatment. 
  • A personalized survivorship care plan with the medical guidance you’ll need to go back to a healthy life after colon cancer treatmentWatch a video to learn more about MSK’s Adult Survivorship Program.