Colon Cancer

While surgery is the most common treatment for colon cancer, the type of surgery you need depends on the location and size of the tumor, and whether cancer has spread. Whenever possible, our surgeons use a minimally invasive surgical approach that results in less scarring, reduced pain and infection risk, shorter hospital stays, and quicker recovery. 

Partial Colectomy or Total Abdominal Colectomy

Removes the area of the colon where the cancer is, as well as surrounding tissue. Lymph nodes are removed to determine if cancer has spread. A total abdominal colectomy may be performed in people with cancers that run in their families, with numerous polyps, or whose cancer has recurred.

Endoscopic Mucosal Resection

Endoscopic procedures are performed through an endoscope, a flexible tube used to reach your GI tract. An electrical device is passed through the tube to cut and remove early-stage cancers, precancerous growths, and surrounding tissue from the GI lining. Tumors that have penetrated deeper layers of the GI wall can be removed through different but similar procedures called endoscopic submucosal dissection or endoscopic full-thickness resection.

Endoluminal Stent Placement

An expanding metal scaffolding device called a stent may be inserted into the colon through a small, lighted endoscope to clear a blockage created by a tumor.

Chemotherapy

Slows or kills tumor growth. Sometimes recommended after surgery if recurrence risk is high, and if cancer has spread to lymph nodes or beyond.

Targeted Therapies

Bevacizumab (Avastin) and other targeted therapies block a protein called vascular endothelial growth factor (VEGF). Blocking this protein cuts off the supply of blood and nutrients that let tumors grow and survive. 

Finding colon cancer early and obtaining an accurate diagnosis are key to obtaining the best possible outcome. Several methods are used to detect and diagnose colon cancers.

Colonoscopy

A camera at the tip of a flexible plastic tube is inserted in the rectum to allow the doctor to evaluate the entire colon. We routinely use high-resolution colonoscopy to create clearer images that offer better detection of polyps and cancer not seen with standard colonoscopy.

FIT (Fecal Immunochemical Test)

FIT tests for hidden blood in stool, which can be an early sign of cancer. A kit is mailed to your home with instructions on how to collect the stool. Your primary care doctor will order this test to be repeated annually. If you have a positive FIT, a colonoscopy is recommended for further evaluation of your colon.

Stool DNA

A stool DNA test looks for abnormal DNA from cancer or polyp cells in your stool. This can be an early sign of cancer or, in some cases, large polyps. This test is usually ordered by your primary care doctor. A kit is mailed to your home with instructions on how to collect and return the stool to be tested. Since some insurance companies do not pay for this test, you should talk to your insurer and your primary care doctor first. If you have a positive stool DNA test, a colonoscopy is recommended for further evaluation of your colon.

Virtual Colonoscopy

A special CT scan is used to image the colon. Studies show that it is effective for identifying medium to large polyps but is less effective in identifying small or flat polyps. Also called CT colonography, it may be best for people who cannot have or have failed a conventional colonoscopy. If you plan to pursue this option, please discuss it with your insurance company and primary care doctor, as this test may not be covered by your insurance. 

Comprehensive, High-Quality Colon Cancer Care
As a National Cancer Institute-designated Comprehensive Cancer Center, we offer a level of expertise found only in the top cancer centers across the country. The skills and experience of our colon cancer specialists come from working with people with colon cancer every day.

A Team of Specialists
We have a range of board-certified colon cancer specialists, including medical and radiation providers, colorectal surgeons, gastroenterologists, radiologists, and pathologists. They work with geneticists, specially-trained nurses, nutritionists, and social workers to regularly discuss your care, collect opinions, and offer coordinated surgical, medical, and follow-up care.

Nationally Recognized Experts
Our specialists test new approaches in clinical trials. For example, we were involved in the development of the targeted therapy Avastin, which shrinks tumors and extends survival in patients when colorectal cancer has spread. We also study genes, how they function, and their impact on health.

One-Day Evaluation
As a first-time patient here, you will undergo a thorough, day-long evaluation and consultation. You will leave with a comprehensive treatment plan that meets your needs. We can expedite the process even further if you bring with you the results of blood tests, scans, and other tests that were performed prior to your visit. If you need additional imaging or testing, those services are conveniently located within our facilities.

Access to Clinical Trials
You may be eligible to participate in our ongoing colorectal cancer clinical trials. These trials give you access to emerging anti-cancer targeted therapies, surgical approaches, and methods for minimizing common cancer-related symptoms. 

When Colon Cancer Spreads to Brain or Spine
New treatments are making it possible for people to live longer, with a better quality of life, when cancer has spread to the brain or spine. Duke experts in the medical and surgical management of metastatic brain and spine tumors use these advanced therapies to extend life for people who may have been told they are out of options. 

Enhanced Recovery Shortens Hospital Stays
Our doctors are national leaders in enhanced recovery, a program that minimizes fasting before surgery, encourages physical rehabilitation immediately after surgery, and incorporates specialized pain management to reduce the stress of colon surgery. Duke research shows that these enhanced recovery approaches decrease postoperative complication rates and reduce the length of hospital stays. 

More Minimally Invasive Options
Nearly 80 percent of our colon cancer surgeries are performed laparoscopically or robotically to minimize pain and scarring, and lower incidence of infection. In this procedure, surgeons insert a device through small incisions. This less invasive method is used to identify and sometimes remove tumors and can result in smaller wounds. You may also leave the hospital sooner and recover faster.

Hereditary Colorectal Cancer Counseling and Testing
If you are at high risk for or have a family history of colon cancer, you can work with the genetic counselors in our hereditary cancer clinic to determine and reduce your risk.

Support for You and Your Loved Ones
Our comprehensive support services range from helping patients minimize the side effects of treatment to coping with the emotional and psychological effects of diagnosis and treatment. View all of our cancer support groups in our event calendar.