Colon and small intestine cancer
Because colon cancer and rectal cancers have many features in common, they are sometimes referred to together as colorectal cancer. Colorectal cancer is malignant cells found in the colon or rectum. The colon and the rectum are parts of the large intestine, which is part of the digestive system. Cancerous tumors found in the colon or rectum also may spread to other parts of the body.
At North Shore-LIJ Health System, the physicians are not just treating colon cancer. They are finding the right treatment for each patient. It starts with doctors and surgeons who are at the top of their game and work together as a team that fights for and along with each patient. Also, patients have full access to the comprehensive clinical resources available through the entire integrated health system, for whatever their health needs may be. And with over 30 years of clinical trial experience – the most on Long Island – each patient’s care will be anything but one-size-fits-all.
North Shore-LIJ Health System takes an advanced approach to treating colon and small intestine cancer. The distinguished experts at the Gastrointestinal Oncology Center, part of the North Shore-LIJ Cancer Institute, draw upon decades of training and experience, applying the latest technology and research-backed therapies to treat all stages of colon and small intestine cancer.
From diagnosis through treatment and follow-up, patients are in the capable hands of some of the region's top colon and small intestine cancer experts every step of the way.
Highlights of the state-of-the-art treatments and services include:
- Advanced colon cancer treatments, including minimally invasive surgery, robotic-assisted surgery
- Novel chemotherapies, targeted therapies and biologic therapies
- Cutting-edge approaches to delivering chemotherapy
- Highly precise radiation therapy techniques such as intensity-modulated radiation therapy (IMRT)
- Endoscopic ultrasound and other leading-edge diagnostic and therapeutic procedures
- Noninvasive virtual colonoscopy
- Specialists in gastrointestinal genetics and genetic counseling
- Broad range of supportive care services
A Team Approach to Colon and Small Intestine Cancer
Within the first several days of a visit, a team of physicians with different specialties will conduct comprehensive testing and use these findings to develop a personalized treatment program. Each diagnosis is unique, so the multidisciplinary team of colon and small intestine cancer experts meets weekly to share ideas and best practices for delivering collaborative patient care and reviews each treatment phase to constantly improve care and ensure treatment milestones are reached.
Colon Cancer Symptoms
Even though increasing numbers of people have regular colon cancer screenings, many see their doctors when they experience colon cancer symptoms such as:
- Change in the frequency of bowel movements
- Diarrhea, constipation or feeling that the bowel does not empty completely
- Bright red or very dark blood in the stool
Please be aware that these symptoms could be due to conditions other than colon cancer, so it’s best to see a doctor right away.
Small Intestine Cancer Symptoms
Some people with small intestine cancer may not have any symptoms. Others may experience:
- Blood in the stool
- Dark stools
- Abdominal lump
- Abdominal pain or cramps, with possible nausea or vomiting
- Unexplained weight loss
Please be aware that these symptoms could be due to conditions other than small intestine cancer, so it’s best to see a doctor right away.
The first step in making a colon or small intestine cancer diagnosis is usually a physical. A doctor will also consider personal and family medical history. If colon or small intestine cancer is suspected, the patient will be referred to a specialized physician for diagnosis.
North Shore-LIJ Health System specialized physicians use various procedures and tests to deliver an accurate colon or small intestine cancer diagnosis and to determine the stage (extent) of the cancer. These can include:
- Digital Rectal Exam (DRE): With a DRE, the doctor manually checks for anything unusual or abnormal. This test can detect cancers of the rectum but not the colon.
- Exams Using Specialized Scopes: Some procedures use different types of scopes to check for cancer and pre-cancerous tissue. Scopes are flexible, tube-like instruments with a light, viewing lens and tool to remove (biopsy) suspicious tissue for further analysis. Scope-based procedures include:
- Proctoscopy: examines the rectum
- Sigmoidoscopy: examines the rectum and half of the colon
- Endoscopy: examines the small intestine and is inserted through the mouth or the rectum
- Colonoscopy: examines the entire length of the large intestine and the lower part of the small intestine
- Biopsy: If suspicious areas such as polyps are detected during a test, a tissue sample is removed for further analysis under a microscope.
- Blood Count: This test looks for anemia and cancer markers in the blood.
- Fecal Occult Blood Test: This test checks for hidden (occult) blood in the stool, a common sign of colon or small intestine cancer.
- Liver Function Test: Function tests measure possible disease caused by small intestine cancer.
- Endoscopic Ultrasound (EUS): A thin, lighted tube called an endoscope is inserted into the body. It emits ultrasound waves and creates images of internal organs and structures.
- Upper GI Series: A doctor takes X-rays of the esophagus, stomach and small intestine after the patient drinks a special liquid called barium.
- Virtual Colonoscopy (CT Colonography): This non-invasive type of colonoscopy uses computerized tomography (CT scan) to create a 3-D model of the colon so it can be examined for polyps or masses.
- Laparotomy: A small cut is made to look inside the abdomen for signs of small intestine cancer.
- CT or CAT Scan (Computerized Axial Tomography): This diagnostic procedure uses X-rays and computer technology to produce detailed images of the colon, rectum, small intestine and other organs.
- MRI Scan (Magnetic Resonance Imaging): A magnet, radio waves and computer imaging combine to create highly detailed pictures of areas inside the body.
- PET Scan (Positron Emission Tomography): Small amounts of radioactive sugar are injected into the bloodstream to highlight cancers.
Colon and small intestine cancers are divided into several stages, depending on how far they have spread:
- Stage 0: Abnormal cells are found in the mucosa (innermost layer) of the colon or small intestine walls. These abnormal cells may become cancer and spread. Stage 0 is also called carcinoma in situ.
- Stage I: Cancer has formed in the mucosa (innermost layer) of the colon or small intestine walls and has spread to the submucosa (layer of tissue under the mucosa). Cancer may have spread to the muscle layer of the colon or small intestine walls.
- Stage II: Cancer has spread to or through the muscle layer of the colon or small intestine walls or to the serosa (outermost layer) of the colon or small intestine walls, where it may have spread to nearby organs.
- Stage III: Cancer has spread to one or more lymph nodes.
- Stage IV: The cancer has spread through the blood and lymph nodes to other parts of the body, such as the lungs, liver, abdominal wall or ovaries.
With the results from these state-of-the-art diagnostic tests for colon and small intestine cancer, the doctor will determine how far the cancer has spread and develop a customized treatment plan.
The most common form of small intestine cancer, adenocarcinoma, is diagnosed and treated just like colon cancer. But there are several other types of small intestine cancer, each requiring its own response:
- Leiomyosarcomas and Gastrointestinal Stromal Tumors (GIST)
- Carcinoid Tumors