Colon Cancer Questions To Ask

Absolutely. After being diagnosed with colon cancer, your first inclination may be to “get it out” as soon as possible. However, there is always time to seek additional opinions and get informed answers to your questions about colon cancer and its treatment. If you’re told there isn’t time for a second opinion or you feel rushed to have surgery, look elsewhere for care. It is important to get a second opinion from an institution that offers all treatment options, such as The University of Kansas Cancer Center, which is the region’s only National Cancer Institute-designated cancer center.

Yes, The University of Kansas Cancer Center is a National Cancer Institute-designated comprehensive cancer center – 1 of only 53 in the entire country. Comprehensive designation is the highest level of recognition awarded by the NCI. The very latest treatment options are developed, refined and offered to patients first at NCI-designated cancer centers like ours. This is because we not only treat patients, we have a strong basic research program that develops drugs and therapies to be used in the future care of cancer patients. Many of our cancer physicians conduct research studies and have leading roles in national and international organizations and at conferences. We are nationally recognized for our innovative cancer research and education, both of which set us apart from other cancer centers in the region. Taken together – research, clinical research studies and specialized care for those at high-risk – patients at NCI-designated cancer centers have a 25% better chance of survival.

Colon cancer specialists – gastroenterologists, colorectal surgical oncologists and GI medical oncologists – have years of experience treating people with colon cancer. It’s important to see specialists who treat your cancer daily. There is a big difference between a general oncologist or surgeon and a GI medical oncologist and colorectal surgical oncologist. GI medical oncologists have advanced training and know what works for each subset of colon cancer. The more members on your team who treat only colon cancer, the better. Be sure to include this among your questions to ask about colon cancer.

When it comes to cancer, experience matters. Colorectal surgical oncologists, for instance, only operate on GI cancers, as compared to general surgeons, who may devote part of their time to colorectal-specific cancers. Studies show subspecialized surgeons offer advanced surgical techniques and have better outcomes, including lower complication rates and higher patient survival. According to a study of patient outcomes, your chances of surviving cancer are up to 25% higher at NCI-designated cancer centers.

Surgery is almost always used to treat colon and rectal cancer. Colorectal surgical oncologists can often remove and cure colorectal cancer when they find and treat it early. Chemotherapy and radiation therapy may also be recommended. More recently, we have been treating more patients with immunotherapy, which involves manipulating the body’s cells to reactivate and strengthen their abilities to attack and destroy cancer cells. As an NCI-designated cancer center, we are far more advanced in applying immunotherapy as a cancer treatment. See Corina Ramirez story. Another option for colon cancer treatment, which is only performed at high-volume cancer centers such as ours, is hyperthermic intraperitoneal chemotherapy. This procedure delivers heated chemotherapy directly inside the abdomen to help destroy any microscopic cancer cells and tumors that cannot be seen by the surgeon. Interventional radiology is another alternative that uses a technique called radioembolization, a minimally invasive cancer treatment, to deliver radioactive particles to a tumor through the blood stream.  

Hyperthermic intraperitoneal chemotherapy is a surgical procedure that begins with removing all visible tumors from the abdomen. HIPEC then delivers heated chemotherapy directly inside the abdomen to help destroy any microscopic cancer cells and tumors that cannot be seen by the surgeon. The heated chemotherapy circulates inside the abdomen, which allows it to reach more of the internal surface area. The goal of HIPEC is to prevent cancer cells from growing into new tumors and allowing the cancer to return. HIPEC can improve outcomes with advanced, complex and recurrent abdominal and primary peritoneal cancers and select ovarian cancers. HIPEC can be used to treat advanced cases of cancer and recurrent cancer, including colorectal cancer.

Interventional radiology uses a technique called radioembolization to treat primary liver cancer and liver metastases from colon cancer. Radioembolization is a minimally invasive cancer treatment that delivers radioactive particles to a tumor through the bloodstream. The particles embed in the tumor and emit radiation that kills cancer cells. The procedure is also known as Y-90, which stands for yttrium-90, the radioactive isotope used in this therapy.

There are side effects to colon cancer treatment, so it’s important to ask your provider what he/she will do to prevent or treat them. You will need regular checkups and you may want to learn about lifestyle changes that can speed recovery and improve your quality of life. Our experienced team of doctors, nurses, counselors, dietitians and research coordinators can help you:

• Understand your treatment
• Deal with complications
• Assess and manage side effects
• Monitor for cancer recurrence
• Give you access to clinical studies
• Make diet and exercise recommendations

Our support services staff includes social workers, psychologists, dietitians, a chaplain, a physiatrist (specialist in cancer rehabilitation), nurse navigators, financial counselors and a resource center coordinator along with other specialists to support the specific needs of you and your loved ones. This team helps identify challenges you and your caregivers may face and provides tools to manage them, whether they are physical, nutritional, spiritual, social or psychological. In addition, because more young people are developing colon cancer, we have experts who can assist with fertility preservation if/when that becomes a treatment issue. 

We provide a GI oncology high-risk clinic for anyone at increased risk for colon cancer. Individuals with a family history of colon cancer are 3 times more likely to develop the disease. If someone has a known genetic mutation increasing their risk of cancer, family members should seek genetic counseling and testing, as they may have the mutation. To help you understand your risk factors for cancer, we offer genetic counseling with board-certified genetic counselors who follow guidelines set by the National Comprehensive Cancer Network. Those at high risk for colon cancer include:

• Being age 45 or older
• Having a strong family history of colon or rectal cancer (2 generations, with one getting the disease before age 50)
• A past history of colon cancer
• Having another type of cancer, such as cancer of the ovary or uterine cancer
• Having polyps removed from your colon, especially if you had large polyps or a large number of polyps
• Having ulcerative colitis or Crohn’s disease for more than 10 years
• Having radiation therapy in your abdomen or pelvis
• Having type 2 diabetes
• Being African-American carries a higher risk of colon cancer
• Having Lynch syndrome

Yes, we offer many clinical trials and will assess your eligibility if you are interested. Clinical trials provide access to potential advancements in cancer care and lead to innovations in cancer prevention and treatment. There are 4 phases of clinical trials, each of which is designed to answer specific questions. Knowing the phase of the clinical trial is important because it can give you some idea about how much is known about the treatment being studied. NCI-designated cancer centers offer early-phase clinical trials. This means that patients can be the first to receive a promising new drug or treatment that is not yet widely available. Ask your doctor about participating in a clinical trial for colon cancer.

While most clinical trials are conducted by pharmaceutical companies, at The University of Kansas Cancer Center our physician-researchers can design and initiate their own clinical trials. Called an Investigator-Initiated Trial, or IIT, the investigator develops his/her original idea with the aid of a complex support system that is unique to an academic institution like The University of Kansas Cancer Center. The goal of an IIT is not always to test a new therapy, but to find new or revised applications for existing products. IITs expand product knowledge, including safety. To accomplish and execute their studies, IITs rely on a support system of quality control and quality assurance, design and data analysis and interpretation, which our cancer center provides.