Colorectal Carcinoma

What is colorectal carcinoma?

Colorectal carcinoma is a cancer that can occur anywhere along the colon (large intestine) or rectum (the last few inches of the digestive tract).

Colorectal carcinomas are diagnosed in stages 0 to IV, depending on how severe the disease is:

• At stage 0, the cancer is still contained within the immediate area where it formed. By stage IV, the cancer has spread outside the colon or rectum to at least one other organ.

How common is colorectal carcinoma?

• About 150,000 people develop colorectal carcinoma in the United States each year.
• Childhood colorectal carcinoma is rare. Fewer than 100 U.S. children younger than 20 are affected each year—about one in a million.

When it occurs, childhood colorectal carcinoma most often affects children with the following:

• A family history of these cancers
• An inherited condition called familial intestinal polyposis, if the small-intestine polyps (growths) are cancerous

What are the symptoms of colorectal carcinoma?

Symptoms of colorectal carcinoma include the following:

• Pain in the abdomen (belly)
• Constipation or diarrhea
• A lump in the abdomen
• Unexplained weight loss
• Loss of appetite
• Blood in the stool

How is colorectal carcinoma treated?

Colorectal carcinoma treatment is based mainly on the stage when the cancer is diagnosed. For the best chance of a complete cure, the tumor must be completely removed by surgery. If the tumor is too large to start with, chemotherapy and/or radiation may be used to try to shrink it.

• Stage 0 — If the cancer is small enough, surgeons may remove the tumor along with any precancerous polyps (growths) that may be present. If the tumor is large, surgeons may take out the affected section of the colon or rectum and sew the remaining parts back together.
• Stage I — Treatment usually involves surgery to remove the cancer along with a small amount of tissue in the area. For most patients, no other treatment is needed.
• Stages II and III — Surgeons may remove the affected section of the colon or rectum and sew the remaining parts back together.
• Stage III — Chemotherapy may be added following surgery.
• Stage IV — Treatment may include the following:
  • Surgery to remove the cancer, along with the tissue around the cancer. The surgeon will then sew the remaining parts back together and remove parts of other organs to which the cancer has spread.
  • Chemotherapy (“chemo”) is used to shrink the tumor before surgery and to treat any remaining cancer. Chemo uses powerful medicines to kill cancer cells or stop them from growing (dividing) and making more cancer cells.
• Recurrent Disease — (disease that returns) Treatment may include the following:
  • Surgery to remove the cancer and to remove parts of other organs where the cancer has spread.
  • Radiation (high-energy X-rays or other types of radiation used to kill cancer cells or stop them from growing) or chemo to relieve symptoms and improve the patient’s quality of life.

What are the survival rates for colorectal carcinoma?

• The five-year survival rate for adults is about 90% for stage I, 75% for stage II, 60% for stage III and less-than 10% for stage IV.
• The rarity of colon cancer in patients less than 20 years old makes it hard to figure survival rates.
• Most information suggests that younger patients often have stage III or IV disease by the time they are diagnosed.

Why choose St. Jude for your child’s colorectal carcinoma treatment?

• St. Jude is the only National Cancer Institute-designated Comprehensive Cancer Center devoted solely to children.
• St. Jude has created more clinical trials for cancer than any other children’s hospital in the United States.
• The nurse-to-patient ratio at St. Jude is unmatched— averaging 1:3 in hematology and oncology, and 1:1 in the Intensive Care Unit.
• St. Jude offers a dedicated team of specialists to meet the needs of children with colorectal carcinoma, including: surgeons; doctors and nurses who treat this cancer; doctors who specialize in pathology (making a correct diagnosis by looking at tumor tissue under the microscope) and in radiation therapy; experts in diagnostic imaging and nuclear medicine; genetic counselors; nutritionists; child life specialists; psychologists; researchers; scientists; and many others.
• Complete, quality surgery is an important part of treating colorectal carcinoma. The expert skills and experience of St. Jude specialty surgeons can help improve patients’ chances for best outcomes.
• St. Jude has access to new “experimental” medicines that can be used if the cancer comes back or becomes resistant to the initial treatment.