About Colon Cancer

About Colon Cancer

At Penn Medicine's Abramson Cancer Center, patients with colon cancer receive their care from a multidisciplinary team of nationally recognized experts in the diagnosis, treatment and research of gastrointestinal cancer.

The colon is the largest part of the large intestine, also known as the large bowel. After food is chewed and swallowed, it travels through the stomach and small intestine where it is broken down and most of the nutrients absorbed. It then passes to the large intestine where water and nutrients are absorbed from the food and waste matter is stored. The colon's function is to change liquid waste into solid waste and prepare it to be expelled from the body through the anus.

Colon cancer is the third most common type of cancer in both men and women, and is the second leading cause of death from cancer in the United States. Colon cancer is cancer that forms in the lining tissues of the colon. Most colon tumors begin when normal tissue forms a polyp, or pre-cancerous growth projecting from the wall of the colon. As the polyp grows, a tumor forms. Because the tumor grows slowly, early detection is possible through screening and tests.

Colon cancer is often combined with rectal cancer and can be referred to as “colorectal cancer.”

Penn Medicine's multidisciplinary approach to cancer diagnosis and treatment provides better outcomes and gives patients access to the most advanced treatment, surgical techniques and clinical trials.

Because navigating a cancer diagnosis and treatment options can be difficult, patients who wish to connect with a cancer specialist at Penn Medicine can speak with a cancer nurse, who can help them make an appointment with the right physician.

To connect with a cancer nurse at Penn Medicine, patients should call 800-789-PENN (7366).

Colon Cancer Risk and Prevention

Most risk factors for colon cancer, like age and family history, cannot be prevented. Patients who feel they are at risk for developing cancer may benefit from consulting with a Penn Medicine GI genetics risk assessment specialist.

Colon Cancer Risk Factors

Risk factors affect the chance of getting colon cancer. Having a risk factor, or even several, does not mean that someone will get cancer.

Here are some risk factors for colon cancer.

  • Age. Most people diagnosed with colon cancer are age 50 or older.
  • Family history. Having family members with colon or rectal cancer can increase someone’s risk of developing the disease. Having a sibling, parent or child with colon cancer, or a history or the disease, makes a person two to three times more likely to develop colon cancer.
  • Hereditary conditions. Conditions such as familial adenomatous polypsis (FAP), Lynch syndrome, juvenile polyposis, MYH-associated polyposis, Peutz-Jeghers syndrome and Cowden syndrome may increase risk.
  • Other health conditions. Having inflammatory bowel disease (ulcerative colitis or Crohn’s disease) may increase someone’s risk of developing colon cancer.
  • Personal history. Someone who has had cancer of the colon, rectum, ovaries, endometrium is at an increased risk for developing colon cancer.
  • History of polyps. Having polyps in the colon may increase risk.
  • Being African American. African American men and women are diagnosed with and die from colorectal cancer at higher rates than men and women of any other ethnic group. The reason is not yet understood.
  • Lifestyle factors. Studies show that people who eat a diet high in fat and red meat, but low in vegetables and fruits may be at an increased risk for colon cancer. Also, smoking, obesity and excessive alcohol intake may also put someone at a higher risk.
  • Smoking. Smoking tobacco has been linked to an increased risk of colon cancer.

Colon Cancer Prevention

The best way to prevent colon cancer is to follow the colonoscopy guidelines. Removing polyps before they become cancerous can prevent the disease (see the detailed colonoscopy guideline for average- or high-risk population).

Most risk factors for colon cancer, like age and family history, cannot be avoided.
However, there are things people can do to minimize their risk of developing colon cancer.

Colon Cancer Risk Assessment

People with a personal or familial history of colorectal cancer, or those with conditions that put them at risk may benefit from consulting with a genetic counselor to determine their risk of developing colon cancer.

Younger patients who develop colon cancer usually have a family member or close relative who has a history of colon or rectal cancer.

These programs offer knowledge about the presence of genetic risk factors for cancer and provide patients with important, sometimes life-saving options.

Types of Colon Cancer

  • Adenocarcinoma
  • Carcinoid tumor


More than 95 percent of colon cancer is diagnosed as adenoncarcinoma. Adenocarcinomas are cancers that start in the glandular cells that make the mucus that lubricates the inside of the colon.

Carcinoid Tumor

Carcinoid tumors (may develop in other parts of digestive system) are tumors that start from specialized hormone-producing cells in the intestine. Carcinoid tumors are discussed in more depth under neuroendocrine tumors.

Colon Cancer Symptoms

Symptoms of colon cancer can look like symptoms of other conditions. Patients who experience any of these symptoms should contact their healthcare provider.

  • Bleeding from the rectum
  • Blood (bright red or very dark) in the stool or toilet after a bowel movement
  • A change, or narrowing of the stool
  • Cramping or pain in the abdomen
  • Feeling the need to have a bowel movement, but not having one
  • Excessive fatigue
  • Frequent gas, bloating or feeling of fullness
  • Weight loss for no known reason
  • Nausea and vomiting

Staging Colon Cancer

Staging systems provide doctors with a common language for describing tumors. After cancer is first diagnosed, a series of tests are used to investigate the extent of the cancer and to see whether it has spread to other parts of the body from where it started. Staging is a way of recording the depth, aggressiveness and growth of a cancer, and determining the plan for treatment. By understanding the stage of their cancer, patients can make informed decisions about their treatment.

Staging colon cancer attempts to discover the following:

  • The depth of the tumor
  • Whether the cancer has spread to nearby lymph nodes and tissues
  • Whether the cancer has spread to other parts of the body

Colon Cancer Treatment at Penn

After being diagnosed with colon cancer, patients at the Abramson Cancer Center may be evaluated through the Gastrointestinal Cancer Evaluation Center (GICEC). The center provides patients with expert support and evaluation to discuss treatment options and individualized treatment plans.

ADAM Image

Patients with pancreatic cancer are treated by a multidisciplinary team of cancer specialists who see more patients with gastrointestinal (GI) cancers in one year than many doctors see in their careers.

The physicians of Penn Medicine’s GI cancer program are nationally recognized for their expertise in the diagnosis and treatment of cancer.

Penn’s GI cancer treatment team includes:

  • Nationally recognized medical experts with years of experience in diagnosing and treating GI cancer (including gastroenterologists, surgeons and medical oncologists).
  • Nurses with advanced training and experience in caring for patients with GI cancer.
  • Oncology Navigation Specialists to help patients navigate the health system.
  • Registered dietitians to provide nutrition counseling.
  • Cancer counselors to provide individual or family counseling for issues many cancer patients face.
  • Rehabilitation therapists who specialize in the diagnosis and treatment of physical effects from cancer and its treatment.

Oncology Navigation Specialists

Every step of cancer treatment – from cancer diagnosis, to surgery and treatment to forming a survivorship plan – comes with different needs and issues that should be addressed.

Oncology Navigation Specialists at the Abramson Cancer Center are available to make a patient’s experience as seamless as possible. As experts in navigating complex health care situations, patient support specialists serve as a consistent point of contact and a reliable source for advice, support and direction for patients and families. They can help in a variety of ways including; provide emotional support, identify resources, and ensure access to information, support services, educational programs and community resources.

Learn more about Patient Navigation specialists at the Abramson Cancer Center.

Diagnosing Colon Cancer

An accurate cancer diagnosis from trusted cancer specialists is the first step in getting personalized treatment options to treat colon cancer.

Patients who choose Penn’s Abramson Cancer Center benefit from a multidisciplinary team of cancer specialists including gastroenterologists, radiologists, pathologists and surgeons who work together to provide a diagnosis and joined by radiation oncologists and medical oncologists to develop an appropriate treatment plan customized for each patient with colon cancer.

Cancer specialists at Penn Medicine are highly experienced in using the most advanced techniques for diagnosing colon cancer and are actively researching better and more precise ways to detect colon cancer.

Navigating a cancer diagnosis and treatment options can be difficult, patients who wish to connect with a cancer specialist at Penn Medicine can speak with a cancer nurse, who can help them make an appointment with the right person. Penn Medicine’s contact center has experienced cancer nurses available and ready to guide patients in finding the cancer specialist right for them.

To connect with a cancer nurse at Penn Medicine, patients should call 800-789-PENN (7366).

Read more Diagnosing Colon Cancer

Colon Cancer Treatment

Following the diagnosis and staging of colon cancer, cancer specialists at Penn Medicine’s Abramson Cancer Center develop a personalized treatment plan. Penn’s treatment options for colon cancer include:

  • Surgery
    • Segmented colon resection
    • Local excision
    • Resection of limited metastatic disease
  • Radiation therapy
    • 3-D conformal radiation
    • Intensity-modulated radiation therapy (IMRT)
    • Volumetric-modulated arc therapy (VMAT)
    • Proton therapy
  • Chemotherapy and biologic therapies
    • Chemotherapy (alone or combined with monoclonal antibody therapy)
    • Liver-directed therapies
    • Monoclonal antibody therapy
  • Clinical trials
  • Other treatments
    • Integrative medicine and wellness
    • Palliative care
    • Penn Home Care and Hospice

Because navigating a cancer diagnosis and treatment options can be difficult, patients who wish to connect with a cancer specialist at Penn Medicine can speak with a cancer nurse, who can help them make an appointment with the right person.

To connect with a cancer nurse at Penn Medicine, patients should call 1-800-789-PENN (7366).

Read more Colon Cancer Treatment

Colon Cancer Survivorship

Survivorship programs at Penn Medicine are a distinct phase of colon cancer care and are designed to help patients' transition from their cancer treatment routine to a post-cancer care lifestyle. There are more than 12 million cancer survivors living and thriving today as a result of advances in cancer treatment. However, cancer treatments can result in physical, emotional and financial complications long after the therapy is complete.

Read more Colon Cancer Survivorship

Stand Up to Cancer

Peter O'Dwyer, MD, professor of Hematology-Oncology and program director of Development Therapeutics in the Abramson Cancer Center, was interviewed on NBC10's 10! Show about Penn's work as part of the Stand Up to Cancer Dream Team... Read more

Clinical Trials

Colorectal Cancer Trials

Phase III Randomized Trial of the Role of Whole Brain Radiation Therapy in Addition to Radiosurgery... more