Jefferson University Hospitals

Frequently Asked Questions

Is surgery the only treatment needed?

When a polyp is removed by colonoscopy, it is usually the only treatment needed.

For colorectal cancer, surgery is the normal treatment and is often the only treatment needed when the cancer is detected early. In some cases, your specialist can remove the cancer using colonoscopy. Often, an open surgical procedure will be required. Treatment may also include radiation therapy before, during or after surgery; chemotherapy after surgery; or immunotherapy to strengthen the body’s immune system so it can attack and destroy cancer cells. These cancer treatments may be given separately or in combination. Your doctor will recommend the treatment methods best for you, depending on the size of the tumor, the stage of malignancy and whether it has metastasized, or spread, as well as other factors.

If I have colorectal cancer, will I have to have a colostomy?

Usually not. Surgeons can almost always treat colon cancer by removing the cancerous part of the colon and joining the remaining two ends together. Other times, a procedure called a colostomy may be needed. In this surgery, the cancerous part of the bowel is removed, after which the surgeon creates an artificial opening in the abdomen, bypassing the lower colon and rectum for the elimination of body waste. The waste is collected in a special bag attached to the opening.

Usually, a colostomy is only temporary, to give your bowel time to heal. In fact, thanks to new medical and surgical developments in recent years, the need for permanent colostomies has been significantly reduced. Today, even patients with rectal cancer, whose only choice in the past was usually a permanent colostomy, have other options. Preoperative radiation therapy and innovative surgical techniques can treat cancer in the lower rectum without jeopardizing the natural function of the muscles that control bowel habits, thereby dramatically reducing the likelihood of needing a colostomy.

Will I have to come back after treatment?

Once you have been treated for polyps or, especially, colorectal cancer or its precursors, you must remain vigilant. Your doctor will want to use blood tests, as well as other screening tests described above, to watch for any reoccurrence, suspicious areas or warning signs of any additional cancer.

What are polyps?

Colon cancer is believed to begin as a small growth called a polyp. The colon, also known as the large intestine, has several continuous areas, and the lowest portion is called the rectum. Colorectal polyps are bumps or growths on the inside lining of the colon or rectum. Most colorectal cancer develops in or at the site of polyps. Since 90 to 95 percent of all colon cancers stem from polyps, removing them helps to prevent cancer.

What does it mean if polyps are found in your colon?

There are two types of benign polyps that are related to colon cancer.

  • Hyperplastic polyps are usually very small and were formerly thought to not increase the risk of cancer. Now there is evidence to show that there is an increased risk of cancer if a patient has more than 30 hyperplastic polyps at the initial exam.
  • If the polyps found are adenomas, there is an associated risk of colon cancer, and these patients need to be screened at least every five years because they are definitely at risk for forming new polyps, and it is imperative that repeat colonoscopy be done on a regular basis.

According to the statistics about 75 percent of cases occur in patients who have no predisposing risk factors.

If your doctor finds a small polyp, he or she will usually remove it, often in the same endoscopic exam. Even if the polyp does not appear cancerous, it may become cancerous; therefore, it is normally taken out. The Hospital’s lab will examine the polyp to see if it has any areas indicating cancer.

If your doctor sees a large polyp, tumor or other abnormality, the first step may be a biopsy. The specialist takes out a small piece of tissue through the colonoscope. Examining the tissue helps determine if the area is cancerous or benign, or the result of inflammation.

Your medical team may use a follow-up colonoscopy procedure to remove small, limited areas of precancerous or early- cancerous tissue or discrete tumor. For more significant or established cancer (higher-stage cancer), abdominal surgery may be necessary.

Do I need a second opinion?

Polyp removal is a widely accepted preventive step; however, treatment decisions for actual colorectal cancer can be more complex. Before starting such treatment, patients might want another doctor to review the diagnosis and the treatment plan. Here are ways to find another doctor for a second opinion:

  • Patients can call the Jefferson Cancer Network at 1-800-JEFF-NOW.
  • Ask your doctor to suggest a specialist.
  • Contact a local medical society, nearby hospital or medical school.

Are polyps common?

Colon polyps are common. Studies suggest that at least 30 percent of middle-aged people in the U.S. have colon polyps and others quote findings up to 50 percent of people over 60 years of age.

The risk of developing colon cancer is increased by the size and number of polyps found at the initial exam and following exams. If a polyp is larger than 1 centimeter, there is a greater risk that it contains cancer cells.