Duke’s colon cancer specialists use the latest medical and surgical advances to find and treat colon cancer at the earliest possible stage. We have the advanced training and expertise needed to perform complex sphincter-sparing procedures that remove colorectal cancer while reducing your chance of needing a permanent colostomy bag to collect the waste that leaves your body. We give you the personalized care you need to maximize your quality of life and your colon health.
Medical advances in colon cancer
If you or someone you know is concerned about colon cancer, you need a healthcare team that uses the most effective techniques and treatments, and minimizes the chances that you will need a permanent colostomy.
As a National Cancer Institute-designated Comprehensive Cancer Center, our colorectal cancer physicians and surgeons work closely with colorectal cancer patients every day. They are experts in identifying colon cancer tumors, and lead the nation in testing new approaches in clinical trials, including the development of the targeted therapy Avastin, which shrinks tumors and extends survival in patients when colorectal cancer has spread. We continue to test new therapies in clinical trials, and explore genomics, which studies genes, how they function, and their impact on health, so we can provide you with more personalized treatment options.
Choose Duke for your colon cancer treatment because we offer:
- High-definition colonoscopy. We routinely use high-resolution colonoscopy imaging to create clearer images that offer better detection of polyps and cancer not seen with standard colonoscopy.
- One-day evaluation. As a first-time patient here, you will undergo a thorough, day-long evaluation and consultation. You will leave with a comprehensive treatment plan that meets your needs. We can expedite the process even further if you bring blood, scans, and test results with you that were performed prior to your visit. If you need additional imaging or testing, the services are conveniently within our facilities.
- Nationally ranked cancer program. We are consistently ranked among the best cancer programs in the nation by U.S. News & World Report.
- Comforting environment. Our Duke Cancer Center features spacious waiting areas, a Quiet Room, large infusion rooms, and a rooftop garden area where patients — based on their treatment regimen — can receive chemotherapy outdoors.
- Access our clinical trials. You may be eligible to participate in our ongoing colorectal cancer clinical trials. These trials give you access to new anti-cancer targeted therapies, new surgical approaches, and ways to minimize common cancer-related symptoms before they become widely available.
- Enhanced recovery reduces hospital stays and readmissions. Our physicians are national leaders in enhanced recovery, a program that minimizes pre-operative fasting, encourages immediate post-operative physical rehabilitation, and incorporates specialized pain management to reduce the stress of colon surgery. Duke research shows their enhanced recovery approach decreases post-operative complication rates, and reduces the length of hospital stays.
- More minimally invasive options. Nearly 80 percent of surgeries are performed with a laparoscope, which is inserted into the body through small incisions. This less invasive method is used to identify and sometimes remove tumors. As a result, you’ll experience smaller wounds, less pain and scarring, and lower incidence of infection. You will leave the hospital sooner, and recover faster.
- A team of specialists. Our board-certified colon cancer specialists — medical, radiation and surgical oncologists, gastroenterologists, radiologists, pathologists, geneticists, specially trained nurses, nutritionists and social workers — meet regularly to discuss your care, collect opinions, and offer coordinated and advanced surgical, medical and follow-up care.
- Hereditary colorectal cancer clinic. If you are at high risk for, or have a family history of colon cancer, you can work with the genetic counselors in our hereditary cancer clinic to determine and reduce your risk.
- Support for you and your family. Our comprehensive support services range from helping patients minimize side effects to coping with the emotional and psychological effects of diagnosis and treatment.
Surgery is the most common treatment for colon cancer. The type of surgery depends on the location and size of the tumor, and whether cancer has spread. Whenever possible, our surgeons use a minimally invasive surgical approach that results in less scarring, reduced pain and infection risk, shorter hospital stays and quicker recovery. As a result of our extensive training and expertise, we can perform surgeries that minimize the need for a permanent colostomy. Surgical procedures may include:
- Polypectomy. Removes polyps during colonoscopy. We are one of only a handful of sites in the nation evaluating the use of robots during colonoscopy to determine if it improves outcomes and results in better sexual function post-surgery.
- Partial colectomy or total abdominal colectomy. Removes the area of the colon where the cancer is, as well as surrounding tissue. If appropriate, lymph nodes may be removed to determine if cancer has spread. A total abdominal colectomy may be performed in patients with cancers that run in their families, multiple polyps, or a cancer recurrence.
Performed by a gastroenterologist on less invasive cancers and large polyps (adenomas) which have not been identified as cancer. The mass is removed through a colonoscope which is inserted in the colon. An electrified needle cuts and removes the suspicious area and surrounding tissue.
When a tumor is creating a blockage, a gastroenterologist may insert an expanding metal scaffolding device, called a stent, through a small, lighted endoscope, to clear the blockage.
Slows or kills tumor growth. Sometimes recommended after surgery if recurrence risk is high, and if cancer has spread to lymph nodes or beyond.
Our doctors lead the nation in testing new drugs for colon cancer through clinical trials, including the development of bevacizumab (Avastin). These intravenous (IV) drugs work on certain colon cancers by targeting a protein called vascular endothelial growth factor (VEGF), and cutting off the supply of blood and nutrients that let tumors continue to grow and survive. You may also participate in clinical trials studying additional targeted therapies for colon cancer.
Finding colon cancer early and obtaining an accurate diagnosis are key to your healthy outcome. Several methods are used to detect and diagnose colon cancers.
A physical exam during which your physician will check for abnormal growths.
Detecting colon cancer requires a combination of stool tests, which look for blood in the stool. Blood tests look for certain proteins once cancer has been diagnosed.
A camera at the tip of a flexible plastic tubing is inserted in the rectum to evaluate the lower part the colon.
A longer version of sigmoidoscopy that lets doctors view the entire colon. Learn more about colonoscopy at Duke.
The lower part of the colon is coated with barium liquid, then drained and filled with air. This makes the area visible on X-rays so doctors can look for cancer and other abnormalities.
PET, MRI and CT colonography — also known as virtual colonoscopy — may also be used to look at the tissue and lining inside the colon.