Colorectal Cancer Symptoms Screening and Treatment

Colorectal Cancer: Symptoms to Watch For, Screening, And Treatment

with FPG Colon & Rectal Surgeon Samir Agarwal, MD, FACS, FASCRS

Excluding skin cancer, colorectal cancer is the third most prevalent cancer for both men and women in America. And according to recent studies, it’s a disease that’s affecting more and more young people in their 30s and 40s. 

However, a concerning characteristic of colorectal cancer is its ability to appear without symptoms at all, says FPG colorectal surgeon Samir Agarwal, MD, FACS, FASCRS. “Because of that, colorectal cancer is sometimes called ‘The Silent Disease,’” he says. “Some even call it ‘The Silent Killer.’”

But while colorectal cancer is serious, it is also highly treatable if found early. For this reason, it’s very important to stay on top of recommended screening for colorectal cancer, which includes regular colonoscopies starting at age 45.

What Is Colorectal Cancer?

Simply speaking, colorectal cancer is cancer that begins in the colon or rectum, which, put together, form your large intestine. The colon makes up the bulk of the large intestine, while the rectum is the shorter section that connects the colon to the anus and is nestled within the bones of the pelvis.

Colorectal cancer typically begins as polyps within the large intestine. These grow on the inner lining of the colon or rectum and, over time, have the potential to become cancerous. The most common types of polyps, called Hyperplastic polyps and inflammatory polyps, are generally not pre-cancerous. What are called adenomas, however, can sometimes grow into cancer and are considered pre-cancerous.

Other than the type of polyp, the size (large) and quantity (more than three) can also indicate risk of cancer.

The goal is to find the polyp before it becomes cancerous—and definitely before any cancer can spread to neighboring blood vessels and lymph nodes—and safely remove it.

Reduce Your Risk

Here are a few easy ways to reduce your risk of colorectal cancer:

  1. Eat Well: Avoid high saturated fats and excessive amounts of red meat, and make sure to get enough fiber from fruits and vegetables. And try to maintain a healthy weight.
  2. Exercise regularly: It doesn’t have to be a hardcore workout, but get some exercise on a daily basis, if you can. Even a small walk goes a long way.
  3. Quit Smoking: Tobacco use increases the risk of multiple types of cancer, including colorectal cancer


When colorectal cancer is symptomatic, common symptoms include:

  • Rectal bleeding
  • Constipation
  • Pain with bowel movements
  • Weight loss
  • Change in bowel habits

But remember, colorectal cancer is also called “The Silent Disease” for a reason. Not having symptoms is no reason to skip recommended colonoscopies.

Some African Americans may even want to speak with their doctors about starting colonoscopies at age 40, says Dr. Agarwal, with recent data showing that African American populations “have a somewhat higher incidence of colorectal cancer.”


If a colonoscopy confirms a diagnosis of colorectal cancer, treatment options will vary depending on how advanced the cancer is. However, there are some typical steps taken and types of treatment available.

One of the first steps is always to check if the cancer has spread. This is often done via a CT scan. If the cancer has not spread, then a colorectal surgeon or surgical oncologist can often simply remove the cancer through surgery.

Because surgery often provides the opportunity for a more direct intervention, radiation therapy is not the most common way to treat colon cancer. However, it can be used to shrink a tumor before surgery, as a supplemental therapy during surgery, or to treat possible spread after. For rectal cancer, radiation therapy is much more common, as the anatomy and location can make surgery more difficult.

If the cancer is in its early stages and the polyp is small enough, it can be removed during the colonoscopy via what is called a polypectomy. This quick and simple procedure removes the tumor from the lining of the colon by using tools sent through the colonoscope, so the surgeon does not have to make any external incisions.

For more advanced cancers, colorectal surgeons perform what is called a resection, meaning an entire piece of the large intestine is removed, getting rid of any cancerous tissue and any surrounding blood vessels or lymph nodes that the cancer may have spread to. The remaining sections of the colon are then reconnected.

Many of these surgeries can now be performed minimally invasively, with robotic-assisted accuracy.

“It’s a fact that people have less pain, shorter hospital stays, quicker recoveries and just tend to do better,” says Dr. Agarwal. “As techniques become more advanced, it’s allowed patients to recover even more fully from colorectal cancer.”

And at the Brian D. Jellison Cancer Institute at Sarasota Memorial, colorectal surgeons are also specially trained in performing advanced resections that do not leave the patient with a colostomy, or what is commonly called a “colostomy bag.”

“It makes a difference,” says Dr. Agarwal.

Learn More

To hear more from Dr. Agarwal about the screening and treatment of colorectal cancers, check out our podcast.

Samir Agarwal, MD, FACS, FACRS is a triple board certified and fellowship trained colon and rectal surgeon with First Physicians Group. For more information or help with a referral for Dr. Agarwal, please call 941-262-1400.

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