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Article Category: Highlights

What to Know When You Are Diagnosed with Colorectal Cancer

Published on March 14, 2024

Last updated 09:05 AM March 26, 2025

Like the man in this image, it's normal to be too shocked to ask questions when diagnosed with colorectal cancer. Get answers from experts here.

More young adults—people in their 30s and 40s—are being diagnosed with colorectal cancer. 

“I was in absolute shock,” said Samantha McInturff, a mother of two school-age children when she was diagnosed with stage 4 colon cancer at 48. “I was stunned. I probably didn’t ask enough questions.”

Like Samantha, patients don’t always think to ask questions on the spot. But questions come up once they’ve had a little time to process the news. That’s why we brought together a panel of gastrointestinal health experts and a colon cancer survivor to answer the questions you may have here. 

 
 Image of colorectal cancer experts and patients including Samantha McInturff, colon cancer survivor; Nancy Page, Wellstar oncology nurse navigator; Dr. Sahir Shroff, Wellstar surgical oncologist; and Dr. Shani Clay, Wellstar gastroenterologist.

Colorectal cancer staging

What stage is my cancer and how will that affect my treatment plan?

Dr. Sahir Shroff, surgical oncologist: The staging of the cancer is a way to evaluate if the cancer is localized or if it has spread. It involves multiple imaging studies and blood tests. 

For colon cancer, we mostly use CT scans of the chest, abdomen and pelvis with contrast. Sometimes we do a PET scan. CT scan results typically are in within a week of having the scan. For rectal cancer, the staging is a little more involved. We also do an MRI of the rectum itself to delineate the exact location and relationship of the tumor with related structures in the pelvis. Clear identification really helps us evaluate the best treatment for each patient. 

The other part of staging is looking for a tumor biomarker called carcinoembryonic antigen—or CEA—a protein in the blood. Patients excrete excess amounts of CEA if they have colorectal cancer. Checking the CEA throughout treatment is a benchmark to see if the treatments are working. We typically have bloodwork results within a few hours.

If a patient has surgery, we send tissue removed during the operation to be analyzed and tell us a more accurate stage to determine the next phase of treatment. 

Colorectal cancer treatment

What are my treatment options? 

Dr. Shroff: Treatment of colorectal cancer is an evolving field. There have been so many changes around the most effective combinations of chemotherapy, immunotherapy, cancer surgery and radiation oncology. Recently, a non-operative treatment option has become available for patients with an excellent response to chemotherapy.

At Wellstar, we give patients access to the most comprehensive care for colorectal cancer, which includes genetic testing, clinical trials and the highest level of complex surgical procedures. Our specialists work collaboratively and follow the latest evidence-based practices. Everything we do is geared toward giving patients the most personalized care.

The types of treatment and the order of the different treatments vary depending on the type of cancer—rectal cancer or colon cancer—and personal factors such as the stage and location of the cancer. 

Dr. Shani Clay, gastroenterologist: Patients can bring their family members in to accompany them at the time of their visits so that everyone has a good understanding of the treatment plan. 

Nancy Page, RN, oncology nurse navigator: We have national accreditation for rectal cancer, which is huge for patients. Through our rectal tumor board, they’re getting expert, evidence-based care for rectal cancer and state-of-the-art treatments.

Dr. Shroff: Yes, the NAPRC accreditation is excellent—it’s changed how we manage rectal cancer. Every patient is reviewed by a multidisciplinary team regardless of the stage. Decisions are made about treatment by a team of experts.

Listen to your doctor and ask a lot of questions. There are no bad questions. Lean on your support system of friends and family. In the beginning, it’s a scary process as you’re going through treatment and you have new symptoms. If you’re the type to blame yourself, don’t. When I was diagnosed, I thought, “What did I do to cause this?” I now know cancer can happen to anybody.

- Samantha McInturff

Colorectal cancer survivor

How long will I stay in the hospital after surgery?

Dr. Shroff: A patient with colon cancer that has not spread will typically have an operation to remove the cancer. The colon is removed, the cancerous portion is taken out and then the colon is reconnected. The patient will spend around three days in the hospital and three weeks recovering before they get back to their regular activities.

Patients who have surgery for rectal cancer typically spend three to five days in the hospital, and recovery is approximately four weeks.

How long will I go through cancer treatment?

Dr. Shroff: Depending on the regimen used, chemotherapy could last three to six months. And someone who is a candidate for non-operative treatment will need close monitoring for three years, the time when the cancer is most likely to come back.

For some patients, there is an additional layer of treatment called radiation therapy. Radiation could shrink the tumor and reduce the risk of it coming back. Usually, the radiation treatment for rectal cancer is Monday through Friday for just over five weeks.

Nancy: Usually, the time of cancer treatment for rectal cancer is, give or take, around nine months. Each patient is evaluated by the NAPRC multidisciplinary team and a precise plan of care is given for each patient based on their tumor size and other factors. It’s not a cookie-cutter plan, but based on the individual needs of the patient. 

What can I eat?

Nancy: When patients are initially being treated for rectal cancer with chemoradiation, we want them to be on a low-residue diet and then again after their surgery. The low residue diet makes it easier for the patient to digest the food and then be able to pass the stool with less discomfort or pain. The diet limits high-fiber foods, like whole-grain breads and cereals, nuts, seeds, raw or dried fruits and vegetables.

We generally recommend a balanced diet. Proteins like chicken and turkey. Fresh fruits, vegetables, soups, pudding and protein shakes. Because of chemotherapy side effects, some people get a bad taste in their mouth, so they don’t like to eat. We don’t want you to lose weight, so if it comes down to it, eat what you can eat! People say cancer feeds off sugar—that’s the biggest myth there ever was. If you can’t get anything down except a bowl of ice cream, go for it.

Hydration—drinking 64 oz. of water per day—is so important while you’re on chemo. Caffeine needs to be limited, and herbal tea is typically fine, but it should be cleared with your medical oncologist.

What can I do to have the best outcomes?

Samantha: Listen to your doctor and ask a lot of questions. There are no bad questions. Lean on your support system of friends and family. In the beginning, it’s a scary process as you’re going through treatment and you have new symptoms. 

If you’re the type to blame yourself, don’t. When I was diagnosed, I thought, “What did I do to cause this?” I now know cancer can happen to anybody. Cancer does not discriminate. 

My sons did well because they had watched my sister walk through cancer treatment and she was okay, so they believed I would be okay. We tried to keep things more positive for them. 

Dr. Clay: It is important, regardless of the treatment plan selected, for patients and families to maintain a positive attitude while going through the journey. Cancer treatment can be difficult and stressful, and a positive attitude can help patients have a better quality of life throughout treatment.

Nancy: So many things are coming into play and your life is changing. Just remember it’s not the rest of your life. It’s temporary. For a while, your life is going to be different. You’re going to be going to doctors more than ever before. It’s mentally taxing. I love the Colorectal Cancer Alliance. They have wonderful information and online support groups for patients, caregivers and family members. That’s really huge.

Should I limit my activity so I get more rest?

Nancy: Get the proper amount of rest, but you should also exercise. You need to be up and mobile to avoid muscle waste and blood clots or pneumonia. Walk at least 30 minutes a day. If you’re home and sedentary, walk at least 10 minutes a day. 

I’m overwhelmed. What do I say to family and friends when they offer to help?

Samantha: Psychologically, it’s quite a blow when you’re diagnosed. Everyone’s different in how they want to communicate their cancer to others and that’s okay. Some people want to be quiet. Some people want to tell the world. I went public because one, I believe in the power of prayer, and two, it’s important to be screened and I wanted to spread the word.

Accept help when it’s offered. It felt fragile at first but now I’m an old pro! As to what family and friends can do, ask them to be there to listen and provide comfort. To provide meals or give cards. I remember when the men in our small group from church came and got our yard ready for the season. Our small group also came and prayed for me. Allow people to be there, rally and support you and help you stay positive and hopeful. 

Nancy: Stop depending on yourself to do everything. You must depend on your network. Lean on family and friends so you have someone to talk to, to help with food and rides. I worked with a single man who had no family locally and didn’t know who would help him. Once he shared his diagnosis with his colleagues, he learned he had a safety net of people who loved him. They set up a meal train and transportation. And his sister came in from out of town to support him for several weeks. It was a huge lift to his heart, and he was filled with gratitude.

Life after colorectal cancer

Can I get cancer again?

Nancy: Unfortunately, cancer can come back. After treatment, it’s important to continue to follow up with your doctors as directed for what is called surveillance. That’s where you go back to your medical oncologist every three months for a year and it tapers down over time. They draw blood and do imaging to make sure everything’s fine. If the cancer does come back, it can be caught earlier through surveillance and treatment can start faster.

Will my bathroom habits change?

Dr. Shroff: Some patients may have a higher frequency of bowel movements after rectal cancer surgery, but that doesn’t happen to everybody. 

Do I need to change things about my lifestyle, like what I eat and which vitamins I take? 

Dr. Shroff: You’ll have to change your diet before surgery, such as adding amino acid shakes. You’ll continue that for a little while after surgery because it helps the body to heal better. Once recovered and on a regular diet, you’ll have no restrictions. You can get back to exercising and a normal diet that is rich in fiber and low in red meat. 

Dr. Clay: Patients should eat healthy diets that are high in fiber and low in red meat, if not already doing so, and should quit any tobacco use. Unfortunately, there is no specific vitamin or supplement that has been shown to cure colon cancer, despite what may be out there on social media channels. Following your doctor’s advice is key.

Face cancer with confidence
At Wellstar, people with colon cancer have highly coordinated and collaborative care—close to home. Our multidisciplinary team offers the most advanced diagnostics, treatments and clinical trials. If you’re looking for a cancer expert at Wellstar or need a second opinion, call 1 (877) 366-6032 or find a colorectal cancer specialist near you.


Encourage someone you love to get screened
Wellstar offers colorectal cancer screening to save lives. When physicians find pre-cancerous polyps during a colonoscopy, it prevents cancer from developing. Learn more about screening for colorectal cancer or schedule a screening.

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Wellstar Kennestone Regional Medical Center has earned another three-year accreditation from the National Accreditation Program for Rectal Cancer (NAPRC), a quality program of the American College of Surgeons. This accreditation demonstrates our commitment to providing personalized, high-quality cancer care close to home for patients in Georgia.

To achieve voluntary NAPRC accreditation, a rectal center must demonstrate compliance with the NAPRC standards addressing program management, clinical services and quality improvement for patients. Centers are required to establish a multidisciplinary rectal cancer team that includes clinical representatives from surgery, pathology, radiology, radiation oncology and medical oncology.

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Additionally, the program at Wellstar Kennestone met standards addressing the clinical services that the rectal cancer program provides, including Carcinoembryonic Antigen (CEA testing), Magnetic Resonance Imaging (MRI) and Computerized Tomography (CT) imaging for cancer staging, which allow patients to start treatment within a defined timeframe. Rectal cancer programs accredited by the NAPRC undergo a site visit every three years and are also accredited by the American College of Surgeons Commission on Cancer.  

“Our patients are surrounded by a team of experienced rectal cancer experts who provide the highest level of personalized care,” said Wellstar Surgical Oncologist Dr. Sahir Shroff, who serves as the rectal cancer program chair.  “We are proud to be the first medical center in metro Atlanta to receive this important accreditation. Our pioneering efforts to adhere to the most rigorous standards and combine the latest technologies and techniques help us achieve excellence in rectal cancer care for our patients.”

Accreditation by the NAPRC is granted only to those programs that are committed to providing the best possible care to patients with rectal cancer. The NAPRC provides the structure and resources to develop and operate a high-quality rectal center. Accredited programs follow a model for organizing and managing a rectal center to ensure multidisciplinary, integrated, comprehensive rectal cancer services. Wellstar Kennestone earned its first accreditation in 2022.

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Highlights

Wellstar Offers Advanced Colorectal Cancer Care Close to Home

When a Wellstar patient is diagnosed with colorectal cancer, their multidisciplinary care team works with them to create a personalized care plan with advanced treatment available at every step. 

Support from the start

Patients are surrounded by a team of experts from the very beginning of their cancer care. To better prepare patients for treatment, Wellstar offers a “pre-hab” program with support services to care for patients’ overall well-being.

“Patients often ask what they can eat or do to prepare for treatment, and we want them to feel empowered,” said Wellstar Surgical Oncologist Dr. Sahir Shroff.

Patients can meet with team members including dietitians, physical therapists or behavioral healthcare providers so they feel their best both physically and mentally.

Learn more about cancer support services. 

Innovative care options

Robotic surgeries provide patients with benefits like less recovery pain, less blood loss, fewer complications and shorter hospital stays, or for some outpatient procedures, no hospital stay at all. That means patients can start living cancer-free sooner and get back to their routines and the activities they enjoy. 

About 85% of colorectal cancer surgeries at Wellstar are now robotic procedures, according to Wellstar Surgical Oncologist Dr. Sartaj Sanghera. 

“Robotic surgery has really provided us the tools as far as the instruments and vision so that a larger cohort of surgeons in general, colorectal surgeons and surgical oncologists have been able to adopt the technology,” Dr. Sanghera said.

Patients with smaller, early-stage tumors may be candidates for transanal minimally invasive surgery, known as TAMIS. Rather than making an incision in the abdomen to remove a tumor, the surgeon is able to access the tumor through the anus.

“It is working through a natural orifice, through the anus. It’s not actually poking a hole in the belly,” Dr. Sanghera said. “It’s really minimally invasive.”

TAMIS is usually offered as an outpatient surgery with no hospital stay. It has been especially helpful in treating patients who may be at higher risk with traditional surgery due to their age or other health conditions, Dr. Sanghera noted.

Clinicians also adapt treatment methods based on the location of the cancer, according to Dr. Shroff. For example, if one spot is near a blood vessel, the care team may opt to use radiation rather than surgery to prevent blood loss.

New approach to treatment improves outcomes

The colorectal cancer experts at Wellstar have adopted a relatively new approach to treatment called total neoadjuvant therapy, or TNT, which makes surgery the last step in the cancer treatment process. Patients receive chemotherapy and radiation first, then finish treatment with surgery.

“Recognizing that rectal cancer is a systemic disease, with risks of spreading to other parts of the body, we have evolved in our management of rectal cancer, offering an operation as the last step in the treatment process,” Dr. Shroff said.

Wellstar has seen positive results with this technique.

“We have adopted that approach for nearly all patients now,” said Wellstar Hematologist and Oncologist Dr. John French. “We are seeing that if you do that approach, it’s safe, more patients are able to complete all the therapy lines, and we are noticing an increase in pathologic complete response rates.”

Pathologic complete response describes the absence of any detectable cancer cells in a tissue sample following a particular treatment. It refers to the absence of cancer cells in the area of the body where the tumor was originally located, as well as anywhere the cancer may have spread.

Nonoperative care

Some patients at Wellstar don’t require surgery at all.

“There have been recent studies of a subgroup of patients who are treated pre-surgery through chemotherapy, immunotherapy and radiation and they are seeing great responses,” Dr. Shroff said.

The care team continues to monitor these patients for any signs of cancer.

“We're excited to offer this different pathway for patients,” Dr. Shroff said.

Immunotherapy

Immunotherapy is based on the concept that a patient’s own immune system can fight their cancer.

When given, immunotherapy drugs wake up the patient’s own immune system to recognize and fight the cancer. People with colorectal cancer are screened for four proteins that help with DNA repair. If these proteins are missing or mutated, the patient is more likely to respond to immunotherapy.

While immunotherapy has been groundbreaking in the treatment of stage 4 colorectal cancer, only about 15% of patients are found to be eligible for the treatment based on their protein screenings, Dr. French noted. 

If you are interested in immunotherapy, ask your clinician about your care options.

Top-of-the-line rectal cancer care

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