As a primary care physician, I prescribe Cologuard all the time for colon cancer screening. I prefer patients to get a colonoscopy, but if they won’t, then I ask them to do a Cologuard test. Cologuard is an at-home test that requires the patient to collect a sample of stool to send back to a lab for testing. The sample is analyzed for DNA mutations and blood, which can indicate colon cancer. Because I wanted to see what my patients went through using the test, I decided to use the kit myself.
At the time I was 47, a little past the newly recommended screening age of 45. I followed the instructions for collecting and preserving the sample and scheduled the pick-up to send it to the lab.
The results came back positive.
My first thought was that it was a false positive, or at worst, a small polyp. I had no symptoms, no family history; I don’t smoke, drink alcohol, or eat much red meat, which are common risk factors.
The next step was to get a colonoscopy.
I woke up after the test to the news that the GI doctor had removed three polyps, but he was concerned about another spot that he was unable to fully retrieve due to its size and other concerning factors. I needed to see a colorectal surgeon.
I’m just one of thousands of people who face the realities of colorectal cancer each year. Within recent years the age of diagnosis has dropped. More and more young people are getting the disease, and some are not lucky enough to catch it before it is too late.
The good news, however, is that, when caught early, survival rates are good.
Colon cancer usually develops slowly. It starts with polyps, which may grow quietly with no symptoms at all. While many are harmless, others can turn into cancer over time. Because this change happens gradually, screening — especially colonoscopy — is one of the best ways to detect polyps early, when they can be removed before they turn into cancer. A colonoscopy enables the doctor to find polyps and remove them immediately, preventing cancer from starting.
What is colorectal cancer?
Colorectal cancer starts when cells in the colon or rectum grow out of control, turning into small growths called polyps. Depending on the type of mutation in the tissue, polyps can take anywhere from three to 10 years to transform into cancer. This gives medical professionals the opportunity to screen patients early and prevent further polyp growth. According to the United States Preventive Services Task Force, people with an average risk of developing colon cancer should start screening for it around age 45.
The best screening method is a colonoscopy, done by a digestive disease specialist called a gastroenterologist, or GI doctor. During a colonoscopy the GI doctor inserts a long, flexible tube with a light and camera on the end into the rectum and colon while the patient is sedated. This allows the doctor to view the lining of the colon on a monitor to look for any polyps or other abnormalities. To help create as clear a picture of the colon as possible, patients are required to “prep” the day prior to the test, drinking only fluids and using a strong laxative to clean the colon completely. The most common complaint I hear is that people do not like the prep. Trust me when I tell you, I understand that. You know what is worse than the prep, though? Colon cancer.
Some patients would rather do a Cologuard test. -Again, however, nothing compares to direct visualization, so colonoscopy should be done if possible.
What are the treatments for colon cancer?
Treatment for colon cancer depends on the stage of the cancer, the overall health of the patient, and whether the disease has spread. Though the first step for me was surgery, many patients receive a combination of therapies to remove tumors, prevent recurrence, or manage advanced disease.
Here are the treatments for colon cancer:
Surgery
Surgery is the most common, and often first‑line treatment for colon cancer that has not spread. Surgeons remove the section of the colon containing the tumor along with nearby lymph nodes. Minimally invasive approaches, including laparoscopic and robotic surgery, can reduce recovery time while preserving quality of life.
For localized cancers (Stage I–III), surgery alone may be enough, though some patients need additional therapy depending on the tumor. [mdanderson.org] [cancer.gov]
Chemotherapy
Chemotherapy uses drugs that kill rapidly dividing cells and is commonly used:
- After surgery to eliminate remaining cancer cells (adjuvant therapy)
- Before surgery to shrink tumors (neoadjuvant therapy)
- For metastatic colon cancer to slow disease progression
Radiation therapy
This therapy uses high‑energy beams to destroy cancer cells. It is more commonly used in rectal cancer but may be appropriate for other gastrointestinal tract colon cancers, especially when tumors cannot be fully removed surgically, or to relieve symptoms. It may be combined with chemotherapy. [mdanderson.org]
Targeted therapy
Targeted therapies work by attacking specific molecules that cancer cells rely on to grow or spread. They often have fewer side effects than traditional chemotherapy. Targeted therapies are especially important for metastatic colorectal cancer and are often tailored based on tumor genetic testing. [mdpi.com]
Immunotherapy
Immunotherapy helps the body’s immune system recognize and attack cancer cells. There are newer approaches being developed that show promise for treating advanced or treatment-resistant colorectal cancers. [link.springer.com]
Ablation and other local treatments
For some cancers that have spread to places like the liver or lungs, doctors may use special treatments to destroy the tumors. These include:
- Radiofrequency or microwave ablation: Heat is used to kill the cancer cells.
- Cryotherapy: Cold is used to freeze and destroy the cancer cells.
- Embolization: Medicine or tiny particles are placed into a blood vessel to block blood flow to the tumor, which helps shrink or kill it. [mdanderson.org]
Clinical trials and emerging therapies
Leading cancer centers continue to develop new treatments, including:
- New targeted drugs: Medicines that focus on specific cancer cells.
- Combination immunotherapies: Treatments that help your immune system fight cancer using more than one method.
- Personalized treatments: Care that is designed to match the cancer’s unique genes and how it grows.
These advances strive to improve survival while reducing side effects. [mskcc.org]
The recommended treatment in my situation was surgery. Due to the location, size, and tissue traits of my lesion, the surgeon and I decided on a right hemicolectomy, a type of colon surgery where the right side of the colon is removed. Along with 13 inches of colon, which included the lesion, the surgeon removed 14 lymph nodes. Thankfully, further testing revealed that all 14 nodes were negative for cancer cells.
What the symptoms can look like
Colorectal cancer doesn’t cause symptoms early on, but when it does, people often notice changes in digestion or bathroom habits. Some find themselves dealing with diarrhea or constipation that doesn’t improve. Others notice stools becoming narrower or feeling like they still need to use the bathroom even after going.
There can also be visible changes in stool, such as blood that appears bright red or very dark. Stomach discomfort, cramping, bloating or mucus in the stool may also happen. Beyond digestive issues, some people feel unusually tired, lose weight without trying, develop anemia or start feeling full faster than usual. These symptoms don’t automatically mean cancer, but if they continue for several weeks, it’s important to get checked.
Is colorectal cancer rare in women?
There’s a common belief that colorectal cancer mainly affects men. While men are diagnosed more frequently, women are still very much at risk. According to 2026 American Cancer Society projections, about 55,410 men and 53,450 women will be diagnosed with colon cancer, while 28,750 men and 21,240 women will be diagnosed with rectal cancer. [theworlddata.com]
This means that even though women have slightly lower rates, colorectal cancer remains one of the most commonly diagnosed cancers in women overall. It shouldn’t be dismissed as a “male” disease. Women also benefit from early detection and preventive screening.
Risk factors for colorectal cancer
Age: Historically most cases of colorectal cancer occur after 50 As I can attest, however, younger adults have been increasingly diagnosed in recent years.
Family history: When a close relative has or had colorectal cancer, the chances of developing it rise. Genetics can increase risk dramatically, especially for people with inherited syndromes like Lynch syndrome. There are genetic tests available that can help guide treatment if someone has a family history of colorectal cancer.
Lifestyle and health habits: Eating a lot of red or processed meat, not getting enough fiber, smoking, heavy drinking and lack of exercise may all increase risk. Conditions such as type 2 diabetes, obesity, Crohn’s disease and ulcerative colitis add another layer of risk.
What the numbers say about survival
Survival rates depend heavily on the stage of the cancer at diagnosis. When found early, before it spreads outside the colon, the five‑year survival rate is about 91%. Once it spreads to nearby lymph nodes or tissues, survival drops to around 74%. If it reaches distant organs such as the liver or lungs, survival falls to 13–15%.
These numbers show just how important early detection is. Finding colorectal cancer early can mean the difference between a highly treatable condition and a much more serious one.
Updated screening guidelines
The American Cancer Society and U.S. Preventive Services Task Force now recommend starting screening at age 45 (down from 50) for average‑risk adults. Regular screening should continue until age 75. Screening can involve a few different approaches, including at‑home stool tests and in‑office visual exams. [cdc.gov], [nccn.org]
Anyone with a higher‑than‑average risk, such as those with a strong family history or inflammatory bowel disease, may need to start screening earlier or be screened more frequently. [nccn.org] For those with a family history, the general recommendation is to start screening ten years prior to the age your relative was when they were diagnosed. This means that all three of my children will need to start having colonoscopies when they are 37.
Colorectal cancer is serious, but the combination of slow development, dependable screening tools, and advancing treatments gives people more control. Be sure to get the screenings your doctor recommends.
Today, I still am trying to regulate to a new normal, but had I waited until 50 to be screened, I likely would have been in the 13-15% statistical bracket of metastatic disease.
As it is, I keep up with my three teenaged daughters and husband, and I still work full time. I don’t have to deal with chemotherapy, radiation or any of the other complications that go with cancer treatment. I am grateful for early screening and intervention, which saved my life. If I can inspire even one person to screen early, thereby preventing the development of cancer, then my experience will be worth it.
