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Diagnosis – Cancer What Now
What Now?

Your Colorectal Cancer Treatment & Recovery Online Resource in Alberta

Answers, insights & inspiration

Step 1: Diagnosis

Why me? What are the causes of Colo-Rectal Cancer?

The cause of rectal cancer is unknown. Certain things may increase your risk of developing rectal cancer:

  • Age
  • Polyps
  • Family history
  • Genetics (Hereditary nonpolyposis colorectal cancer (HNPCC) and familial adenomatous polyposis)
  • Ulcerative colitis
  • Crohn’s disease

Colo-Rectal cancer is the most common cancer of the gastrointestinal system and is found equally in men and women. There is about a 1/20 (5%) chance that you could develop this cancer over your lifetime. Colo-Rectal cancer may be caused by diets that are high in animal fat and low in digestive fiber. It is thought that fiber may reduce the exposure of the digestive system to carcinogens (cancer causing agents).  There are several rare genetic (hereditary) causes of this cancer, but less than <5% is causes by known genetic markers.

Learn more:

  • To find out more about causes click here.
  • To find out more about Colorectal cancer click here.

What is going to happen next?

Diagnosing cancer is not easy. Several tests are required to “Diagnose” or find out that you have cancer. Other tests are used to determine what kind of cancer “Pathology” and finally diagnostic imaging (scans) are used to determine if the cancer has spread, this is called “Staging”.

Patient’s who may have rectal cancer will have a series of appointments:

Diagnostic path:

1. Screening

Screening tests are designed to detect cancer early before patients have symptoms. Colon cancer can be cured 90% of the time if detected early.  A screening test such as the FIT Stool test can help detect cancer before you have any problems or symptoms. If you have no family history of colo-rectal cancer, and are considered low risk –  we recommend that you have the FIT test every 2 years after the age of 50.

a) FIT Stool Test

Learn more about screening

  • To find out more about screening in Alberta click here
  • To find out more about screening click here  or for a  video here
  • To find out hoow to do your FIT Test click here
  • To find out more about diagnosing colorectal cancer click here
  • To find out more different screening tests clikc here 

Which patients should skip FIT screening and have a colonoscopy or other tests

  • If you have symptoms of cancer
  • If you have a close family member who was diagnosed before age 50

2. Gastroenterologist

If you  have a positive screening test or symptoms of cancer you may require a colonoscopy. A colonoscopy is a procedure performed by a gastroenterologist where a video camera is inserted into the rectum. The gastroenterologist will examine the entire colon and take samples from suspicious or cancerous areas. These samples will be evaluated under a microscope to determine if they are cancerous and what type of cancer. Some polyps can be benign (not cancerous), pre-cancerous (may become cancer if left untreated), or cancerous. The 2 most common types of cancer are Adenocarcinoma (90%) and Squamous Cell (5%)

 Learn more Biopsy and Pathology

  • To find out more about Biopsy click here
  • To find out more about Polyps and Cancer click here

3. Surgeon

The surgeon is going to ask questions about your health, and suitability for surgery and evaluate your tumor and body to see what surgery will be best. They will perform a medical examination, rectal exam and may need to repeat the endoscopy to carefully evaluate your cancer. The surgeon will decide what type of surgery is needed to control your cancer. There are many types of Surgery this depends on the type of cancer, its location and your health and body. Your surgeon will work with you to determine which options are best for you.

Learn more:

  • To learn more about the types of surgery click here

4. Diagnostic Imaging Tests

Specialized tests are required to determine the size, location of your cancer and to find out if it has spread.

Learn more:

  • To learn more about Pelvic MRI click here 
  • To learn more about CT Scans click here

5. Blood Tests

Blood tests are needed to evaluate your general health and look at many other organs and body systems making sure there are no other problems. Blood tests in general cannot tell if the cancer has spread. 

CEA – is a test that may be used to monitor your therapy and to follow you after your cancer diagnosis.

Learn more:

  • To learn more about blood tests click here
  • To learn more about CEA click here 

6. Oncologists and Cancer Team

Taking care of patients with cancer is a team effort.  You will be meeting with different members at each step of your journey. 

Your first appointment at the cancer center is called a New patient visit. Be prepared to spend 2-3 hours as you will be meeting many members of your team:

  • Nurse
  • Resident
  • Patient educator
  • Dietitian
  • Radiation Therapist
  • Psychologist
  • Social Worker
  • Doctor

During this visit you will have a medical examination and repeat your rectal exam. Afterwards your specialist will talk to you about what your diagnosis, stage, options and treatment plan.

What is Colo-Rectal cancer?

Cancer is a term used for diseases where abnormal cells divide without control and are able to grow and invade other tissues. Cancer cells can spread to other parts of the body that are located next to each other, or can spread through the blood and lymphatic systems.

The rectum is part of the body’s digestive system. The digestive system removes and processes nutrients (vitamins , minerals , carbohydrates , fats, proteins , and water) from food, and helps pass waste material out of the body. The digestive system is made up of the esophagus , stomach , and the small and large intestines. The first 6 feet of the large intestine are called the large bowel or colon. The last 12 cm are the rectum and the anal canal. The anal canal ends at the anus (the opening of the large intestine to the outside of the body). 

How to describe your cancer

When talking about your cancer there are many important features:

  • Organ – where the cancer started
  • Pathology – what type of cancer
  • Size – how big is the cancer
  • Depth of Invasion – how deep the cancer
  • Grade – how aggressive the cells appear on microscope
  • Location – how far up into the colon
  • Spread – spread to any lymph nodes or other organs

Your cancer team will look at all these factors and tell your what “Stage” your cancer is and see what options will be best for you.

Learn more:

  • To download a PDF about Colorectal Cancer Staging click here
  • To learn more about the anatomy of the rectum or colon click here
  • To learn more about your Pathology report click here

Stages of Colo-Rectal Cancer

Colorectal cancer has five stages. Staging helps determines which treatment options are best for you, and your chances of cure. Low stage cancers are more easy to cure.

Stages inform us about the size and  spread of the tumor. 

  • Stage 0 – Precancerous polyps
  • Stage 1 – Small cancerous polyps that have not invaded deep into the bowel
  • Stage 2 – Larger cancer that has invaded deeper into the bowel
  • Stage 3 – Cancer has spread from the bowels to nearby lymph nodes
  • Stage 4 – Cancer has spread beyond the rectum to other organs

Learn more:

  • To download a PDF on the cancer stage click here
  • To learn more about staging click here

Where do I go?

You will receive a phone call and mailed appointment from the New patients booking office.

In Alberta there are 5 cancer centres

Tom Baker Cancer Centre

Calgary

Jack Ady Cancer Centre

Lethbridge

Central Alberta Cancer Center

Red Deer

Cross Cancer Institute

Edmonton

Grand Prairie Cancer Centre

Grand Prairie

In Calgary you will be seen at one of the Main cancer clinics

How can I prepare?

Parking

Be prepared to spend at least 90 minutes at the appointment, please ensure that you park appropriately. If you have multiple appointments in a day – you could spend up to 3 hours.

Arrival

These are large facilities and it is easy to get lost please prepare to arrive 15-30 Minutes BEFORE your designated appointment time.

Comfort

There are food and bathroom facilities wheelchair access. However feel free to bring snacks drink and anything you need while you are waiting.

Support

This is an important meeting with your cancer team. You may get difficult and complicated information please bring family members or a close friends to help you. Bring note paper or recording devices so that you can keep records

Bring your Medications

Bring your medications, AND a detailed list of your current medications (include herbal or natural products). It is important to share any complementary medicine you may be taking with your healthcare team. Some medicine may interact with each other and may not be recommended during some or all of your cancer treatments.

Physical Exam

Your doctors is going to perform a general medical examination and a digital rectal examination (gyne examination in some women). For your comfort please ensure that you have cleared your bowels.

Learn more:

  • To learn more about rectal exams click here or here