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Let’s talk about colorectal cancer.

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Although a colorectal cancer (CRC) diagnosis is serious, you should know that CRC is treatable. The more you know about CRC, the more you can talk about it with confidence when working closely with your care team.
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Diagnosis and what to expect

Explore treatment types

Ways to work with your care team
Living with cancer

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Diagnosis and what to expect

See how doctors diagnose CRC.

CRC often develops from polyps that grow on the colon’s inner lining. Some polyps can become cancer, usually over a period of 10 to 15 years. CRC may first appear as blood in the stool or changes in bowel habits.

To make a diagnosis, doctors will use tests such as a biopsy and possibly biomarker testing.

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Biopsy

For CRC, a biopsy usually involves collecting a small piece of tumor during a colonoscopy, then examining it in a lab. In some cases, a blood sample may be taken and examined instead.

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Biomarker testing

Biomarkers are signals in tumor cells that can show how cancer may change, grow or respond to treatment. Biomarker testing may be done at the same time as a biopsy.

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Have you asked about biomarker testing?

Biomarker testing can help your care team design a treatment plan tailored to you. We’ll help you build a discussion guide you can take to your next visit.

Get started

Take a deeper look at biomarkers

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Not all CRC types are the same.

Once diagnosed, doctors look at where the cancer started and certain features to determine the type. They may further determine type through biomarker testing.

While treatment usually depends on the cancer’s stage, factors like biomarkers and the specific cancer type also play a role.

Here are some, but not all, of the types you may hear about.

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Adenocarcinoma

These tumors start in the tissue of the colon or rectum and make up over 90% of all CRC cases.

Adenocarcinoma has several sub-types, based on things like biomarker status or how the cancer cells look. These sorts of traits can impact your treatment plan.

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Other types of CRC

  • Neuroendocrine tumors (NET)
  • Primary colorectal lymphoma
  • Gastrointestinal stromal tumors (GISTS)
  • Leiomyosarcomas
  • Squamous cell carcinomas
  • Familial adenomatous polyposis (FAP)

Your tumor type, biomarker status, how much the cancer has spread, and how the cancer cells look, will impact your treatment plan.

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Understand CRC stages.

A stage defines how far the cancer has grown or spread, from early-stage to more advanced.

The TNM system helps determine the stage. It looks at tumor size (T), whether cancer is in lymph nodes (N), and whether it has spread to other parts of the body, or metastasized (M).

You may also hear about the cancer’s grade. A grade describes how normal or abnormal the cancer looks. Normal-looking cancers tend to be less aggressive, and grow more slowly, than abnormal-looking cancers.

Knowing your stage and grade helps you understand your cancer and helps guide your doctor’s treatment decisions.

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Stage 0

Abnormal cells are found within the innermost lining of the colon or rectum.

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Stage 1

Cancer has grown deeper into the lining of the the colon or rectum but has not spread beyond that.

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Stage 2

Cancer has grown through the colon or rectum wall but has not spread to nearby lymph nodes.

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Stage 3

Cancer has spread to nearby lymph nodes but not to distant parts of the body.

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Stage 4

Cancer has spread to distant parts of the body. This is called metastatic colorectal cancer.

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Explore treatment types

There’s more than one way to treat CRC.

Your CRC treatment plan may include more than one type of treatment and will depend on a few factors:

  • The type of cancer you have
  • The stage and grade of your cancer
  • Your biomarker status
  • Your overall health, including your age and any previous or current health conditions you’ve had or are managing

Knowing about different treatments helps you talk about them with your doctor and take an active role in your care.

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Surgery

Surgery is used to remove polyps during a colonoscopy or separate procedure. If the polyp couldn’t be removed completely, or if the biopsy shows more cancer, another surgery may be needed. If the cancer has spread, a piece of the colon and nearby lymph nodes may be removed.

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Radiation therapy

Radiation therapy uses high-energy rays to destroy cancer cells. It is often used after surgery to lower the risk of the cancer coming back. Different radiation techniques may be used depending on a person’s treatment plan.

Radiation may be used in combination with chemotherapy.

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Chemotherapy

Chemotherapy, or chemo, uses a combination of two or three powerful medications to attack and stop cancer cells from growing. It can also kill some healthy cells, which is why people may experience side effects, like hair loss.

Typically a fluid delivered into a vein (IV), it may also be given as an injection or pills.

Sometimes chemo is used before surgery to shrink the cancer and help make surgery possible. It may also be used after surgery for highly abnormal cancer, cancers that cause an obstruction or hole in the colon, or if cancer has spread to blood and lymph vessels.

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Targeted therapy

Targeted therapy is designed to act on specific features of cancer cells, such as proteins or gene changes identified through biomarker testing, although it can also affect some normal cells. It’s also called personalized or individualized therapy and is used alone or with chemo.

Targeted therapy is usually given as a pill but can also be an infusion (IV) or injection.

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Immunotherapy

A therapy that boosts your body’s own immune system to fight cancer. Immunotherapy may be used before surgery depending on the stage of the cancer or whether certain gene mutations are found. In some cases it may be used to shrink the cancer which helps make surgery possible.

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Clinical trials

If available treatments aren’t a fit for your particular cancer, participating in a clinical trial may be right for your situation. Clinical trials study the safety and efficacy of potential new medicines, including cancer treatments. Your doctor can tell you about the benefits and risks, and whether taking part in a clinical trial is right for you.

Explore clinical trials

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Ways to work with your care team

From questions to clarity, your doctor can help.

Diagnosis, testing, and treatment types can bring lots of questions. We can help prepare you to get the most out of your conversations.

Get ready

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Unsure what to ask? Let’s get you started.
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Diagnosis
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Treatment
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Support
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Get answers about your diagnosis.

  • What type of cancer do I have?
  • Has it spread or grown?
  • What stage is my cancer?

Get more diagnosis questions

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Talk about your treatment plan.

  • What types of treatment are used for my cancer?
  • If biomarker testing was done, how do the results impact my treatment plan?
  • What are the goals of my treatment plan?

[Get more treatment questions](https://pfizerforallcomna-main-page.web.pfizer/cancer/prepare-for-care?open-accordion-card=2)

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Ask about support and resources.

  • What support services are available?
  • Who can help me navigate care and next steps?
  • Who on my care team can I reach out to when I have questions?

Get more support questions

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We’re committed to helping you afford your Pfizer prescriptions.

From co-pay cards to help navigating insurance approvals, we’ll guide you to the right support. And if you’re eligible for our programs, we’ll help you get the Pfizer medicines you need.

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Explore ways to save
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You could help advance a breakthrough.

Clinical trials study the safety and efficacy of potential new medicines, including cancer treatments.

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Explore clinical trials
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Living with cancer

Get a little inspiration.

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I want to make it a positive experience. And hopefully when my son is an adult he'll look back and be proud of the way his mom handled it.”

Lindsay

Actual patient with CRC

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When I'm playing music, my mind is occupied with what I'm doing, so it can't be occupied with thinking about my cancer.”

Billy

Actual patient with cancer

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Information to support you along the way.

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Sharing your diagnosis

Read now

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7 questions to ask after an early onset cancer diagnosis

Read now

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Understanding types of studies: Exploring clinical trials and real-world evidence

Read now

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Communicating the support you need at work

Read now

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Lindsay’s story: Facing cancer as an oncology nurse and a mom

Read now

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Billy’s story: Making every note count

Read now

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Still have questions?

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What are targeted therapies?

Targeted therapies are treatments that target the ways cancer cells grow, divide, and spread. One of the ways doctors determine if targeted therapies make sense in a treatment plan is through biomarker testing.

Find out more about biomarker testing

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What if there aren’t any targeted therapies for my cancer?

If there aren’t any targeted therapies, your doctor may recommend traditional treatment methods like chemotherapy, radiation, or surgery. There may also be potential clinical trials available to you.

Explore clinical trials

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What can I do if I’m having trouble affording my medicine?

Managing treatment costs and paying for your medicine can be overwhelming. We’ve got resources on how to help manage costs and information on where you may be able to find financial support for Pfizer medications.

Get help navigating costs

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Can I still go to work if I’m getting cancer treatment?

About half of people living with cancer are at an age where they’re still working. If you’re one of them, you may be wondering about how to talk to your co-workers about what you’re going through, what you need, and your ability to do your job. We’ve got you covered.

Communicating what you need at work

Getting back to work after treatment

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Are there communities and advocacy groups I can join?

There are many patient advocacy and support groups in the colorectal cancer community. Here are a couple to get you started with connecting to other patients and caregivers, as well as resources to support you during your journey:

fightcolorectalcancer.org

ccalliance.org

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Do race and ethnicity play a role in colorectal cancer risk?

Colorectal cancer affects some racial and ethnic groups at different rates for a variety of reasons.

  • Black adults are about 20% more likely to be diagnosed with colorectal cancer than White adults
  • Colorectal cancer is a leading cause of cancer-related death among Native populations
  • People of Ashkenazi Jewish heritage may have a higher risk due to certain inherited gene mutations
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Why should people under 50 years old get tested for CRC?

Rates of colorectal cancer in adults under 50 have been increasing. As a result, screening guidelines have been updated to help detect cancer earlier. Awareness and screening are especially important for younger adults.

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When should I seek a second opinion?

Getting a second opinion is a common process that can give you peace of mind.

  • You may want or need a second opinion because:
  • You have a rare type of cancer and want to be sure of your diagnosis
  • Your doctor gives you limited treatment options, and you think other treatments might be available at a different medical center
  • Your doctor is not a specialist in your type of cancer
  • Your doctor tells you there is uncertainty about your type or stage of cancer
  • You’re having trouble understanding and communicating with your doctor, or you want your options explained by someone else
  • You feel uncomfortable with your doctor and their ability to answer your questions or give you the time you need
  • Your insurance company asks you to get another opinion before you start treatment
  • You want to feel confident in your treatment plan