Recognizing the Signs of Colorectal Cancer
- A fit and healthy mom of two dismissed lingering bloating symptoms lasting months and stomach pain for overeating the wrong foods, which later turned out to be a tumor the size of a tennis ball.
- She was diagnosed with stage 4 bowel cancer (also called colon or colorectal cancer). Its advanced stage means the cancer had spread beyond the colon to her stomach lining, lymph nodes, pelvis, and liver.
- Experts stress that while surgery is essential for early-stage colon cancer, those with advanced cases often require personalized approaches, which may prioritize chemotherapy or experimental therapies.
- The mother of two struggled with sharing her diagnosis with her young daughters. Experts suggest being as honest with them as possible, as you want them to be prepared for what might happen, but at the same time, you want to protect them and be as gentle as possible.
- “Having these conversations may bring up deep emotions you may have stowed away. There is nothing wrong with showing our emotions to children as long as we can remain calm and give them a sense of safety,” Licensed clinical psychologist Dr. Marianna Strongin said.
- Colorectal screenings are recommended to begin around age 45. However, people at increased risk – such as having a family history of the disease – may want to screen sooner. Discussing your screening options with your doctor is recommended.
“I was focusing on me and trying to be the best version of myself… I was feeling really good,” she told The Daily Mail’s Femail news magazine, reflecting on the months before her diagnosis.
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What doctors found was devastating: a tumor the size of a tennis ball. Further MRI scans revealed the cancer had already spread to her stomach lining, lymph nodes, pelvis, and liver.“My cancer was quite aggressive,” Driver explained.
Driver was diagnosed with stage 4 (metastatic) colon cancer, which means the disease has spread beyond the colon, often reaching the liver, lungs, or peritoneum—the tissue lining the abdomen.
WATCH: Not all stage 4 colon cancer patients are the same; thus, different treatment options are necessary.
Each case of metastatic colon cancer presents a unique treatment path. According to Dr. Daniel Labow, Chief of the Surgical Oncology Division at Mount Sinai Health System:
“Most patients, when they come in the door—as I am a surgeon as well as an oncologist—want to go right to the operating room, because they just feel getting it out is a critical thing.”
Surgery was the first step, but chemotherapy is next. While she’s bracing for the grueling side effects—nausea, fatigue, hair loss—her motivation remains clear: her young daughters.
“I want my story to help others catch it sooner,” she said, hoping her experience will encourage others to listen to their bodies and seek help early.
While surgery is a vital weapon against colon cancer, it’s not always the first—or the right—step for everyone. For those diagnosed with stage 1, 2, or 3 colon cancer, surgery is typically part of the treatment plan, though stages 2 and 3 often require chemotherapy as well.
The emotional toll of her diagnosis hit hardest when one of her daughters asked the question no parent wants to hear.
“She just looked at me and said, ‘Do you have cancer?’… I was speechless,” Driver recalled her daughter asking.
Navigating cancer is never just physical—it’s deeply personal. For parents, explaining a diagnosis to young children adds another layer of complexity. Experts often recommend speaking with a mental health professional to help guide these conversations in age-appropriate ways.
As Tahnee begins chemotherapy in mid-August, she steps into this next chapter. Her story serves as a vital reminder: even when you feel at your healthiest, don’t ignore persistent or unusual symptoms. Listening to your body and acting early could be the difference between catching cancer in time and facing a much more challenging road ahead.
WATCH: When to operate on colon cancer.
Stage 4 patients like Driver face more complex treatment options, based on how far and where the cancer has spread. Surgery may be recommended when metastases are limited to a single area, but extensive disease often leads to primary treatment with chemotherapy.
“The overall view of treating metastatic colon cancer is that most of those patients cannot proceed to surgery, and so their cancer can never be removed entirely,” said Dr. Paul Oberstein, a medical oncologist at NYU Langone’s Perlmutter Cancer Center.
In such cases, patients often live with their cancer while undergoing continual therapy or experimental treatments designed to keep the disease in check and preserve quality of life.
Expert Resources on Colorectal Cancer
What Treatment Options Exist for Colon Cancer?
“There are a lot of advances being made in colorectal cancer,” Dr. Heather Yeo, a colorectal surgeon at Weill Cornell Medicine, previously told SurvivorNet.
Colon cancer treatment is more targeted, meaning doctors often test for specific changes or genetic mutations that cause cancer growth.
Biomarkers are key to tailoring specific treatments. Biomarkers are molecular patterns becoming more commonly used in colon cancer diagnosis, prognosis, and management. According to the National Cancer Institute, a biomarker is “a biological molecule found in blood, other body fluids, or tissues that is a sign of a normal or abnormal process, or a condition or disease,” such as cancer.
“In colon cancer, we’re starting to look more and more at people’s biomarkers, so we’re starting to take the cancers, sequence them, understand where the different mutations are to figure out whether or not someone has a normal gene here or an abnormal gene,” Dr. Yeo explained.
“Those are the areas that people want to be able to target a little bit more. We’re getting close to more of what we would call precision medicine, meaning we can start looking at people’s genetic mutations and think about how they might respond to different drugs.”
There are different types of biomarkers, including DNA, proteins, and genetic mutations found in blood, tumor tissue, or other body fluids. The biomarkers most commonly used in colon cancer management are:
Genetic mutations within the tumor, such as MMR/MSI, KRAS, BRAF, and HER2
Bloodstream carcinoembryonic antigen (CEA)
CEA is a protein produced by most tumor cells (but not all) and can be picked up in the bloodstream. High CEA levels do not establish a colon cancer diagnosis. However, higher CEA levels correlate with a worse prognosis and potential metastasis. Carcinoembryonic antigen is important for post-treatment follow-up to ensure the cancer hasn’t returned. Be sure to check with your doctor before treatment starts to ensure a CEA blood sample has been obtained.
More on Treating Colon Cancer
Surgery and chemotherapy are common approaches to colorectal cancer.
Some examples of Food and Drug Administration (FDA) approved chemotherapy drug treatments include:
- FOLFOX: leucovorin, 5-FU, and oxaliplatin (Eloxatin)
- FOLFIRI: leucovorin, 5-FU, and irinotecan (Camptosar)
- CAPEOX or CAPOX: capecitabine (Xeloda) and oxaliplatin
- FOLFOXIRI: leucovorin, 5-FU, oxaliplatin, and irinotecan
- Trifluridine and tipiracil (Lonsurf)
WATCH: Understanding Your Options with Metastatic Colon Cancer
Among metastatic colon cancer patients, multiple treatment options exist, including surgical and non-surgical options.
One treatment option includes an oral treatment called Fruquintinib, which is a targeted therapy for adults who have metastatic colorectal cancer and have tried other treatments. Results from a trial published last year showed the drug improved overall survival and progression-free survival, which measures the amount of time before the cancer returns or spreads. It works by blocking the growth of blood vessels, which increases tumor growth.
Once you get to the metastatic setting, many patients “just run out of options,” Jennifer Elliott, head of solid tumors at Takeda, explained to SurvivorNet at the ASCO Annual Meeting. So it was critically important for Takeda to do this deal to in-license fruquintinib. We hope to give patients another option.”
Fruquintinib has been approved in China since 2018 and was originally developed by the Chinese biopharmaceutical company HUTCHMED. Takeda Oncology acquired the exclusive worldwide license for the drug outside of mainland China, Hong Kong, and Macau in January 2023.
Understanding Colon Cancer
Colon cancer is very treatable and curable if caught early. Colon cancer screenings can involve at-home tests such as Cologuard, but a colonoscopy is more effective, according to SurvivorNet experts.
The cancer starts when abnormal lumps called polyps grow in the colon or rectum. It takes up to 10 years for a colon polyp to become full-blown cancer, according to SurvivorNet experts.
The American Gastrointestinal Association lowered the recommended initial age for colorectal screening from 50 to 45. However, experts recommend screening earlier for some people who may be at an increased risk of developing colon cancer, such as those with a family history of the disease.
WATCH: Debunking misconceptions about colon cancer.
The most poignant symptom of colon cancer includes a change in bowel habits. This may include constipation or diarrhea due to changes in the size or shape of bowel movements. A change in stool color, particularly black or tarry stools, can indicate bleeding from a tumor that lies deep in the colon.
Other symptoms can be harder to pinpoint, such as abdominal pain and unintentional weight loss. Finally, some tumors bleed a small amount over a long period of time, resulting in anemia (low red blood cell count) that is picked up on blood work.
Tips for Parents Struggling to Talk About Their Cancer
When Tahnee Driver was diagnosed with cancer, one of her most difficult challenges wasn’t just the treatment—it was figuring out how to explain her diagnosis to her young daughters.
Driver, like many parents facing serious illness, wrestled with how to approach the conversation in a way that was honest but not overwhelming. Experts say that preparation and emotional awareness are key.
Licensed clinical psychologist Dr. Marianna Strongin emphasizes that children are highly attuned to their parents’ emotional states. “If, at this moment, you are feeling scared, it might be helpful to calm and soothe yourself first before speaking to your child,” she advised.
Strongin encourages parents to embrace their emotions while maintaining a sense of stability.
“Having these conversations may bring up deep emotions you may have stowed away. There is nothing wrong with showing our emotions to children as long as we can remain calm and give them a sense of safety,” she said.
Creating that sense of safety helps children process difficult news and equips them with emotional tools to manage their feelings. One strategy Strongin recommends is speaking from your own childhood experience.
“I love using my childhood self when explaining anything to children,” she said. “I might say, ‘When I was your age, I remember feeling scared of many things, but one thing that always helped is taking three very deep breaths and telling my body it will be okay.’”
“It is these kinds of dialogues that allow our children to feel safe and in control,” she added.
WATCH: Talking to Kids About Cancer
There’s no one-size-fits-all approach to discussing cancer with children. Widower John Duberstein, who lost his wife Nina to breast cancer, shared his experience with SurvivorNet.
“I think it’s really important to be open with the kids as much as you can, as much as you feel like they can handle,” Duberstein explained.
He recalled how, as Nina’s appearance began to improve, their children started forming silent assumptions about her recovery.
“When Nina started to look less like a cancer patient, the kids started to make unspoken assumptions about where Nina stood,” he said.
But those assumptions weren’t accurate, and the couple had to gently correct them.
“It was hard for them to hear even though they’d already been prepared,” Duberstein said. “We had to remind them that her cancer was not going away gently.”
For parents like Driver and Duberstein, these conversations are never easy—but they’re essential. With honesty, emotional grounding, and age-appropriate language, families can face the unknown together, one conversation at a time.
Questions to Ask Your Doctor
If you are facing a colon cancer diagnosis, here are some questions you may ask your doctor.
- What are my treatment options based on my diagnosis?
- If I’m worried about managing the costs of cancer care, who can help me?
- What support services are available to me? To my family?
- Could this treatment affect my sex life? If so, how and for how long?
- What are the risks and possible side effects of treatment?
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