A 45-Year-Old Mom’s Bathroom Troubles Were Dismissed As Hemorrhoids By Her Doctors Until Symptoms Worsened and She Was Diagnosed With Stage 4 Colon Cancer

Eventually, she underwent a colonoscopy—a critical screening tool for colon cancer. The results confirmed her fears.

“Things never got better. In fact, all they did was get worse,” she said.

Amber was diagnosed with stage 4 colon cancer. By the time it was discovered, the disease had already spread to her liver and lymph nodes. The diagnosis was devastating.

Stage 4 colon cancer means the cancer has metastasized—reaching other organs such as the liver, lungs, or the peritoneal cavity, which houses the stomach and intestines. According to SurvivorNet experts, colorectal cancer often begins as polyps that, if left untreated, can become cancerous over time. This transformation can take up to a decade, which is why regular screening is so critical.

WATCH: Colon Cancer Screening Is Extremely Important

Experts recommend colonoscopy as the gold standard for screening. If you’re at average risk—meaning no family history or lifestyle risk factors like smoking—screening should begin at age 45.

Amber’s diagnosis came when her children were just eight years old and 16 months old.

“It was like an out-of-body experience. I thought I was going to die. When I was told it had spread to my liver, I dropped the phone to the doctor and phoned my mom to say I was dying,” she recalled.

Her treatment began immediately with an aggressive chemotherapy regimen. After 12 rounds, her tumors shrank to the point of being undetectable. Today, Amber is in remission.

The goal of chemotherapy in advanced cases like Amber’s is to reduce the cancer burden enough to make surgery possible. When cancer has spread beyond the colon, neoadjuvant therapy—treatment given before surgery—can help target cancer throughout the body. If the response is strong, surgery may be recommended to remove both the primary tumor and any metastases.

“It really was a miracle,” Amber said.

“My kids were eight and 16 months. I had made buckets for them, I made journals—I was preparing them for life without me. When I got the news, it was all gone.”

Chemotherapy: Navigating Treatment and Side Effects

“Both chemotherapy and surgery play vital roles in treating colon cancer. The key is determining which approach to start with, based on each patient’s unique situation,” explains Dr. Daniel Labow, Chief of Surgical Oncology at Mount Sinai Health System.

Chemotherapy is a powerful tool in fighting cancer, but it’s not without its challenges. Common side effects include fatigue, nausea, vomiting, and hair loss—each patient’s experience can vary.

Watch: Chemotherapy While Treating Colon Cancer

One of the most frequently used treatments is 5-FU-based chemotherapy. Most patients receive a regimen called FOLFOX, which combines 5-FU with oxaliplatin. This can be administered intravenously or taken orally as capecitabine (Xeloda). In some cases, additional medications may be added. Your oncologist will help tailor the regimen to your specific needs.

Watch: Chemotherapy Before Colon Cancer Surgery

Many people tolerate chemotherapy well and are able to continue working, taking time off only around treatment days. The most common side effects affect the gastrointestinal system—diarrhea, fatigue, mouth sores, bleeding, and lowered white blood cell counts, which can increase infection risk.

Surgery: Weighing the Risks and Benefits

Surgery is often a cornerstone of colon cancer treatment, especially for stages one through three. But it’s not a one-size-fits-all solution. If you’re referred to a surgeon, expect a thoughtful conversation about whether surgery is right for you and what recovery might look like.

Watch: Deciding When to Operate on Colon Cancer

Recovery varies from person to person, so don’t hesitate to ask questions—surgeons are used to walking patients through this process. It’s also important to understand what “complications” might mean. They can range from treatable infections to issues that may require additional procedures.

For older adults or those with other health conditions like heart or lung problems, the risks may be higher. In these cases, your care team will help you explore all options to preserve your quality of life.

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.

Colon Cancer Is Treatable and Curable When Caught Early

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.

When you have a colonoscopy, the gastroenterologist looks for polyps inside your intestine. Although polyps can’t be felt, they can be picked up by screening tests before they cause a problem, such as colon or rectal (colorectal) cancer.

A polyp found during a colonoscopy can be removed, which can prevent the development of cancer. Almost all polyps that are removed are precancerous, meaning that they have not yet progressed to cancer.

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 signature of colon cancer is a change in bowel habits. Changes in the size or shape of bowel movements may cause constipation or diarrhea. A change in stool color, particularly black or tarry stools, can indicate bleeding from a tumor 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.

A Colonoscopy Explained

A colonoscopy is a procedure doctors use to screen for colon cancer by looking inside the colon.

This procedure requires your colon to be “cleaned out.” To clear out your colon, your doctor will prescribe a “bowel prep,” a liquid you drink the night before the procedure. The prep acts as a laxative that causes you to have multiple loose stools before your procedure.

Once your colon is cleared, the gastroenterologist performing the procedure can have a clear look to evaluate if any polyps or masses are present.

Depending on the size and number of polyps found, it is recommended that patients undergo a repeat colonoscopy within three to five years.

WATCH: What Doctors Look for During Colonoscopies

Dr. Zuri Murrell, a colorectal cancer surgeon and Director of the Cedars-Sinai Colorectal Cancer Center, previously explained the colonoscopy procedure to SurvivorNet.

“When we see a polyp, we actually physically take the polyp out through the colonoscope,” he explained.

“What does that mean? That means we basically put a wire through with a little bit of a flange at the end, and we pull the polyp out. Now, note there is no pain with that. Inside the colon, there are no pain fibers. So there’s no pain,” Dr. Murrell added.

The advantage of a colonoscopy is that your doctor can remove any polyps found during the test. Many colon cancers can be caught on a colonoscopy before they develop or when the polyps are small enough to be removed without surgery.

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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