“Before diagnosis, it was baseball,” Mancini told Jake Marsh on the “On the Call” podcast.

“And when you’re diagnosed with serious colon cancer, you don’t care if you even play baseball again. It was definitely a perspective changer.”

Mancini’s cancer was already stage 3, meaning it had spread beyond the colon wall and into nearby lymph nodes, but not to distant organs, as seen in stage 4 disease.

“When it’s stage 3, it means the cancer has left the organ site in the colon and traveled toward the local nodes,” explained Dr. Daniel Labow, Chief of the Surgical Oncology Division at Mount Sinai Health System.

He added that the standard treatment approach is “surgery, followed by chemotherapy,” with chemo aimed at destroying any lingering cancer cells that may have escaped surgical removal.

As Mancini began treatment, he leaned heavily on the support of his teammates — but it was his wife, Sara, who became his anchor. With pandemic restrictions limiting in‑home medical visits, she stepped into a role neither of them expected.

“Sara became my defacto at‑home nurse,” Mancini said. “You get your port out every couple of weeks, and usually they have a nurse that comes out and does it, but because of COVID, the nurse couldn’t, so Sara had to learn how to do that and a lot of other medical stuff.”

How To Help A Loved One Diagnosed With Cancer

After a cancer diagnosis, it’s natural for spouses to grapple with a whirlwind of emotions — anger, grief, anxiety, and beyond. The journey ahead can feel overwhelming, but it’s important to remember that a cancer diagnosis is not a death sentence. There are strategies to navigate uncertainty, find support, and face challenges with resilience.

Some popular approaches, backed by research and many anecdotal accounts, include:

• Talking to a therapist to share feelings you’re going through
• Having candid conversations with your loved one about the diagnosis
• Researching the disease together to learn about available treatment options
• Joining a support group or connecting with others who have gone through, or are going through, the same experience

WATCH: Glenn Torchia talks about how he was there for his wife, Millie, while she battled stage 4 lung cancer

The Role of a Caregiver

SurvivorNet has spoken with a collection of expert oncologists, social workers, and patient advocates to provide a helpful list of how cancer caregivers can help throughout the treatment journey and beyond.

Attend Doctor Visits

Throughout the treatment process, the patient will often receive a large amount of information at once. As a caregiver, attending as many doctor visits as possible can help a lot. This lets you take notes on treatment options, protocols, needed lifestyle changes, and more.

Connect With a Social Worker or Patient Navigator

Ask for the patient’s medical team to connect you with a patient navigator or social worker. Many hospitals and cancer centers have specialized staff who can connect you with additional resources, including arranging transportation to and from doctor appointments, assisting with insurance claims, and more.

WATCH: How Patient Navigators Can Help

“Patient navigators can function differently at different hospitals,” Dr. Kathie-Ann Joseph, a surgical oncologist at NYU Langone Health’s Perlmutter Cancer Center, told SurvivorNet.

“We have a really wonderful program at [NYU] where we use lay navigators, meaning they’re not nurses — although you can use nurses or social workers, who pretty much help newly diagnosed cancer patients through the continuum of care,” Dr. Joseph added.

Additional services patient navigators may provide include:

• Attending future appointments with you
• Providing an assessment for the next steps of care
• Assisting with housing, transportation, or immigration issues
• Helping with financial issues
• Providing direction on legal issues

Helping the Patient Keep Track of Their Symptoms

As mind-boggling as a cancer diagnosis can be for a spouse or loved one, it’s likely more stressful for the patient.

Sometimes, it is easier for the caregiver to monitor the patient’s symptoms than for the patient. Try to maintain an open line of communication and encourage your loved one to share their feelings regularly to help monitor symptoms.

Let the Patient Speak for Themselves Whenever Possible

As a caregiver, your role is to be the best advocate possible for the patient. While assisting with various tasks, it is essential to let them maintain a sense of independence whenever possible. Cancer caregivers can help track symptoms, navigate finances, and manage emotions—but they should also let the person they are caring for speak up about what they genuinely need throughout the process.

“Some of the best examples that I have seen in caregivers are those spouses or loved ones who really, almost sit back and allow the patient, or they want the patient to express what the patient feels first, rather than barging in,” gynecologic oncologist Dr. Jayanthi Lea told SurvivorNet.

“…Step back a little bit and let the patient speak for themselves. Let them express what they are feeling. That is so important for the patient’s overall quality of life and well-being,” Dr. Lea added.

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.

WATCH: Does Alcohol Impact the Risks for Colon and Other Cancers?

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 screening test that allows doctors to examine the inside of the colon for signs of cancer or other abnormalities.

To prepare, the colon must be completely emptied. Your doctor will prescribe a bowel prep—a liquid solution taken the night before—that works as a strong laxative and triggers multiple loose stools to clear the colon.

With the colon clean, the gastroenterologist can carefully inspect the lining and remove or evaluate any polyps or suspicious areas.
Follow‑up timing depends on what’s found. If polyps are present, especially larger or multiple ones, doctors typically recommend repeating the colonoscopy in three to five years.

WATCH: What Doctors Look for During Colonoscopies

What Treatment Options Exist for Colon Cancer?

“There are a lot of advances being made in colorectal cancer,” Dr. Heather Yeo, a surgical oncologist and colorectal surgeon at NewYork-Presbyterian/Weill Cornell, 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 with metastatic colorectal cancer who 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. In January 2023, Takeda Oncology acquired the exclusive worldwide license for the drug outside of mainland China, Hong Kong, and Macau.

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?

[fast facts]

Contributing: SurvivorNet Staff

Learn more about SurvivorNet's rigorous medical review process.

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