Department of Medical Oncology
Atrayee Basu Mallick, MD
Avnish Bhatia, MD
Andrew E. Chapman, DO, FACP
Susan J. Littman, MD
Nancy L. Lewis, MD +
Edith P. Mitchell, MD, FACP *
Madhaven Pillai, MD *
Michael J. Ramirez, MD
Lewis J. Rose, MD, FACP
*Practice Focus: Gastrointestinal Oncology
For further information contact:
Thomas Jefferson University Hospital
In the United States, colorectal cancer is the fourth most common cancer in men, after skin, prostate, and lung cancer. It is also the fourth most common cancer in women, after skin, breast, and lung cancer.
Risk factors include age over 50 (colorectal cancer is more likely to occur as people get older), colorectal polyps, family history of colorectal cancer, genetic alterations such as hereditary nonpolyposis colon cancer and familial adenomatous polyposis, personal history of colon cancer, ulcerative colitis or Crohn’s disease, a diet that is high in fat and low in calcium, folate and fiber, and/or cigarette smoking.
Cancer that begins in the colon is called colon cancer, and cancer that begins in the rectum is called rectal cancer. Most colon cancers are adenocarcinomas (cancers that begin in cells that make and release mucus and other fluids).
Stage 0: The cancer is found only in the innermost lining of the colon or rectum. Carcinoma in situ is another name for Stage 0 colorectal cancer.
Stage I: The tumor has grown into the inner wall of the colon or rectum. The tumor has not grown through the wall.
Stage II: The tumor extends more deeply into or through the wall of the colon or rectum. It may have invaded nearby tissue, but cancer cells have not spread to the lymph nodes.
Stage III: The cancer has spread to nearby lymph nodes, but not to other parts of the body.
Stage IV: The cancer has spread to other parts of the body, such as the liver or lungs.
At the Jefferson Colon and Rectal Cancer Center, over 7,000 colonoscopies are performed annually. We offer our patients the latest technological advancements, including autofluorescence endoscopy (narrow band imaging), chromoendoscopy, confocal laser endomicroscopy, CT virtual colonoscopy and the unique “J” shape catheter, which helps identify polyps hidden on the back of colon folds.
Treatments available for patients who present unique challenges include endoscopic mucosal resection (EMR) combined with laser ablation, which permits the removal of large, flat, sessile or pedunculated polyps, often in one session; minimally invasive surgical techniques, for pathology not amenable to endoscopic management; and double-balloon colonoscopy, for patients with altered anatomy who have failed complete colonoscopy elsewhere,
Patients at high risk for colon cancer are treated with a multidisciplinary team approach that might involve not just gastroenterologists but genetic counselors, gynecologists, oncologists and other specialists. This high-risk group includes patients with chronic inflammatory bowel disease being screened for dysplasia, a family history of colorectal cancer and inherited colon cancer syndromes such as familial adematous polyposis (FAP), hereditary nonpolyposis colon cancer (HNPCC) and Peutz-Jeghers syndrome. These patients need intensive screening for multiple neoplasms in addition to colorectal cancer.
If colon cancer is diagnosed, after it is staged, treatment may include colon resection, radiation therapy, either external beam radiation or brachytherapy and/or chemotherapy. Targeted therapies may be used alone or with chemotherapy.
Researchers at the Kimmel Cancer Center of Thomas Jefferson University Hospitals are studying the genes responsible for inherited forms of colon cancer and the genetic alterations responsible for sporadic colorectal cancer. They are developing new and novel approaches for identifying at-risk individuals and are searching for prognostic indicators in tumor specimens.
For more information please visit:
Kimmel Cancer Center at Jefferson
National Cancer Institute