Colorectal Cancer Diagnosis and Staging

Why choose Henry Ford for a colorectal cancer diagnosis?

Whether you’re seeking a second opinion or have concerning symptoms, we’re here to help. When you turn to us for a colorectal cancer diagnosis, you’ll find:

• Colorectal tumor boards: Colorectal cancer specialists, including surgeons, gastroenterologists, medical oncologists, radiation oncologists and pathologists, meet to review your case. You receive a diagnosis from a team of top experts.
• Convenient diagnostic testing: Our cancer pavilion houses the most advanced diagnostic technology available. You can get all the tests you need in one place, often during the same visit. If you don’t live near our pavilion, we help you find a Henry Ford hospital or outpatient cancer center that’s convenient for you.
• Expert second opinions: People with all stages of colon, rectal or anal cancer come to us for second opinions. Our multispecialty tumor boards, wide range of therapies and clinical trials mean we can often offer a more accurate diagnosis or additional treatment options.

How we diagnose colorectal cancer

You may need a colorectal cancer diagnosis if you have concerning gastrointestinal symptoms or abnormal results on a colorectal cancer screening test. Learn more about getting started with colorectal cancer care.

Talk to your doctor if you experience:

• Abdominal pain or cramping
• Changes in your bowel habits, such as constipation or diarrhea
• Rectal bleeding or blood in your stool
• Unexplained weight loss

We start by doing a full medical history and performing a physical exam. Your doctor will ask about your health, symptoms and any known risk factors, such as family members with colorectal cancer.

We may use several tests to diagnose colorectal cancer:

• Digital rectal exam (DRE): A DRE is part of a physical exam. Your provider inserts a gloved, lubricated finger inside your rectum to feel for abnormal masses.
• Stool tests: Stool tests check your poop for occult (hidden) blood, which could be a sign of cancer. Stool tests are usually done at home and can screen for colorectal cancer.
• Blood tests: We look for tumor markers in your blood. These proteins or DNA changes may be present if you have cancer.
• Colonoscopy or anoscopy: We insert a tube with a video camera or light into your anus. A colonoscopy  uses a video camera to examine your entire colon. An anoscopy examines only your anus and lower rectum.
• Biopsy: We take a sample of tissue from a polyp or other abnormal growth during a colonoscopy or anoscopy. A pathologist examines the sample under a microscope to check for cancer.
• Imaging tests: If other tests indicate colorectal cancer, we may recommend an MRI, CT scan or ultrasound to find out if cancer has spread to other parts of your body.

Colorectal cancer staging

Staging is the process of finding out if and how far cancer has spread (metastasized). This information is important for diagnosing colorectal cancer and determining the most effective treatments.

Staging varies depending on whether you have colon cancer, rectal cancer or anal cancer. A lower number indicates an earlier stage. Stage IV (4) colorectal cancer is advanced, meaning it has spread to distant parts of your body. At Henry Ford, our doctors have specialized expertise in metastatic colorectal cancer. We offer a range of innovative therapies for hard-to-treat cancer that helps people live longer.

In general, colorectal cancer is classified into these stages:

• Stage 0: This is the earliest stage of cancer, or carcinoma in situ. Abnormal cells are there but haven’t grown past the lining of the colon, rectum or anus.
• Stage I: There are very small tumors, typically no more than 2 centimeters (less than an inch) across. The cancer hasn’t spread beyond the colon, rectum or anus.
• Stage II: There are bigger tumors, typically no larger than 5 centimeters (about 2 inches) across. Cancer may have gone deeper into the wall of the colon, rectum or anus but usually has not spread to lymph nodes or other organs.
• Stage III: Cancer has spread to nearby lymph nodes or other organs near the colon, rectum or anus.
• Stage IV: Cancer has spread to distant organs. Colorectal cancer is most likely to spread to the liver, lungs, brain and peritoneum (abdominal cavity lining).

Genetic testing for colorectal cancer

Some colorectal cancers arise from genetic changes inherited from parents. If your diagnosis may be tied to inherited cancer, we can coordinate genetic testing and counseling through Henry Ford’s Cancer Genetics Program. A counselor helps evaluate your risk for an inherited cancer syndrome, such as Lynch syndrome or familial adenomatous polyposis, and determine if genetic testing is right for you.