Colorectal Cancer Treatment Explained — From Staging to Personalized Care

Dr. Aneel Damle of Colon and Rectal Surgery Associates and the Division of Minnesota Oncology discusses key topics in colorectal cancer care, emphasizing how staging directly guides treatment and outcomes. “For colon cancer, surgery is the most often first line treatment for stage one, two and three cancers,” he explained. Early-stage disease is often highly treatable, as “stage one and two colon cancers are localized to the colon and most often require no further treatment after surgery,” with cure rates above 90%. For stage 3 disease, which involves lymph nodes, chemotherapy is typically added after surgery, and “about two-thirds to three-quarters of patients can be cured.” In contrast, stage 4 cancers that have spread are more difficult to cure and are usually treated with chemotherapy or immunotherapy. “This shows how important it is to have your colonoscopy early,” he emphasized.

Advances in surgery and personalized treatment

Surgery remains a cornerstone of care, but techniques have improved significantly over time. Dr. Damle noted that “the way that we do these operations has fundamentally changed,” with most patients now eligible for minimally invasive approaches such as laparoscopy or robotic surgery. These methods use smaller incisions and are linked to better outcomes, as “patients who undergo these minimally invasive procedures have lower rates of complications, faster recovery… and better overall survival.” He encourages patients to ask their surgeons about these options.

Treatment is also becoming more personalized through advances in molecular and genomic testing. “The goal is to have treatments that are increasingly personalized… to kill cancers without harming the patients,” Dr. Damle said. In some cases, particularly in rectal cancer, immunotherapy guided by these tests may help patients avoid chemotherapy, radiation or even surgery.

Rising cases in younger adults and the importance of team-based care

Dr. Damle highlighted a concerning rise in colorectal cancer among younger adults. “The rates of colon cancer have actually more than doubled in the past few decades in people between 30 and 50 years of age,” he said, noting it is now “the leading cause of cancer death in individuals aged 20 to 44.” Many patients do not experience symptoms, making awareness and screening important. “Having regular colonoscopies actually decreases your chances of dying from colon cancer by 90%,” he added, while urging patients not to ignore symptoms such as bleeding, changes in bowel habits or unexplained fatigue.

He also stressed the value of multidisciplinary care. “Multidisciplinary care is absolutely critical,” Dr. Damle said, explaining that optimal treatment often involves coordination between surgeons, medical oncologists, radiation oncologists and other specialists. He encourages patients to advocate for themselves, ask questions and confirm that their case has been reviewed by a tumor board to ensure comprehensive care.

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