What is a Nurse Navigator?

Our specialized Nurse Navigators are your "one-stop" resource for all the information you need about your diagnosis and treatment plan.

Learn More & Meet Our Navigators

Colon and rectal cancers are both cancers of the intestine. However, their treatments are quite different. We offer customized care for each condition.

 

Colon Cancer

Colon cancer is the third most common type of cancer in the U.S. However, it is also one of the most curable, and survival rates have been increasing steadily over the past few years. Awareness and early detection are key—colon cancer can often be caught in its early stages, when treatment can be most effective.

Our online Learning Center has up-to-date, evidence-based information about numerous topics related to colon cancer, including diagnostic tests, treatment options, management of treatment side effects, and more.

Visit the Learning Center

These resources are not a substitute for the guidance of your physician but can help you learn more about colon cancer and what to expect during treatment.  All content is provided courtesy of the Mayo Clinic Health Library.

Most patients with early stage colon cancer do not have any symptoms, so it is very important to keep up with screening tests, as recommended by your doctor. Once colon cancer reaches a more advanced stage, it will cause a variety of symptoms, including:

  • A change in bowel habits
  • Blood in the stool (blood may appear bright red or black and tarry)
  • Stools that are narrower than usual
  • Diarrhea, constipation, or a feeling that the bowel does not empty completely
  • General abdominal discomfort, such as frequent gas pains, bloating, fullness and cramps
  • Unexplained weight loss
  • Constant feelings of fatigue or tiredness
  • Vomiting

Learn More

Early detection of cancer can be key to successful treatment, so it is important to understand what increases your risk of colon cancer. Risk factors can include:

  • Age: The risk of developing colorectal cancer increases with age, with more than 90% of cases occurring in people over the age of 50.
  • Race/Ethnicity: African-Americans have a greater risk of colon cancer than people of other races.
  • Inflammatory Bowel Disease: Chronic inflammatory diseases of the colon and rectum, such as ulcerative colitis and Crohn's disease, increase your risk of colorectal cancer.
  • Behaviors & Lifestyle: Certain behaviors can increase your risk of colon cancer. These include:
    • A sedentary lifestyle
    • Having obesity
    • Use of alcohol
    • Use of tobacco
    • Eating a low-fiber, high-fat diet 
  • Family History: A strong family history of colon or other cancers can increase your risk. It is important to talk to your doctor if you or your close relatives have had:
    • Colon cancer before age 50
    • Endometrial (uterine) cancer before age 50
    • Two or more Lynch Syndrome cancers (colorectal, endometrial, gastric, ovarian, ureter/renal, pelvis, biliary tract, small bowel, brain, sebaceous adenoma)
    • At least 10 or more cumulative colorectal benign (non-cancerous) polyps
    • Colon cancer associated with multiple polyps

If you have concerns about any of these risk factors, please talk to you doctor.

There are several different ways to test for colon cancer. After reviewing your medical history and doing a basic medical exam, your doctor will most likely perform one of the following:

  • Digital Rectal Exam: Your doctor will insert a lubricated, gloved finger into your rectum to check for lumps or abnormal areas.
  • X-ray of the Large Intestine: This test creates images of the bowel surface and is used to help identify the presence of polyps in the intestine. Your doctor will likely use a contrast agent to improve the images.
  • Fecal Occult Blood Test: A small stool sample is placed on a special card and tested for hidden blood.
  • Colonoscopy: Your doctor will insert a flexible tube containing a small camera into your bowel to look for irregularities, such as polyps. 

The evidence-based treatment plan your doctors choose is based on a number of factors: type of cancer, grade and stage of the cancer, your overall health, and your treatment preferences.

Surgery

If your cancer has not spread beyond the colon or lymph nodes, surgery to remove the tumor is the most common treatment. Depending on your specific case, family history, and doctor’s recommendations, the following surgical options may be used:

  • Local Excision: A tube is placed up the rectum into the colon, and the cancerous tumor is removed. This procedure is used most often with early stage cancers.
  • Partial Colectomy: Both the tumor and a small amount of surrounding healthy tissue and lymph nodes are removed. This surgery is used for larger tumors. In many cases, your surgeon will reconnect the healthy portions of the colon and rectum, possibly avoiding the need for a permanent colostomy.
  • Partial Resection or Total Colectomy and Colostomy: If your surgeon cannot reconnect the colon, a colostomy will be necessary. A surgical opening will be made through the wall of the abdomen into the colon; this is where waste material will leave the body and be collected by a special bag. The colostomy may either be temporary or permanent.

Medical Oncology

Chemotherapy for colon cancer involves the use of medications to destroy cancer cells. It can be used before surgery, with the goal of shrinking a tumor before the operation. Most commonly, however, it is given after surgery if the cancer has spread to the lymph nodes. This can help reduce the risk of cancer recurrence.

The board-certified medical oncologists, nurses, and technicians at Connecticut Oncology Group provide the most effective, advanced care with warm, personal attention and support for patients and their families. Your medical oncology team will work closely with your other providers and help provide access to clinical trials.

Radiation Oncology

Radiation oncology is the highly-controlled use of radiation to cure or treat symptoms of your cancer.

Learn more about radiation therapy options at Middlesex

Rectal Cancer

The rectum sits in a tight space in the body, narrowly separated from other organs and structures in the pelvic cavity. As a result, complete surgical removal of rectal cancer is challenging and complex. However, your expert team will collaborate to guide you through your rectal cancer journey.

Our online Learning Center has up-to-date, evidence-based information about numerous topics related to rectal cancer, including diagnostic tests, treatment options, management of treatment side effects, and more.

Visit the Learning Center

These resources are not a substitute for the guidance of your physician but can help you learn more about rectal cancer and what to expect during treatment. All content is provided courtesy of the Mayo Clinic Health Library.

There are a number of signs and symptoms of rectal cancer, including:

  • A change in bowel habitsb
  • Blood in the stool (blood may appear bright red or black and tarry)
  • Stools that are narrower than usual
  • Diarrhea, constipation, or a feeling that the bowel does not empty completely
  • General abdominal discomfort, such as frequent gas pains, bloating, fullness and cramps
  • Unexplained weight loss
  • Painful bowel movements
  • Constant feelings of fatigue or tiredness
  • Iron deficiency anemia

Early detection of cancer can be key to successful treatment, so it is important to understand what increases your risk of colon cancer. Risk factors can include:

  • Age: The risk of developing colorectal cancer increases with age, with more than 90% of cases occurring in people over the age of 50.
  • Race/Ethnicity: African-Americans have a greater risk of colon cancer than people of other races.
  • Inflammatory Bowel Disease: Chronic inflammatory diseases of the colon and rectum, such as ulcerative colitis and Crohn's disease, increase your risk of colorectal cancer.
  • Behaviors & Lifestyle: Certain behaviors can increase your risk of colon cancer. These include:
    • A sedentary lifestyle
    • Having obesity
    • Use of alcohol
    • Use of tobacco
    • Eating a low-fiber, high-fat diet 
  • Family History: A strong family history of colon or other cancers can increase your risk. It is important to talk to your doctor if you or your close relatives have had:
    • Colon cancer before age 50
    • Endometrial (uterine) cancer before age 50
    • Two or more Lynch Syndrome cancers (colorectal, endometrial, gastric, ovarian, ureter/renal, pelvis, biliary tract, small bowel, brain, sebaceous adenoma)
    • At least 10 or more cumulative colorectal benign (non-cancerous) polyps
    • Colon cancer associated with multiple polyps

If you have concerns about any of these risk factors, please talk to you doctor.

There are several different ways to test for rectal cancer. After reviewing your medical history and doing a basic medical exam, your doctor will most likely perform one of the following:

  • Digital Rectal Exam: Your doctor will insert a lubricated, gloved finger into your rectum to check for lumps or abnormal areas.
  • X-ray of the Chest, Abdomen, and Pelvis: This test can help determine if your cancer has spread to other organs. Your doctor will likely use a contrast agent to improve the images.
  • Fecal Occult Blood Test: A small stool sample is placed on a special card and tested for hidden blood.
  • Rectal Ultrasound: This test is used to see how far through the rectal wall a cancer has grown.
  • Colonoscopy: Your doctor will insert a flexible tube containing a small camera into your bowel to look for irregularities, such as polyps. 
  • Blood Tests: Your doctor might also order certain blood tests to help determine if you have rectal cancer. These tests may include a complete blood count (CBC), liver enzymes, and tumor markers. 

Rectal cancer often requires more than one type of treatment. Your team of physicians, nurses, and other experts will determine which combination is best for you. 

Surgery

  • Local Excision: A tube is placed up the rectum into the colon, and the cancerous tumor is removed. This procedure is used most often with early stage cancers.
  • Low Anterior Resection: This procedure, which leaves the anus intact, may be performed when the tumor is located in the upper part of the rectum. The surgeon removes the tumor but not the lower part of the rectum. The end of the colon is then attached to the remaining section of the rectum.
  • Abdominoperineal Resection (APR) with End Colostomy: This surgery is done to remove the sigmoid colon, rectum, and anus. After an APR, it is no longer possible to pass stool through the anus; therefore, patients need a permanent colostomy.

Medical Oncology

Chemotherapy for rectal cancer involves the use of medications to destroy cancer cells. It can be used before surgery, with the goal of shrinking the tumor before the operation. Most commonly, however, it is given after surgery if the cancer has spread to the lymph nodes. This can help reduce the risk of cancer recurrence.

The board-certified medical oncologists, nurses, and technicians at Connecticut Oncology Group provide the most effective, advanced care with warm, personal attention and support for patients and their families. Your medical oncology team will work closely with your other providers and help provide access to clinical trials.

Radiation Oncology

Radiation oncology is the highly-controlled use of radiation to cure or treat symptoms your cancer.

Learn more about radiation therapy options at Middlesex

 

Meet our Colorectal Cancer Nurse Navigator

Shana Proulx, BSN, RN is the Colorectal Cancer Nurse Navigator at the Middlesex Health Cancer Center.

Nurse Navigators are specialized Registered Nurses who guide patients through their cancer journey. They can provide education and support, and they help connect patients to other supportive services, such as social work or nutritional counseling.

Learn More
Colorectal Cancer - Your Risk & How It Impacts Screening

In this presentation, the genetic counselors of the Middlesex Cancer Center discuss hereditary colorectal cancer and how genetic counseling can help.

Locations

2 Specialty Care Locations

1Middlesex Health Cancer Center - Middletown

536 Saybrook Road
Middletown, CT 06457
Office Hours
Mon
8:00 AM - 4:00 PM
Tue
8:00 AM - 4:00 PM
Wed
8:00 AM - 4:00 PM
Thu
8:00 AM - 4:00 PM
Fri
8:00 AM - 4:00 PM
860-358-2000
Middlesex Health Cancer Center - Middletown

2Middlesex Health Cancer Center - Westbrook

250 Flat Rock Place
Westbrook, CT 06498
Office Hours
Mon
8:00 AM - 4:00 PM
Tue
8:00 AM - 4:00 PM
Wed
8:00 AM - 4:00 PM
Thu
8:00 AM - 4:00 PM
Fri
8:00 AM - 4:00 PM
860-358-2000
Middlesex Health Cancer Center - Westbrook
What is a Nurse Navigator?

Our specialized Nurse Navigators are your "one-stop" resource for all the information you need about your diagnosis and treatment plan.

Learn More & Meet Our Navigators