Colon Cancer and Back Pain: Symptoms, Causes, Treatments

Lower back pain can have a number of different causes. Healthcare providers will first want to rule out common culprits like strains, sprains, and herniated disks when you’ve got pain in the lumbar region. If they cannot find a more likely cause, healthcare providers may also want to look for colon cancer.

A tumor in part of the colon that is close to the spine can grow big enough to cause low back pain. However, if you do have colon cancer, back pain won’t be your only symptom.

Here’s how to tell if colon cancer could be causing your back pain and what to know about this extremely common form of cancer, plus how it’s diagnosed and treated. Colleen Farrell’s personal story is a case example.

After being diagnosed with ulcerative colitis at 19 years of age and having part of her colon removed at age 27, Colleen Farrell was no stranger to health issues. At age 33, she was having severe back pain. After initially being mistaken for a sprain, the back pain would eventually be diagnosed as stage 4 rectal cancer.

The next years of her life involved many rounds of treatment. Chemotherapy gave Farrell uncomfortable physical side effects like burning sensations. Radiation therapy put her in early menopause and caused mental side effects.

Unfortunately, these treatments were unable to stop the cancer from spreading to her liver and lungs. Upon finding out surgery was no longer an option, Farrell was also dealing with the loss of her mother, who had been battled COPD and lung cancer. Her mother’s death added another level of grief to what Farrell was experiencing.

Farrell eventually started immunotherapy—a short infusion similar to chemo—which was rather new at the time. The tumors started shrinking after just two weeks. The side effects were manageable—comparable to flu symptoms. Two treatments over one year gave her a longer life than her healthcare providers had predicted.

The relative survival rate for colorectal cancer is five years. Although cancer took away her chances to become a mother, Farrell passed the five-year survival mark and is hoping to make it another decade. Her tumors are still there, but her regular scans have been promising.

Colon cancer is a disease causing the cells in the large intestine (colon) to grow abnormally. It is also called colorectal cancer because it can affect the rectum as well.

It’s the third most commonly diagnosed cancer in the United States—regardless of sex. There are roughly 107,000 new cases a year. Cancer screening has been able to reduce these rates, but that’s mostly in older adults. The number of people younger than age 50 diagnosed with colon cancer is actually increasing.

You can manage some of your risk factors for colon cancer, but others are out of your control. Farrell, for example, had ulcerative colitis—an inflammatory bowel disease (IBD) similar to Crohn’s disease.

Chronic ulcerative colitis and Crohn’s disease are both risk factors for colorectal cancer. Having either one of these IBDs for 8 or more years can up your risk of developing this cancer.

When the cancer cells start to grow out of control, a tumor forms. If the tumor gets large enough, it can press on certain areas and cause pain. Abdominal pain is a fairly common symptom of colon cancer. That’s because most of the colon is touching other abdominal organs.

Farrell had a rectal abscess that developed into a tumor. The rectum is very near to the spine, so a tumor growing in this area would have been able to put enough pressure on the back to cause pain.

Cancer back pain will depend on where and how the tumor is growing. The pain can also take on a number of different qualities. Farrell described hers as a very sharp, stabbing pain in the back.

Farrell’s pain didn’t go away; it became progressively worse, evolving into a dull ache. She had this ache while sitting, driving, and even trying to sleep. She couldn’t sit down comfortably for more than a few minutes at a time.

While back pain isn’t the most common symptom of colon cancer, it can happen, especially with rectal cancer. However, back pain will be accompanied by other symptoms.

Signs of colon cancer may not necessarily show up right away, but any of these symptoms could tip you off:

• A change in bowel habits lasting for more than a few days—includes: diarrhea, constipation, or narrowing of the stool
• A feeling of needing to have a bowel movement that doesn’t go away after having one
• Blood in the stool, which can give the stool a dark brown or black color
• Cramping or abdominal pain
• Rectal bleeding with bright red blood
• Unintended weight loss
• Weakness and fatigue

The signs and symptoms of colorectal cancer are similar to those of other conditions like infection, hemorrhoids, and irritable bowel syndrome. Regardless of what you think your symptoms may be, you should see a healthcare provider immediately.

Healthcare providers can run tests to detect the cause of your symptoms. Cancer screening is also important. Screening can prevent cancer because it can detect precancerous polyps. These polyps can be removed before they develop into cancer.

When healthcare providers suspect a patient has colon cancer, it may take more than just one exam or test to pinpoint what’s causing the symptoms.

Medical History and Physical Examination

Your healthcare provider will want to know about your risk factors for colon cancer. These include being older than age 50 years, having a history of inflammatory bowel disease, and having a family member with colorectal cancer.

Aside from the healthcare provider feeling your abdomen, the physical examination may include a digital rectal exam. This involves the healthcare provider using a lubricated, gloved finger to feel the inside of your rectum for anything abnormal.

Stool Tests

Colon cancer can cause bleeding and if enough bleeding occurs over time, anemia can develop. You may or may not notice bleeding in your stool.

If deemed necessary, your healthcare provider may suggest a stool test to look for blood you can’t see with the naked eye (occult blood). Fecal occult blood tests and fecal immunochemical tests can both be done at home.

Blood Tests

Blood tests can look for many different markers that can signal cancer. A complete blood count can tell if you have a low number of red blood cells (anemia). Abnormal liver enzymes may be a sign of cancer spreading to the liver, but they aren’t adequate to make a complete determination.

Colorectal cancer cells can sometimes make tumor markers that show up in blood tests. A tumor marker called carcinoembryonic antigen (CEA) is the most common for colorectal cance, but not alwaysr.

Diagnostic Colonoscopy and Proctoscopy

Colonoscopies can be used for cancer screening by detecting changes that could be cancer. This same procedure can also be used to diagnose colon caner.

For this test, a thin tube with a video camera on the end is inserted through the anus and into the colon. The tube allows for instruments to be passed through that can biopsy or remove anything that looks suspicious.

Proctoscopy is like a colonoscopy, but instead of the entire colon, only the rectum is examined. This procedure is used for suspected cases of rectal cancer.

Biopsy

Biopsies are samples of tissue collected during endoscopy or surgery. The samples get sent to a lab where they are evaluated for any changes in specific genes or proteins. Biopsies can provide information on the type of colorectal cancer.

Imaging Tests

Medical imaging uses various techniques to be able to see pictures of inside the body. They can be used to examine areas suspected of cancer, see how far cancer has spread, determine if treatment is working, and look for signs of cancer returning after treatment.

The types of imaging tests that may be used to detect colorectal cancer are listed below:

Treatment for colorectal cancer will vary depending on which stage the cancer is in. The stage lets you know the degree to which the cancer has spread. Staging for colon cancer ranges from stage 0 (within colon) to stage 4 (spread to other parts of the body).

Standard colon cancer treatments may include any of the following seven types:

• Chemotherapy: This therapy uses medicines—taken by mouth, injected into a vein, or delivered directly to cancer sites in the body—to stop cancer cells from growing.
• Cryosurgery: Sometimes called cryotherapy, cryosurgery is when an instrument is used to freeze and destroy abnormal tissue.
• Immunotherapy: A biologic therapy, immunotherapy uses the patient’s own immune system to boost the body’s natural defenses against cancer.
• Radiofrequency ablation: This treatment uses a probe with tiny electrodes to kill cancer cells.
• Radiation therapy: High energy X-rays or other types of radiation can kill cancer cells or stop them from growing. External radiation therapy is delivered by a machine outside the body. Internal radiation therapy is delivered by a radioactive substance placed into or near the cancer.
• Surgery: This is the most common form of treatment for all stages of cancer. In early stages of cancer, surgery can involve removing a small section of tissue. In later stages, it may involve removing a larger section of the colon.
• Targeted therapy: This treatment attacks specific cancer cells, and it’s usually less harmful to healthy cells than chemotherapy or radiation. Examples include monoclonal antibodies, angiogenesis inhibitors, and protein kinase inhibitors.

People with more advanced stages of the disease (stages 3 or 4) may want to consider joining a clinical trial. Clinical trials are essential tools for developing new forms of treatment or improving existing ones.

Colon cancer isn’t very high on the list when healthcare providers are trying to determine the cause of low back pain. That’s because back pain can have a number of more likely causes, and abdominal pain is more common in colon cancer than back pain. However, a tumor in your rectum could be causing pain in your lumbar area.

When you and your healthcare provider are trying to determine what’s ailing you, remember you are your own best advocate. Listen to yourself if something is nagging you or doesn’t feel right and speak up. When detected early, colon cancer can be treated.