Rectal Cancer, Colon Cancer: Whats the Difference?

Medically reviewed by: Gary H. Hoffman, MD

Colon CancerColon Cancer.  Rectal Cancer.  Should they Be Combined And Treated The Same? Or, Are They Two different Diseases?

By now, thanks to many organizations, news outlets and patient education from physicians, most people know about colon cancer, rectal cancer and the use of colonoscopy to screen for polyps which can transform into a malignancy.  But how many non-physicians actually know the difference between cancer of the colon and cancer of the rectum?  Even in large metropolitan areas such as Los Angeles and Beverly Hills, the level of understanding is not complete.  Are there differences?  Yes.  And no.  Any questions about similarities and differences can be answered by your proctologist, also known as a colon and rectal surgeon, or coloproctologist.

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The Same.

The colon is divided into many parts.  It is a long muscular tube which propels intestinal contents forward into the storage are known as the rectum.  At the appropriate time, the stool is discharged through the anal canal.  The rectum is 15 to 20 cm in length and acts as a reservoir.  The microscopic tissues of the colon and rectum are similar in appearance, with some differences.  Importantly, cancers of each organ look similar and behave in a similar manner.


The structural supports of each part are different.  The rectum is surrounded by fatty tissue and fascia (strong supporting tissue).  The colon is floppy in areas and bound down in others.  The colon is adjacent to many other organs including the small intestine, the liver and spleen and the stomach.  Again, they both can harbor the same type of cancers, termed adenocarcinoma.

How Does All of This Impact Patients?

While there are diseases which affect the colon and not the rectum (and vice versa), that is not the concern here.  Most patients want to know about cancer; cancer of the colon and cancer of the rectum.  Essentially, both behave the same.  And, they both must be removed whenever possible.  The critical difference is in the therapy that precedes each operation.  The surgeons of Los Angeles Colon and Rectal Surgical Associates can more fully explain similarities and differences in treatment plans.  What follows will allow you to make a visual comparison between the treatments for colon cancer and rectal cancer:

Question:                       Colon Cancer     Rectal Cancer
Preoperative chemotherapy 	Rarely           Yes
Preoperative radiation therapy  No               Yes


Waiting period after diagnosis  Short            Yes, after chemoradiation**
Name of operation              	Colectomy        Low Anterior resection
Open (traditional) surgery   	Yes              Yes
Laparoscopic Surgery         	Yes              Yes (experienced surgeons)
Robotic surgery                 Yes              Yes (trained, certified surgeons)
Postoperative chemotherapy   	Possibly         Possibly
Postoperative radiation therapy No 	         Possibly

There are several noteworthy points:

  • Robotic surgery is performed by trained and certified surgeons at institutions such as Cedars-Sinai Medical Center.
  • In colon cancer, radiation treatment cannot be given for fear of radiating adjacent healthy small intestine and causing radiation enteritis, a strong, symptomatic and possibly permanent inflammation of the small bowel.
  • **Chemoradiation given prior to surgery for rectal cancer is called neoadjuvant therapy.  The rest period after the 6 week treatment period is 6 to 12 weeks followed by an operation.
  • When chemotherapy is administered after surgery, it is termed adjuvant therapy.

Los Angeles Colon and Rectal Surgical Associates

It is important that you ask your surgeon all of the questions necessary to have a clear understanding of the path in front of you.  At Los Angeles Colon and Rectal Surgical Associates, surgeons are available to listen to you, examine you and then treat you using the most modern techniques.  The staff will assist you in many non-medical areas so that you are able to focus on your health.  You can make an appointment by calling (310)273-2310.  Many pre-appointment forms are also available online as well.  Get educated and get evaluated.

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