Cánceres colorrectales

Sigue siendo el método de referencia para la detección y la prevención. Se recomienda para personas con alto riesgo y para quienes desean prevenir el cáncer de colon, ya que permite a los médicos detectar y extirpar pólipos precancerosos para detener su desarrollo. También permite identificar el cáncer colorrectal en sus etapas iniciales, cuando es más tratable. Durante este procedimiento ambulatorio, el gastroenterólogo puede inspeccionar visualmente toda la región del colon y el recto, identificar y extirpar pólipos y realizar una biopsia de cualquier masa presente.

La colonoscopia virtual es una prueba no invasiva que no requiere sedación, lo que permite a las personas conducir a casa después e incluso regresar al trabajo. Es una herramienta de diagnóstico por imagen eficaz que utiliza una tomografía computarizada (TC) avanzada para generar una imagen tridimensional del colon y los órganos circundantes. Los radiólogos buscan posibles anomalías y, si se encuentran pólipos, estos pueden extirparse durante una colonoscopia tradicional antes de que se conviertan en cáncer. Al igual que la colonoscopia tradicional, la colonoscopia virtual puede detectar el cáncer de colon en sus etapas iniciales, cuando es más tratable. Si se observa un pólipo o una lesión en la tomografía, será necesario realizar una colonoscopia tradicional.

Las pruebas de heces, disponibles a través de su médico, se pueden realizar en la comodidad de su hogar. Existen tres tipos de pruebas de heces, y cada una puede ser una primera opción para personas con riesgo bajo o promedio de cáncer colorrectal y que no presentan síntomas. Si una prueba de heces resulta positiva, se debe realizar una colonoscopia. Existen tres tipos de pruebas de heces:

• Prueba de sangre oculta en heces (FOBT): Existen dos tipos de FOBT que detectan el cáncer colorrectal mediante la detección de sangre en las heces. La gFOBT (prueba de sangre oculta en heces con guayaco) detecta la sangre en las heces utilizando una sustancia química llamada guayaco. La iFOBT, también conocida como FIT (prueba inmunoquímica fecal), utiliza anticuerpos especiales para detectar sangre en las heces. Una ventaja de la iFOBT/FIT es que no requiere restricciones en la dieta ni medicamentos. La presencia de sangre en las heces puede ser un signo temprano de cáncer colorrectal.
• Análisis de heces multiobjetivo: Esta prueba identifica la presencia de alteraciones en el ADN de las células de una muestra de heces. Si se detectan alteraciones en el ADN, esto podría ser un signo temprano de cáncer colorrectal.

Si se confirma el cáncer, se utilizan técnicas de imagen como la tomografía computarizada (TC), la resonancia magnética (RM), la ecografía y, en ocasiones, la tomografía por emisión de positrones (PET) para determinar la profundidad del tumor y si se ha diseminado a los ganglios linfáticos u órganos como el hígado o los pulmones. Estas pruebas ayudan a determinar el estadio de la enfermedad, lo que orienta el plan de tratamiento.

Nuestros cirujanos, reconocidos mundialmente, se especializan en procedimientos colorrectales convencionales y mínimamente invasivos, incluyendo cirugía robótica avanzada diseñada para reducir el dolor, acortar las estancias hospitalarias, acelerar la recuperación y minimizar las cicatrices.

Somos expertos en procedimientos como la polipectomía, la escisión local, la resección de colon con anastomosis y, cuando es necesario, la colostomía. Nuestro equipo de coloproctología goza de reconocimiento nacional por sus técnicas de preservación del esfínter, incluyendo la microcirugía endoscópica transanal (TEMS) y la cirugía transanal mínimamente invasiva (TAMIS), que preservan la función intestinal y reducen considerablemente la probabilidad de necesitar una colostomía permanente.

For select advanced or recurrent cases, our team collaborates with a multidisciplinary team to perform complex pelvic resections and other advanced local treatments when appropriate.

Chemotherapy is designed to target and eliminate dividing cancer cells and prevent cancer from spreading—making it one of the most effective treatments in cancer care today. We use the latest in chemotherapy treatments, personalizing each treatment plan to individual patient needs. 

Sometimes doctors can deliver higher doses of chemotherapy directly to the area where the cancer is, which may limit side effects to the rest of the body. If colorectal cancer spreads to the liver, a tube (catheter) can send high‑dose chemotherapy straight into the liver’s main artery, called hepatic artery infusion (HAI). In selected cases where cancer has spread to the lining of the abdomen, our surgeons may remove visible tumors and then wash the abdomen with warm chemotherapy during surgery (called HIPEC).


Visit our Chemotherapy treatment page for more information.

Targeted therapy uses drugs that target specific genetic changes in individual tumors and can mean more effective results along with reduced harm to surrounding healthy tissue.  

Targeted therapy for colorectal cancer uses special medicines that “zoom in” on certain weak points in cancer cells, instead of attacking all fast‑growing cells the way standard chemotherapy does. At our Cancer Center, doctors use targeted drugs, along with biomarker (molecular) testing that looks for specific changes in the tumor, such as EGFR, RAS, BRAF, VEGF, HER2, NTRK, POLE, POLD or MSI‑H/dMMR status, to decide which medicine is likely to work best for each person. Some targeted therapies block signals that tell cancer cells to grow, while others cut off the tumor’s blood supply. These targeted drugs are usually given through an IV in the vein or as pills, often combined with regular chemotherapy for advanced or metastatic colorectal cancer. Montefiore Einstein also offers access to clinical trials, where patients may receive newer targeted or “precision” medicines and regional therapies that deliver treatment directly to tumor areas.

For more information about targeted therapies, visit our Precision Medicine treatment page.

Neoadjuvant therapy is treatment given before surgery to shrink colorectal tumors, make surgery easier, and lower the chance the cancer will come back. For many people with rectal cancer, treatment may include chemotherapy combined with radiation or total neoadjuvant therapy (TNT), where most or all chemotherapy and radiation are given before surgery to treat small, hidden cancer cells early.

In some colon cancer cases, chemotherapy is used before surgery to shrink large or difficult-to-remove tumors. Your doctors will review your cancer stage, tumor location, and lab results to decide whether neoadjuvant therapy is right for you and which combination of treatments is most effective. 

For more information about neoadjuvant therapy, visit our Chemotherapy treatment page.

Immunotherapies represent a dramatic breakthrough in cancer treatment. They enable the immune system to recognize and eliminate cancer cells while leaving healthy cells intact. For colorectal cancer, immunotherapy is most effective for tumors that have certain features, such as being “MSI‑high” or “dMMR,” which means the cancer cells already look very abnormal to the immune system and are more likely to respond to this kind of treatment. Not all colorectal cancers respond to immunotherapy. Your care team uses special lab tests on the tumor to see whether immunotherapy is likely to work for you.

The main type of immunotherapy used for colorectal cancer is called a checkpoint inhibitor. Transformative checkpoint inhibitors supercharge the immune system's ability to directly combat cancer, paving the way for quicker recoveries and new hope for advanced colorectal cancer patients. These therapies are typically administered through an IV every few weeks and may be used alone or in combination with other treatments, particularly for advanced or metastatic colorectal cancer or if cancer returns after standard chemotherapy.

Nuestro Centro Oncológico participa activamente en el descubrimiento y la evaluación de nuevas estrategias de inmunoterapia para atacar y tratar con mayor precisión los cánceres de colon y recto. Nuestros avances en investigación siguen impulsando prácticas de inmunoterapia oncológica revolucionarias y brindan a los pacientes la oportunidad de participar en próximos ensayos clínicos.

Visit our Immunotherapy treatment page for more information.

Radiation therapy is a common cancer treatment, using high doses of radiation to eliminate cancer cells. It is used more often for rectal cancer than for colon cancer and can be given before surgery to shrink a tumor, after surgery to destroy any cancer cells that might be left, or to ease symptoms such as pain or bleeding when the cancer is more advanced. Most patients receive external-beam radiation, in which a machine outside the body aims radiation at the tumor in the pelvis. 

With image‑guided, intensity‑modulated radiation therapy, detailed scans are used to check the tumor’s exact position, and computer‑controlled beams are shaped and adjusted around it, allowing higher doses to the cancer while better protecting nearby healthy tissues. Radiation is often given together with chemotherapy (called chemoradiation), because the chemotherapy can make cancer cells more sensitive to the radiation, so treatment works more effectively.

Montefiore Einstein Comprehensive Cancer Center is a consistent leader in radiation therapy, providing the most innovative and comprehensive services utilizing the latest technology available. Through leadership in scientific discovery, diagnostic excellence and innovative new procedures, we have extended the possibilities of radiation therapies to provide our patients with the highest level of care.

Visit our Radiation Therapy treatment page for more information.

Regional therapy is treatment that delivers cancer‑fighting medicine directly to the part of the body where the colorectal cancer is, instead of sending it through the whole bloodstream like standard IV chemotherapy. The goal is to give a higher dose right to the tumor area, while lowering side effects in the rest of the body. 

Montefiore Einstein uses innovative therapies to address liver tumors that have spread from the colon or rectum, and when standard chemotherapy and surgery have stopped working. We are also pioneers in combining these techniques with vaccines that boost the body’s immune system to fight the cancer and also offer the newest approach to treating cancer that has spread to the liver from the colon or rectum: the hepatic artery infusion pump (HAIP). 

Hyperthermic intraperitoneal chemotherapy (HIPEC) treats advanced colorectal cancers that have spread to the lining of the abdominal cavity. First, any local tumors are removed. Then, high doses of heated chemotherapy drugs are placed into the space within the abdomen. The chemotherapy stays in place for 90 minutes and is then removed and the space rinsed with saline. The procedure occurs while you are still in the operating room after the initial tumor removal takes place.

These therapies are usually combined with regular (systemic) chemotherapy, radiation, or other medicines as part of your individualized treatment plan. 

Visit our Regional Therapy treatment page for more information.