Colorectal Cancer in Louisiana: Screening, Symptoms, and Surgical Treatment

Louisiana consistently ranks among the states with the highest colorectal cancer incidence and mortality rates in the United States. Colorectal cancer is the second-leading cause of cancer death nationally — and in Louisiana, the numbers are worse than the national average. Yet this is also one of the most preventable and treatable cancers when caught early.

At Sulphur Surgical Clinic, our board-certified surgeons have extensive experience evaluating and surgically treating colorectal cancer — from diagnosis and staging through minimally invasive resection and long-term follow-up. Patients throughout Sulphur, Lake Charles, and Southwest Louisiana do not need to travel to Houston or New Orleans for expert colorectal cancer care.

What Is Colorectal Cancer?

Colorectal cancer is cancer that originates in the colon (large intestine) or the rectum (the final portion of the large intestine before the anus). The colon’s primary function is to absorb water and electrolytes from digested food; the rectum stores stool before elimination. Both are susceptible to the same cancer biology, and the term “colorectal cancer” encompasses both sites.

The vast majority of colorectal cancers are adenocarcinomas — cancers that arise from the glandular cells lining the colon or rectum. Less common types include carcinoid tumors, gastrointestinal stromal tumors (GISTs), lymphomas, and squamous cell carcinomas.

How Colorectal Cancer Develops

Most colorectal cancers do not appear suddenly. They develop through a well-understood progression:

Normal colon lining — The inner wall of the colon is lined with glandular cells that are replaced regularly through a controlled cycle.
Polyp formation — Over time, certain cells begin to grow abnormally and form small clumps called polyps. Most polyps are benign and never become cancer.
Adenomatous polyps — A subset of polyps, called adenomas, have the potential to become cancerous. The risk increases with polyp size and certain cellular features.
Dysplasia — As cellular changes progress within an adenoma, atypical cells develop — a pre-cancerous state called dysplasia.
Invasive cancer — Eventually, abnormal cells break through the colon wall lining and invade deeper tissue layers, becoming invasive colorectal cancer.

This progression from a small polyp to invasive cancer typically takes 10 to 15 years — which is exactly why colonoscopy is such an effective screening tool. Removing a polyp during colonoscopy breaks this progression before cancer ever develops. Sulphur Surgical Clinic offers AI-assisted colonoscopy — the only practice in Southwest Louisiana with this technology — to maximize polyp detection during your screening exam.

Who Is at Risk?

Colorectal cancer affects both men and women, and while risk increases substantially with age, it is not solely a disease of the elderly. Risk factors include:

Age — Risk increases significantly after age 45. The American Cancer Society now recommends screening beginning at age 45 for average-risk adults.
Personal or family history — A personal history of colorectal polyps or cancer, or a first-degree relative (parent, sibling, child) diagnosed with colorectal cancer, significantly elevates risk.
Genetic syndromes — Lynch syndrome (hereditary nonpolyposis colorectal cancer, or HNPCC) and familial adenomatous polyposis (FAP) dramatically increase risk and often require earlier, more frequent screening.
Inflammatory bowel disease — Long-standing Crohn’s disease or ulcerative colitis increases colorectal cancer risk, particularly after 8–10 years of disease.
Diet and lifestyle — Diets high in processed meats, red meat, and saturated fat; physical inactivity; obesity; heavy alcohol use; and tobacco smoking all elevate colorectal cancer risk.
Type 2 diabetes — Patients with type 2 diabetes have a modestly increased colorectal cancer risk.
Race — Black Americans have the highest colorectal cancer incidence and mortality of any racial or ethnic group in the United States.

Louisiana’s elevated rates reflect a combination of these risk factors — including dietary patterns, high rates of obesity and diabetes, and lower rates of screening compliance — and underscore the importance of proactive screening in our community.

Symptoms of Colorectal Cancer

Early-stage colorectal cancer often produces no symptoms at all — which is why screening matters. As the disease progresses, symptoms may include:

Rectal bleeding or blood in the stool — A new and persistent finding of blood in the stool or on toilet paper should never be dismissed as “just hemorrhoids” without evaluation.
Changes in bowel habits — A change in stool consistency, frequency, or caliber (narrowing) that persists for more than a few weeks.
Persistent abdominal pain or cramping — Particularly if new, unexplained, or progressively worsening.
A feeling of incomplete bowel emptying — The sensation that the bowel has not completely emptied after a bowel movement.
Unexplained weight loss — Unintentional weight loss without a change in diet or activity.
Fatigue or weakness — Often related to iron-deficiency anemia caused by occult (hidden) bleeding from the tumor.
A palpable abdominal mass — Occasionally, a tumor can be felt through the abdominal wall.

Any of these symptoms — particularly rectal bleeding, a persistent change in bowel habits, or unexplained weight loss — should prompt a call to your doctor. These symptoms are not always cancer, but they always deserve evaluation.

Colorectal Cancer Staging

When colorectal cancer is diagnosed, staging determines how far it has spread and guides treatment decisions. Colorectal cancer is staged using the AJCC TNM system:

Stage I — Cancer is confined to the inner layers of the colon or rectum wall. Surgery alone is typically curative.
Stage II — Cancer has grown through the colon or rectal wall into nearby tissue but has not spread to lymph nodes. Surgery is the primary treatment; some patients receive adjuvant chemotherapy.
Stage III — Cancer has spread to nearby lymph nodes but not to distant organs. Surgery combined with adjuvant chemotherapy is standard.
Stage IV — Cancer has spread to distant organs, most commonly the liver and lungs. Treatment typically involves chemotherapy and targeted therapy, with surgery playing a role in selected patients.

Five-year survival rates are strongly stage-dependent: Stage I colorectal cancer has a survival rate exceeding 90%, while Stage IV survival is significantly lower — underscoring the life-saving importance of early detection through screening.

Treatment of Colorectal Cancer

Colorectal cancer treatment is multimodal and depends on the cancer’s location, stage, and molecular characteristics.

Surgery

Surgery is the primary and often curative treatment for localized colorectal cancer. The goal is complete removal of the tumor with adequate surgical margins and the regional lymph nodes that drain the affected bowel segment. At Sulphur Surgical Clinic, Dr. Devin Seale, Dr. Stephen Castleberry, and Dr. Matthew Ayo perform minimally invasive laparoscopic colectomy — removing the cancerous bowel segment through small incisions with a camera-guided approach that significantly reduces recovery time compared to traditional open surgery.

(For a detailed discussion of laparoscopic colon surgery — the procedure, what to expect, and recovery — see our companion post: “Laparoscopic Colon Surgery at Sulphur Surgical Clinic.”)

Rectal Cancer Surgery

Rectal cancers require specialized surgical approaches depending on their location within the rectum. Total mesorectal excision (TME) — removal of the rectum with its surrounding mesorectal envelope intact — is the surgical gold standard. Depending on tumor location, patients may undergo low anterior resection (bowel reconnected) or, for very low tumors, abdominoperineal resection (permanent colostomy). For rectal cancer specifically, neoadjuvant (pre-surgery) chemoradiation is often recommended to shrink the tumor before surgery.

Chemotherapy

Chemotherapy plays a role in multiple stages of colorectal cancer management. Adjuvant chemotherapy after surgery for Stage III disease reduces recurrence risk. FOLFOX (5-fluorouracil, leucovorin, oxaliplatin) and FOLFIRI (5-fluorouracil, leucovorin, irinotecan) are common regimens. For Stage IV disease, chemotherapy combined with targeted biologic agents forms the backbone of systemic treatment.

Targeted and Immunotherapy

Molecular profiling of colorectal cancer tumors has enabled targeted therapy:

Bevacizumab (anti-VEGF) and cetuximab/panitumumab (anti-EGFR) are added to chemotherapy in appropriate patients.
Pembrolizumab (anti-PD1 immunotherapy) has demonstrated significant efficacy in tumors with microsatellite instability-high (MSI-H) or mismatch repair deficiency (dMMR) — a subset representing roughly 5% of metastatic colorectal cancers.
BRAF V600E inhibitor combinations (dabrafenib + trametinib + cetuximab) are used for BRAF-mutated metastatic colorectal cancer.

Radiation Therapy

Radiation therapy is used primarily for rectal cancer — most often delivered pre-operatively (neoadjuvant) to reduce tumor size, improve surgical margins, and lower the risk of local recurrence. It plays a limited role in colon cancer management.

Colorectal Cancer Care at Sulphur Surgical Clinic

Sulphur Surgical Clinic’s board-certified surgeons bring extensive colorectal surgical experience to patients throughout Southwest Louisiana. Our approach:

Minimally invasive-first philosophy. Dr. Seale, Dr. Castleberry, and Dr. Ayo specialize in laparoscopic techniques — performing the majority of colorectal resections through small incisions with camera-guided precision. Patients benefit from less pain, shorter hospital stays, and a faster return to normal life.

AI-assisted screening. We are the only practice in Southwest Louisiana offering AI-assisted colonoscopy — meaning the most advanced detection technology available is the first line of defense for our patients.

Coordinated care. For patients requiring chemotherapy or radiation, we coordinate closely with your medical oncologist and radiation oncologist to ensure a seamless, well-orchestrated treatment plan.

Local expertise. Patients in our region should not have to travel to Houston, New Orleans, or Baton Rouge for expert colorectal cancer evaluation and surgery. Our surgeons have the training, experience, and technology to provide comprehensive colorectal cancer care right here in Southwest Louisiana.

Frequently Asked Questions About Colorectal Cancer

At what age should I start colorectal cancer screening? The American Cancer Society recommends that average-risk adults begin screening at age 45. If you have a family history of colorectal cancer or polyps, a personal history of inflammatory bowel disease, or certain genetic syndromes, your physician may recommend beginning screening earlier — sometimes as young as age 25 to 40. Talk to your doctor or call Sulphur Surgical Clinic directly to discuss your individual risk.

What is the difference between a colonoscopy and a sigmoidoscopy? A colonoscopy examines the entire colon — from the cecum to the rectum — and is the gold standard screening test because it can both detect and remove polyps in a single procedure. A sigmoidoscopy examines only the lower third of the colon (the sigmoid colon and rectum). Colonoscopy is strongly preferred because a significant proportion of colorectal cancers and polyps occur in the right (proximal) colon, which sigmoidoscopy does not reach.

How often should I have a colonoscopy? For average-risk adults with a normal (negative) colonoscopy, the recommended interval is every 10 years. If polyps are found, the follow-up interval is shorter — typically 3 to 5 years depending on the number, size, and type of polyps removed.

Can colorectal cancer be cured? Yes — when caught early. Stage I colorectal cancer has a five-year survival rate exceeding 90%, and surgery alone is often curative. Even Stage III disease is potentially curable with surgery and chemotherapy in many patients. The key is early detection through regular screening before symptoms develop.

What are the signs that I should see a surgeon rather than just my primary care doctor? If you have rectal bleeding, a persistent change in bowel habits, unexplained weight loss or fatigue, or a positive stool blood test, a surgical consultation is appropriate. A surgeon can evaluate whether colonoscopy, biopsy, or surgical intervention is needed and coordinate your care from that point forward. No referral is required at Sulphur Surgical Clinic — you can call us directly.

Schedule Your Evaluation in Sulphur or Lake Charles, LA

You do not have to drive to Houston or New Orleans for expert colorectal cancer care. Sulphur Surgical Clinic’s board-certified surgeons — Dr. Devin Seale, Dr. Stephen Castleberry, and Dr. Matthew Ayo — provide comprehensive colorectal cancer evaluation and minimally invasive surgical treatment right here in Southwest Louisiana.

Whether you are due for a screening colonoscopy, have received a colorectal cancer diagnosis, or simply have symptoms that concern you, we are ready to help.

Call (337) 527-6363 to schedule your evaluation today. No referral required.

Our offices:

Sulphur Surgical Clinic · 914 Cypress St, Sulphur, LA 70663 · (337) 527-6363
Lake Area Vein Center — Lake Charles office · 1920 W Sale Rd, Suite 5, Lake Charles, LA · (337) 425-9300