Colon Cancer Pain: What It's Like and How to Deal
Pain so intense you’re doubled over. Pain so bad you can’t shake it. Pain that’s new, different, and continues. We never want to think cancer, but pain is an important way our bodies speak to us. Are we listening? Because while it might just be a strain or something we ate, that pain could be a symptom of something as serious as colon cancer. Since people experience pain and symptoms differently with this disease, let’s talk about how to tell the difference between a real red flag and a false alarm.
Pain That's Persistent and Recurrent
Pain is a subjective and yet universal experience, says Kit Wong, M.D., a medical oncologist specializing in gastrointestinal cancers at Seattle Cancer Care Alliance. “We all have pain every now and then,” she says. When should we be concerned? “If the pain persists or is recurrent, seek help.” Duration varies, but we’re talking two to four weeks of the same type of pain and you should see your doctor to rule out something serious.
“Severe abdominal cramping. Like, stop-you-in-your-tracks, bend-you-over-onto-your-knees, abdominal pain,” that’s how Leighann Sturgin, 46, of Wooster, OH, explains what she experienced in 2004. Diagnosed with ulcerative colitis (UC) at 17, Sturgin had stage 4 colon cancer by 30. In early stages, colon cancer might not cause any symptoms—which is why getting screening colonoscopies is so important, says David M. Poppers, M.D., Ph.D., a gastroenterologist at NYU Langone Health, in New York City. If it’s spread—like Sturgin’s—excruciating abdominal pain in one area or throughout the abdomen can be a common red flag.
Gas pains happen to the best of us. They can be caused by eating food high in fiber (we see you, beans), drinking carbonated drinks (think beer), and even chewing gum (swallowing too much air is the culprit there). Food intolerances and chronic intestinal diseases are two more of the myriad reasons for flatulence. Colon cancer can be another, Dr. Wong says. It can cause bowel motility changes, slowing the colon and causing gas buildup. Because this is such a common symptom not related to cancer, seek out your doctor if gas keeps happening—and you’re unsure why.
Bleeding That Includes Pain
Colon cancer pain is often accompanied with other signs and symptoms of the disease, Dr. Poppers says, like anemia, fatigue, unexplained weight loss, weakness, and a key one—stool changes. Those can include rectal bleeding or blood in the stool. If that bleeding is accompanied by pain, it might be related to colon cancer. Or it might be related to something else not as serious, hence why it’s important to seek out your healthcare professional (“don’t be your own doctor,” Dr. Poppers advises).
IBD Pain/Bleeding That's Actually Colon Cancer
The symptoms of inflammatory bowel disease (IBD) and colon cancer can be really similar, and IBD puts you at an increased risk of colon cancer, too. Sturgin experienced daily painful, bloody diarrhea that was more frequent and intense than her normal UC symptoms in the year leading up to her colon cancer diagnosis. Her bleeding didn’t seem right, but her doctors blamed UC. At her previous screening in 2003, they hadn’t found colon cancer; by her 2004 screening, it was stage 4. This is important: Talk to your doctor about cancer screening needs if you have IBD.
“I had this low [pelvic] pain that didn’t feel like UC pain or abdominal cramping,” Sturgin explains. Just before surgery to remove her entire colon (leaving about five to seven inches of her rectum), she saw her OB-GYN. She told him about pelvic-region pain. “He pressed on the outside of my pelvis and could feel something was wrong. He put my hand on it and said, ‘Feel this.’ And you could feel the lump.” Both her ovaries were encased in metastasized tumors. Sturgin had a hysterectomy. Note: Pelvic pain can happen with advanced colon cancer in both men and women.
“I felt like I was sitting on a lump. I could feel the tumor on the rectum. That’s when I knew something was wrong,” says Sturgin. She’s describing the tumor in her remaining rectum, a colon cancer metastasis. When colon cancer is “localized,” or located close to where it started, it might cause pain or pressure nearby, especially in cases of cancers in or near the rectum, Dr. Wong explains. When the cancer spreads to regional parts and later, distant places in the body, you may feel pain in other areas that you might not associate with colon cancer.
Back, Shoulder, and Other Pain
Add these to the list of pain issues you might not expect with colon cancer—in the back, shoulder, and other body parts. This can happen because the cancer has spread, Dr. Wong says. This sounds scary, but it’s actually helpful in identifying cancer. If colon cancer metastasizes to the liver, you might feel pain in your right upper abdomen or right shoulder. “It’s not cancer in the shoulder, but if the liver is full of tumors, you can get a phenomenon called ‘referred pain’ due to nerve connections,” she says. Back pain can also happen from spread to the bone.
You might’ve heard that in late stages of cancer, bone pain can occur, and it’s no exception with colon cancer. Sturgin experienced bone pain even though her cancer hadn’t spread to her bones—it was a side effect of chemotherapy treatment. This type of pain can be a dull ache or pain, Dr. Wong reports. Common bones affected can include those in the spine and the hips.
The Genetic Connection
Declared cancer-free in July 2020, Sturgin still has to contend with having Lynch syndrome, which puts her at increased risk for other cancers. A similar syndrome is familial adenomatous polyposis, or FAP, which she doesn’t have. People with classic FAP often develop multiple noncancerous growths (called polyps) in the colon as early as their teens, and those polyps may become cancerous, on average, by age 39. People with these genetic disorders are high-risk groups for colon cancer, Dr. Poppers says, and should discuss screening options with their doctor.
- Colon Cancer Pain: American Cancer Society. (2020). “Signs and Symptoms of Colorectal Cancer.” cancer.org/latest-news/signs-and-symptoms-of-colon-cancer.html
- Abdominal Pain: Colon Cancer Coalition. (n.d.). “Colon Cancer Symptoms.” cacoloncancer.org/colorectal-cancer-symptoms/
- IBD and Colon Cancer: Cancer Connect. (2018). “Inflammatory Bowel Disease and Cancer Risk Goes Beyond the Risk of Colon Cancer.” news.cancerconnect.com/colon-cancer/inflammatory-bowel-disease-and-cancer-risk-goes-beyond-the-risk-of-colon-cancer-KUGOEJeVFk-a9wib-WncUw
- Localized, Regional, Distant Cancer: National Cancer Institute. (2015). “Cancer Staging.” cancer.gov/about-cancer/diagnosis-staging/staging
- Metastatic Colon Cancer: Scientific Reports. (2016). “Patterns of metastasis in colon and rectal cancer.” ncbi.nlm.nih.gov/pmc/articles/PMC4945942/
- Lynch Syndrome: Oncology Letters. (2019). “Genetics, diagnosis and treatment of Lynch syndrome: Old lessons and current challenges.” ncbi.nlm.nih.gov/pmc/articles/PMC6396136/
- FAP: U.S. National Library of Medicine. (2020). “Familial adenomatous polyposis.” ghr.nlm.nih.gov/condition/familial-adenomatous-polyposis