Are you having back pain with any of the following?

  • Severe pain, weakness or tingling in your leg(s).
  • Difficulty stopping urination or loss of control of bladder or bowels.
  • Unexplained fever, nausea or vomiting.
  • A history of cancer or unexplained weight loss.

We understand that you are experiencing one or more of the health issues that might be impacting your back pain.

We recommend that you discuss these health issues with your doctor before proceeding with this program.

Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.

Cancer Care

Fremont and San Leandro Medical Centers


Nearly all colorectal cancers begin as small growths (polyps) inside the lining of the colon or rectum. While most polyps are harmless (benign), some may turn into cancer over time.

A cancerous growth (malignant tumor) can:

  • Damage the surrounding normal tissue where it grows.
  • Enter the bloodstream and lymph nodes (lymphatic system) and spread to other parts of the body.

Treatment depends on the location and stage of the cancer. The treatment for colon cancer can sometimes be different from the treatment for rectal cancer:

  • Colon cancer treatment most often includes surgery, possibly followed by chemotherapy.
  • Rectal cancer treatment may involve a combination of surgery, chemotherapy, and radiation therapy.

We know a cancer diagnosis is overwhelming. We’re here to provide you with the best treatment available.


Surgery is the most common treatment for colorectal cancer.

During surgery, we remove the:

  • Section of colon that contains the tumor.
  • Blood vessels that support the tumor.
  • Nearby lymph nodes.

We then join the ends of the colon back together.

The cancer is often removed by laparoscopic surgery. We will:

  • Make several small cuts (incisions) in your abdomen.
  • Insert instruments through the incisions, including a small tool with a light. The light lets us see the area of the cancer and remove the affected section of the colon.

Because a large incision is not needed, you may have less pain after surgery and recover more quickly.

You may need a larger incision (open surgery) if the cancer is more advanced, involves other organs, or is in a difficult location.

Risks of Surgery

Before surgery, we’ll talk about the common risks associated with this surgery.

After surgery, you may need to stay in the hospital for several days, depending on any other health conditions you may have. We’ll watch you for signs of:

  • Fever
  • Excessive bleeding
  • Abdominal pain
  • Infection


A colostomy is procedure to create an opening (stoma) in the abdomen. The stoma allows waste (stool) to pass out of the body.

During this procedure, we bring a small part of the intestine out through an incision in your abdomen. We then attach (suture) the intestine to the skin. After a colostomy, stool passes out of the body through this small opening into a bag (pouch).

We may need to perform a colostomy when the:

  • Ends of the remaining colon can’t be reconnected.
  • lEntire ower colon or rectum needs to be removed.
  • Surgery is done on an emergency basis.

A colostomy may be temporary until your colon heals, or it may be permanent. If temporary, we’ll perform another surgery about 2 to 3 months later to reconnect the intestine.

If you require a colostomy, we’ll teach you how to take care of it to prevent irritation and infection. Many people live active lives with a colostomy.


Chemotherapy uses drugs to kill cancer cells. It’s usually given through intravenous (IV) infusion or as pills, depending on the stage of your cancer.

Chemotherapy circulates throughout your entire body. It can destroy cancer cells that travel outside of the colon and rectum.

We may recommend it for:

  • Stage III disease, when we hope to cure the cancer (unless you’re in poor overall health).
  • Stage II disease (in some people), depending on the risks.

For Stage II and Stage III rectal cancer, you may be treated with a combination of chemotherapy and radiation.

Chemotherapy may improve life expectancy for Stage IV disease. The outcome is much better now than several years ago.

Common chemotherapy drugs used to treat colorectal cancer are:

  • Fluorouracil (5-FU)
  • Leucovorin
  • Oxaliplatin
  • Irinotecan
  • Capecitabine (Xeloda)
Side effects

Chemotherapy targets cells that grow and multiply rapidly, such as cancer cells. It can also affect normal cells and cause side effects, such as:

  • Low red blood cells (anemia)
  • Low white blood cells (weakened immune system)
  • Infection
  • Nerve damage that leads to pain (neuropathy)
  • Diarrhea and constipation
  • Nausea and vomiting

We may also prescribe a type of drug (monoclonal antibodies) along with chemotherapy. Examples are bevacizumab (Avastin), cetuximab (Erbitux), and panitumumab (Vectibix). These drugs may cause side effects that are different from typical chemotherapy drugs. 

We can help you manage all side effects. Let us know as soon as you experience any symptoms.

Call our Appointment and Advice Call Center immediately if you develop signs of infection, such as fever and chills.

Radiation Therapy

Radiation therapy uses high-energy beams to kill tumor cells. It’s used for advanced stages of rectal cancer. It’s not often used to treat colon cancer. We might also recommend it to control symptoms such as cancer pain.

The most common type is external-beam radiation therapy. A machine outside the body delivers radiation directly to the tumor and nearby tissue. We use a CT scan to identify the precise location first. You may have radiation 5 days a week for up to 6 weeks.

Side effects

Common side effects from radiation therapy are:

  • Fatigue
  • Bowel discomfort, including diarrhea
  • Frequent urination
  • Pain or discomfort when urinating
  • Red, inflamed, tender skin, with possible blistering

Let us know if you develop side effects. We can help you manage them.

Clinical Trials

We’re always looking for new and better ways to treat colorectal cancer. Clinical trials are research studies that test new treatments and procedures. We can talk about available clinical trials that may be right for you.

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If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder. This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.