What Kirstie Alley's Story Can Help Us Understand About Colon Cancer

What her family said

Kirstie Alley, the Emmy-winning actor known for Cheers and Look Who's Talking, died in December 2022 at the age of 71.

Her children announced her death in a statement, saying the cancer had only recently been discovered. NBC News reported that her manager confirmed the cancer was colon cancer.

Beyond that, nothing was made public. The phrase that carried furthest was "only recently discovered", and it is the part that has real teaching value.

Why "only recently discovered" is so common here

Colorectal cancer usually starts as a polyp, a small growth on the inside lining of the bowel. Polyps sit in the lumen, the hollow channel waste passes through. A small one causes nothing at all.

The channel is wide. A tumor can grow for a long time before it narrows the passage enough to change bowel habits, or bleeds enough to be visible. By the time it does, the disease is often no longer confined to the wall of the bowel.

That is the whole rationale for screening. It is the only way to look at people who feel entirely well. Our page on colorectal cancer covers the disease in more depth.

How far it has gone, layer by layer

Colon cancer staging follows the wall of the bowel outward, and NCI describes it in those terms.

The bowel wall has layers. The mucosa is the innermost lining. Beneath it lies the submucosa, then a muscle layer, then the serosa on the outside.

• Stage 0 is abnormal cells confined to the mucosa.
• Stage I has reached the submucosa or the muscle layer.
• Stage II has gone through the muscle layer to the serosa (IIA), through the serosa to the lining of the abdominal organs (IIB), or through the serosa into a nearby organ (IIC).
• Stage III means lymph nodes are involved, graded by how many.
• Stage IV means spread to distant organs.

Notice that stage II and stage III are not simply "worse" and "worse still". A stage II cancer can be physically larger than a stage III one. What separates them is whether cells have reached the lymph nodes, which is why nodes are removed and examined during surgery.

What the surgery involves

NCI describes surgery as the treatment for all stages of colon cancer, in one of several forms.

Polypectomy. If cancer is found within a polyp, the polyp is often removed during the colonoscopy itself. Diagnosis and treatment happen in the same appointment.

Local excision. For very early cancer, a tube with a cutting tool goes in through the rectum and removes it, with no incision in the abdomen.

Resection with anastomosis. For larger tumors, the surgeon removes the affected segment and a margin of healthy tissue, then sews the cut ends together. Nearby lymph nodes are taken and examined.

Resection with colostomy. If the ends cannot be joined, an opening called a stoma is made in the abdominal wall and waste passes into a bag. NCI notes this is sometimes temporary, allowing the lower bowel to heal before it is reversed, and sometimes permanent if the whole lower colon has to go.

Radiofrequency ablation and cryosurgery, which destroy tumor tissue with heat or cold, are also listed.

Treatment before surgery to shrink a tumor is neoadjuvant therapy. Treatment afterward to lower the chance of return is adjuvant therapy. The chemotherapy drugs NCI lists for colon cancer include capecitabine, fluorouracil, irinotecan, leucovorin, oxaliplatin, and trifluridine with tipiracil, sometimes combined with targeted drugs such as bevacizumab, cetuximab or panitumumab. Our page on chemotherapy explains how those courses run.

When to get checked

Two separate triggers apply, and people often confuse them.

The first is age. The US Preventive Services Task Force recommends screening for all adults aged 45 to 75, and selective screening from 76 to 85. Options range from a stool test done at home each year to a colonoscopy every ten years. Our page on colonoscopy describes what that involves.

The second is symptoms, which do not wait for a screening date. NCI lists these as reasons to see a doctor:

• Blood in the stool, bright red or very dark.
• A change in bowel habits that persists, in either direction.
• A feeling that the bowel has not fully emptied.
• Stools narrower than usual.
• Ongoing gas pain, bloating, fullness or cramps.
• Weight loss with no known cause, fatigue, or vomiting.

Iron-deficiency anemia found on a blood test, with no other explanation, is another common route to diagnosis, because slow bleeding from a bowel tumor can go unnoticed for months.

The numbers

The American Cancer Society forecasts about 158,850 new colorectal cancers in the United States in 2026 and about 55,230 deaths, a projection SEER carries. It is the second leading cause of cancer death in the country, and the median age at diagnosis is 66.

Five-year relative survival for 2016 to 2022 was 65.4% overall: 91.3% while the cancer is confined to the bowel wall, 75.2% once regional nodes are involved, and 16.9% once it has reached distant organs. Localized disease accounts for 34% of diagnoses and distant disease for 23%.

NCI also reports that between 2012 and 2021 the rate of new colorectal cancers rose by about 2.4% a year in people younger than 55, and by about 0.4% a year in people aged 50 to 64, while falling overall. These are population figures and describe no individual.

What this does not mean

Nothing here describes Kirstie Alley's stage, treatment or care, because none of that was made public.

"Recently discovered" describes when the cancer was found, not when it began. Most colorectal cancers have been developing for years before anyone learns about them.

And a story like this is a prompt, not a diagnosis. The useful response is a screening appointment for anyone who is due, or a conversation about symptoms that have persisted, rather than worry about a disease that is treatable when found early.

Sources

• NBC News, Kirstie Alley died of colon cancer. These are the disease's early signs. — https://www.nbcnews.com/health/health-news/kirstie-alley-colon-cancer-signs-symptoms-disease-rcna60310
• NCI PDQ, Colon Cancer Treatment (Patient Version) — https://www.cancer.gov/types/colorectal/patient/colon-treatment-pdq
• NCI PDQ, Colorectal Cancer Screening (Patient Version) — https://www.cancer.gov/types/colorectal/patient/colorectal-screening-pdq
• NCI PDQ, Colorectal Cancer Screening (Health Professional Version) — https://www.cancer.gov/types/colorectal/hp/colorectal-screening-pdq
• NCI PDQ, Colorectal Cancer Prevention (Patient Version) — https://www.cancer.gov/types/colorectal/patient/colorectal-prevention-pdq
• US Preventive Services Task Force, Colorectal Cancer: Screening — https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening
• SEER Cancer Stat Facts, Colorectal Cancer — https://seer.cancer.gov/statfacts/html/colorect.html

How this article was prepared

An AI-assisted editorial system helped prepare this page. No named medical reviewer has reviewed it unless one is listed.

The National Cancer Information Foundation publishes Cancer Explained. This page is for learning. It is not medical advice and does not suggest a test or treatment.

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