When someone hears the words “colon cancer,” it is easy to assume that every diagnosis looks the same.

A tumor is found. Treatment begins. The cancer either responds or it doesn’t.

But researchers are learning that colorectal cancer is much more complicated than that.

Recently, scientists at ChristianaCare’s Helen F. Graham Cancer Center & Research Institute published research that may help explain why some colorectal cancers become more aggressive, resist treatment, and lead to poorer outcomes for patients. Their findings could eventually help doctors better predict how a cancer will behave and create more personalized treatment options in the future.

To understand the study, imagine that every cell in the body follows a set of instructions. These instructions tell cells when to grow, when to rest, and when to mature into healthy adult cells.

In healthy tissue, those instructions work as they should.

Cancer develops when some of those instructions stop working correctly.

The ChristianaCare research team discovered that certain genes, known as HOX genes, may play an important role in this process. These genes are most active before birth, helping a developing baby form organs and body structures. Normally, they become much less active later in life. However, researchers found that some colorectal cancer cells appear to switch these developmental genes back on.

Think of it like a grown adult suddenly trying to follow directions written for a child.

The instructions no longer fit.

The result can be confusion, uncontrolled growth, and behavior that does not belong in a healthy body.

Researchers identified a pattern involving eight HOX genes that was linked to more aggressive colorectal cancers and poorer survival outcomes. They found that some of these genes become unusually active, while others that may help control growth become less active. Together, these changes may help tumors grow faster and adapt more easily.

The study also revealed something else important.

Not every cancer cell inside a tumor behaves the same way.

Some cancer cells rely on one set of genes, while others depend on a different set. This diversity may help explain why certain cancers become resistant to treatment. Even when one group of cancer cells is destroyed, another group may survive and continue growing.

For patients and families, this research is a reminder that cancer is not always straightforward.

Two people may receive the same diagnosis, yet their experiences can be very different.

Their cancers may respond differently to treatment, grow at different speeds, and carry different risks.

While this research is still in the early stages, it gives scientists a clearer picture of what is happening inside aggressive colorectal cancers. Researchers hope these discoveries will eventually lead to treatments that not only shrink tumors but also prevent cancer cells from adapting and returning after treatment.

At Byrd Cancer Education & Advocacy Foundation, we believe that knowledge is one of the most powerful tools we can give our communities. Research like this helps move us closer to a future where cancer care is more personalized, more effective, and more equitable for everyone.

It is also a reminder of why colorectal cancer awareness, screening, and early detection remain so important. The earlier cancer is found, the more options patients often have for treatment and better outcomes.

Science continues to move forward.

And with every new discovery, we gain another piece of the puzzle.

Sources

This article was developed using information from:

• Becker’s ASC Review. “ChristianaCare researchers identify genetic drivers of aggressive colorectal cancer.”
• ChristianaCare Helen F. Graham Cancer Center & Research Institute. “Researchers identify developmental gene signature that drives colon cancer and predicts survival.”

Read the original articles:

• Becker’s ASC Review: https://www.beckersasc.com/gastroenterology-and-endoscopy/christianacare-researchers-identify-genetic-drivers-of-aggressive-crc/
• ChristianaCare Newsroom: https://news.christianacare.org/2026/05/researchers-identify-developmental-gene-signature-that-drives-colon-cancer-and-predicts-survival/

Disclaimer: This article is intended for educational purposes only and should not be considered medical advice. Individuals should consult their healthcare provider regarding questions about cancer risk, screening, diagnosis, or treatment.

Have questions about cancer screening, prevention, or resources? Contact the Byrd Cancer Education & Advocacy Foundation to learn more about available educational programs and support services.