Colorectal cancer is the second-leading cause of cancer-related death. In colorectal cancer, cells from apparently normal tissue adjacent to the tumor (NAT) can harbor molecular changes that may contribute to tumor growth or relapse, but the specific changes that occur in stem cells within NAT remain unclear. To learn more, researchers recently compared colonic stem cells from NAT with those from healthy donors. The cells from NAT and healthy tissues were similar in terms of their structural characteristics and their ability to proliferate and transform into specific cell types. However, the NAT-derived stem cells had different expression of molecules involved in inflammation and tissue scarring (fibrosis), and in mouse experiments, injected NAT-derived cells recruited inflammatory cells and fibrosis-mediating cells. In addition, when NAT-derived stem cells were cocultured with healthy tissue–derived stem cells, they induced the healthy tissue–derived cells to highly express FOSB, a protein that’s associated with stress exposure. It’s not yet clear whether the changes induced in—and by—the NAT-derived stem cells are detrimental or protective. Nevertheless, the findings help clarify the alterations that occur in tumor-adjacent colonic stem cells and lay a foundation for further research on their impacts.