MARCH 1, 2015
Colorectal cancer refers to two types of cancer – colon cancer and rectal cancer. According to the United States Centers for Disease Control and Prevention (CDC), of cancers which affect both women and men, colorectal cancer is the second most deadly cancer in this country. The good news is that this can change with proper screening and early detection. March is Colorectal Cancer Awareness Month, the time to educate yourself and your loved ones on the ways to detect, treat and prevent colorectal cancer.
Colon cancer refers to cancer of the large intestine, the lower part of our digestive systems. Rectal cancer occurs in the last several inches of the colon. Both cancers generally begin as polyps – small, non-cancerous clusters of cells inside the colon. Benign polyps – and even polyps which have become malignant – often do not produce any symptoms, which is a key reason screening is so important.
“If we could get more patients to undergo recommended screening exams, then we could significantly reduce the number of preventable colorectal cancer deaths,” said Jason Allen, M.D., a Texas Health Care colon and rectal surgeon. “Early detection is the key to catching pre-cancerous or cancerous growths in the colon and getting rid of them before they grow or spread. If we can catch it early, the patient has a much greater chance to live a long life thereafter.”
Causes & Symptoms of Colorectal Cancer
Colorectal cancer can be caused by inflammatory bowel disease, Chron’s disease or ulcerative colitis. Additionally, family history of colorectal cancer is a known risk factor. Other factors that may contribute to colorectal cancer include smoking, excessive alcohol consumption, obesity, high-fat/low-fiber diets, lack of physical activity and low vegetable and fruit consumption.
When colorectal cancer does produce symptoms, those can include bloody stool; change in bowel behavior, such as prolonged constipation, diarrhea or discomfort; general fatigue and unexplained weight loss. If you detect any of these symptoms, you should make an appointment to see your physician.
If you have symptoms such as these that cannot be explained as a result of another cause, your physician will likely order a screening test to determine if there are abnormalities in the colon. The most common such test is the colonoscopy.
Screening and Testing
While there are a number of screening measures, the colonoscopy is the most widely used to screen people for cancer and benign polyps when no symptoms are present. Generally, it is recommended that people have a colonoscopy at age 50 and if no abnormal results are found, again once every ten years. However, your physician may decide that a patient should have a colonoscopy at a younger age or more frequent intervals, depending upon medical history and other factors.
For a colonoscopy to be useful, the patient must have a completely empty bowel. This typically means patients cannot eat solid foods the day before the procedure and must limit themselves to certain fluids in order to flush out their bowels. In some cases, a physician will prescribe a laxative to ingest, as well.
The procedure itself usually lasts between 20 minutes and one hour. The patient is usually sedated as the physician inserts a colonoscope, a long tube with a light on the end of it, into the colon. The colonoscope is long enough to travel the entire length of the colon, allowing the physician a complete view.
If polyps are detected, the physician can remove them during this procedure, as well as collect tissue samples for biopsy. When polyps are removed, they are sent to a lab for testing to determine if they are benign or cancerous. In the event a colonoscopy is negative – that is, no abnormalities were detected – the patient will probably not have to undergo another screening for ten years. If benign polyps are detected, the physician may want to perform another colonoscopy in five years. In the event colon cancer is discovered, more frequent colonoscopies may be required as the cancer is treated.
“Some people dread colonoscopies because of the preparation involved or they don’t like to think about the procedure itself,” said Eduardo Castillo, M.D., a Texas Health Care colon and rectal surgeon. “Between the prep and the actual procedure, the whole thing lasts about 24 hours, which is a minor inconvenience for something that could well add years to your life.”
Treating Colorectal Cancer
If colon cancer is detected at an early stage, the physician is often able to remove the cancerous cells through surgery. For small abnormalities, the cancer may be removed during the colonoscopy. Laparoscopic surgery is commonly used to remove colon cancers, and physicians are also able to collect cells from the lymph nodes at this time in order to determine if the cancer has spread.
In later stage colon cancers, in which the cancer has spread to the lymph nodes or to other organs, chemotherapy is used after surgery to destroy remaining cancerous cells. In the event a large cancerous tumor must be removed, radiation therapy may be used to first shrink the tumor, increasing the likelihood that surgery will remove all of the cancerous tissue. Additionally, targeted drug therapies may be used to treat colon cancer, though this is usually done only in cases that are very advanced.
The Bottom Line – Get Checked
While colorectal cancer is the second-leading cause of cancer deaths in the United States (among cancers which affect both genders), it does not have to be. Through recommended routine screenings and subsequent early detection, cancer can often be treated and removed early enough to not cause lasting problems. Even better, abnormal cell growths can be spotted and removed before they become cancerous. All you have to do is get checked when your doctor says it’s time.
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