March is Colorectal Cancer Awareness Month, a time to bring attention to the second-most deadly cancer in America, of cancers that affect both women and men. In 2013, more than 130,000 Americans were diagnosed with colorectal cancer and more than 50,000 died as a result of the disease. However, with proper screening and early detection, colorectal cancer can often be successfully treated.
Colorectal cancer refers to two types of cancer, colon and rectal. 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 polys – and even polyps which have become malignant – often do not produce any symptoms, which is a key reason screening is so important.
“Screening and early detection is essential to reducing colorectal cancer deaths,” says Dr. Lori Gordon, a colon and rectal surgeon. “Detecting pre-cancerous or cancerous growths in the colon and removing them before they grow or spread is the proven way to increase the patient’s chances of survival.”
Causes & Symptoms of Colorectal Cancer
Age is one of the primary risk factors for colorectal cancer; more than 90 percent of cases occur in people age 50 or older. 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 these symptoms cannot be attributed to 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, especially when no symptoms are present. The colonoscopy also detects benign polyps, which can be present in the colon for many years before becoming cancerous. 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 recommend a colonoscopy at a younger age or at more frequent intervals, depending upon medical history and other factors.
For colonoscopy results to be reliable, the patient must have a completely empty bowel. This typically means patients cannot eat solid foods the day before the procedure and must drink certain fluids prescribed by the physician in order to flush out the 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 first sedated. Then 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 the colonoscopy, 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 usually 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.
“Colonoscopies are nothing to be afraid of. While some patients may dislike the idea of undergoing a colonoscopy, we can’t stress enough how important it is to get this potentially life-saving screening done when recommended by your physician,” said Dr. Glen Hooker, a colon and rectal surgeon. “A bowel preparation the evening before the test, followed by the actual procedure the next day, is a minor inconvenience for a screening tool 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.
What About Those Colon “Cleanses”?
There are a number of non-medical products marketed as colon “cleanses,” which purport to detoxify your colon and improve your health. Save your money and don’t believe the hype, says colon and rectal surgeon Dr. Eduardo Castillo.
“The human digestive system naturally removes waste and bacteria from our bodies,” he explains. “There is simply no need to ‘cleanse’ your colon and taking one of these products can cause unwanted side effects, including dehydration, cramping, bloating, nausea or even worse, a perforated bowel or infection.”
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.
“If you’re 50 years or older and have never had a colonoscopy, make an appointment to see your doctor today,” says colorectal surgeon Dr. Paul Senter. “It’s a decision that could well save your life.”
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