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. Colorectal cancer is the fourth-most diagnosed non-skin cancer in the Unites States. In 2016, more than 141,000 Americans were diagnosed with colorectal cancer and more than 52,000 died as a result of the disease. However, with proper screening and early detection, colorectal cancer can often be successfully treated.
To help raise awareness about colorectal cancer and the tremendous importance of screening and early detection, Privia Medical Group North Texas is sponsoring a team in the 2020 Fort Worth “Get Your Rear in Gear” 5k run/walk, benefitting the Colon Cancer Coalition. The coalition works to increase screening rates and screening awareness across the country. The event will be held on Saturday, August 1 at Trinity Park in Fort Worth.
What is Colorectal Cancer?
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 rectum, which connects the colon to the anus. Both cancers generally begin as polyps – small, non-cancerous clusters of cells inside the colon. Benign polys – and even polyps that have become malignant – often do not produce any symptoms, a key reason screening is so important.
“Screening and early detection are the keys to reducing colorectal cancer deaths,” says Dr. Jason Ledbetter, an internal medicine physician. “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.”
Risk Factors & Causes
As with many other diseases, some risk factors for colorectal cancer are out of our control while others are completely within our control based upon the lifestyle choices we make. Risk factors we cannot control include:
- Age: Age is one of the primary risk factors for colorectal cancer, as more than 90 percent of cases occur in people age 50 or older.
- Race: African Americans are at higher risk of colorectal cancer.
- Inflammatory bowel disease (IBD), including Chron’s disease and ulcerative colitis. See this month’s Digestive Health article for more information on IBD.
- Heredity: Family history of colorectal cancer.
Lifestyle decisions that can affect colon cancer risk include:
- Smoking. Colorectal cancer is one of several types of cancer that can be caused by smoking.
- Excessive alcohol consumption. Drinking too much alcohol can increase risk of several types of cancer, including colorectal. Women should have no more than one alcoholic beverage per day and men no more than two.
- Diets that are high in fat and/or low in fiber.
- Lack of physical activity. Everyone should get at least 30 minutes of physical activity at least five days a week.
Additionally, diabetes is a risk factor for colorectal cancer. For some people, diabetes is out of their control but for many, it can be prevented by a healthy diet and adequate exercise.
As noted above, colorectal cancer often does not produce symptoms, which is why screening is so important. 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
There are several types of screening measures used to detect colorectal cancer and precancerous polyps. The colonoscopy is the most widely used method 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 special fluids, prescribed by the physician, to help 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, with the patient typically sedated. 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 for a comprehensive 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.
“As I tell my patients, colonoscopies are nothing to dread,” says Dr. Ledbetter. “For the patient, it involves a bowel preparation the evening before and then the actual procedure, which will be over in under an hour. That’s a small price to pay for a screening that will give you peace of mind – and it may well save 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 even 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 affecting 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 Dr. Ledbetter. “It’s a decision that could add years to your life.”
This article contains information sourced from: