Colorectal Cancer

Colorectal  cancer is the second  most common cancer in the United States, striking 140,000 people annually  and causing 60,000 deaths. That’s a staggering figure when you consider the disease  is potentially curable if diagnosed in the early stages. 

Who  is at risk? 

Though colorectal cancer may occur at any age,  more than 90% of the patients are  over age 40, at which point  the risk doubles every ten years. In addition  to age, other high risk factors include a family history of colorectal cancer and polyps and a personal history of ulcerative colitis, colon polyps or cancer of other organs, especially of the breast or uterus. 

How does  it start? 

It is generally agreed that nearly all colon and rectal cancer begins in benign polyps. These pre-malignant  growths occur on  the bowel wall  and may eventually increase in size and  become cancer. Removal of benign polyps is one aspect  of preventive medicine that really works! 

What are  the symptoms? 

The most common symptoms are rectal bleeding and changes  in bowel habits, such as constipation or diarrhea. (These  symptoms are also common in other diseases  so it is important you receive a thorough examination  should you experience them.) Abdominal pain and weight loss are usually late symptoms indicating possible extensive disease. 

Unfortunately, many polyps and early cancers fail to produce symptoms. Therefore, it is important that your routine physical includes colorectal cancer detection procedures once you reach age 50. 

There are several methods  for detection of  colorectal cancer. These include digital rectal examination,  a chemical test of the stool for blood, flexible sigmoidoscopy and colonoscopy (lighted tubular instruments used to inspect the lower bowel) and barium enema. Be sure to discuss these options with your surgeon to determine which procedure is best for you. Individuals who have a first-degree relative (parent or sibling) with colon cancer or polyps should start their colon cancer screening at the age of 40. 

How is colorectal cancer treated? 

Colorectal cancer requires surgery in nearly all cases for complete cure. Radiation and chemotherapy are sometimes used in addition to surgery. Between 80-90% are restored to normal health if  the cancer is detected and treated in the earliest stages. The cure rate drops to 50%  or less when diagnosed in  the later stages. Thanks  to modern technology, less than 5%  of all colorectal cancer patients require a colostomy, the surgical construction of an artificial excretory opening from  the colon. 

Can colon  cancer be prevented? 

Colon cancer  is preventable. The most important step towards preventing colon  cancer is getting a screening test. Any abnormal screening test should be followed by a colonoscopy. Some individuals prefer to start with colonoscopy as a screening test. 

Colonoscopy provides a detailed examination  of the bowel. Polyps can be identified  and can often  be removed during colonoscopy. 

Though not definitely proven, there is some evidence that diet may play  a significant role in preventing colorectal cancer. As far as we know, a high fiber, low fat  diet is the only dietary measure that might help prevent colorectal cancer. 

Finally, pay attention to changes in your bowel habits. Any new changes  such as persistent constipation, diarrhea, or blood in the stool should be discussed with your physician. 

Can hemorrhoids lead to colon cancer? 

No, but hemorrhoids may produce symptoms similar to colon polyps or cancer. Should you experience these symptoms, you should have them examined and evaluated by a physician, preferably by a colon  and rectal surgeon.