Early Screening for Colorectal Cancer Saves Lives
Nandagopal S. Vrindavanam, MD, is a medical oncologist at Atrium Medical Center in Middletown.
Q. Who is at risk for colorectal cancer? What are the warning signs? What tests do you need to check for colorectal cancer, and how is it treated?
A. Colorectal cancer is common, but the good news is that early screening can catch and cure most cases. March is National Colorectal Cancer Awareness Month, a great time to learn more about your risks and how to recognize and prevent this disease.
Colon cancer is cancer of the large intestine (colon), the lower part of your digestive system. Rectal cancer is cancer of the last several inches of the colon, the passageway connecting the colon to the anus. Together, they're often referred to as colorectal cancer. More than 140,000 new cases of colorectal cancer are diagnosed each year in the U.S., with more than 50,000 people dying from the disease annually. In both men and women, colorectal cancer is one of the top three most common cancers. It accounts for 9 percent of cancer deaths in this country.
The older you are, the greater your chances of having colorectal cancer. It is uncommon before age 40, with more than 90 percent of cases occurring in people age 50 or older. Incidence of the disease is 25 percent higher in men than women, and 20 percent higher in African-Americans than other races.
Both genetic and environmental factors can put you at risk. If your parent, sibling or child had colorectal cancer, you are more likely to get it. In about 5 percent of patients with colorectal cancer, a well-defined inherited syndrome causes the disease. Inflammatory bowel disease (ulcerative colitis and Crohn’s disease), as well as diabetes and insulin resistance, put you at higher risk for colorectal cancer.
Your lifestyle also may increase your risk. Lack of regular exercise, a low-fiber, high-fat diet with few fruits and vegetables, being overweight or obese, consuming alcohol and smoking all can contribute to the development of colorectal cancer. On the positive side, regular exercise reduces the risk of getting the disease by 24 percent for both men and women. Extended, regular use of aspirin and other non-steroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen, also is associated with lower risk of colorectal cancer, although you should not begin taking these drugs long-term without first consulting your doctor.
Most cases of colorectal cancer begin as small, noncancerous (benign) clumps of cells called adenomatous polyps. Over time some of these polyps become cancers. Polyps may be small and produce few, if any, symptoms. However, these symptoms may indicate cancer: abdominal pain, change in your bowel habits, blood in the stool, weakness, anemia and weight loss with no known cause.
Doctors recommend regular screening tests to help prevent colorectal cancer by identifying and removing polyps before they become cancer. Today, colonoscopy is the “gold standard” screening exam. You should have your first colonoscopy at age 50, or earlier if you are at greater risk for the disease. After you’ve prepared by cleaning your colon, you’re given anesthesia. Your doctor uses a long, flexible and slender tube attached to a video camera and monitor to view your entire colon and rectum. If any suspicious areas are found, your doctor can pass surgical tools through the tube to take tissue samples (biopsies) for analysis.
Alternately, your doctor may recommend a barium enema, a test that uses dye and x-rays to make a picture of your colon. Virtual colonoscopy, also called CT colonography, is beginning to become more common. It uses multiple CT images to create an image of your colon.
Regardless of the method, if tests reveal that you have colon cancer, treatment is based on a staging system that assesses the size of the tumor and whether the cancer has spread to lymph nodes and other areas of the body. Surgery is the principal treatment for colorectal cancer. For less invasive cancers, it often is a cure. Depending on the tumor’s stage, a patient may need surgery followed by chemotherapy. New, very sophisticated tests for colon cancer can determine the specific treatment best suited to you based on your genetic type.
Early diagnosis of colorectal cancer can often lead to a complete cure. That’s why knowing your family history and getting appropriate screening is so important. Talk with your doctor about what you can do to prevent colorectal cancer.