March is Colorectal Cancer Awareness Month. Colorectal cancer is the second-leading cause of cancer-related deaths in the United States for men and women combined.
Q: Where and what is the colon?
A: The colon, also known as the large intestine, is a tube-like hollow organ that starts inside the anal opening and includes the rectum, sigmoid colon, descending (or left) colon, transverse colon, and ascending (or right) colon. The colon is shaped like a question mark and is located in the abdomen and pelvis. It is present in all individuals. The colon serves to absorb fluid and electrolytes and transports and stores fecal material until defecation.
Q: What is colorectal cancer?
A: Colorectal cancer is cancer of the colon or rectum that usually begins with the development of noncancerous polyps on the lining of the large intestine. Polyps are mushroom-like growths that form when cells lining the colon grow, divide and reproduce in an unhealthy, disorderly way. Polyps can become cancerous over time, invading the colon wall and surrounding blood vessels and spreading to other parts of the body and lymph nodes. Colorectal cancer strikes men and women with almost equal frequency.
Q: What are the symptoms of colorectal cancer?
A: Colorectal cancer is often a silent disease, which may develop with no symptoms at all. However, when symptoms do occur, they may include: blood in or on the stool; a change in bowel habits; narrower stools than usual; general stomach discomfort, including bloating, fullness or cramping, vomiting, diarrhea, constipation or a feeling that the bowel does not empty completely; along with frequent gas pains, weight loss for no apparent reason, rectal bleeding or constant tiredness.
Q: Why is colorectal cancer a concern?
A: In the year 2001, approximately 140,000 new cases of colorectal cancer will be diagnosed and 56,000 people will die from the disease. These numbers surpass both breast cancer and prostate cancer in mortality; colorectal cancer is second only to lung cancer in number of deaths in the United States. However, polyp-related colorectal cancer can be prevented and the risk of colorectal cancer minimized if adequate preventive steps are taken. Removal of colon and rectal polyps before they become cancerous may prevent cancer from developing.
Q: Who is at risk?
A: Colorectal cancer risk increases with age. People at greater risk for colorectal cancer include those with a personal or family history of colorectal polyps or cancer. Other risk factors include a personal or family history of inflammatory bowel disease, including ulcerative colitis or Crohn's disease, and a personal or family history of ovarian, endometrial or breast cancer. People of African-American and Hispanic descent (who are often diagnosed at a later stage of the disease) and anybody over the age of 50 are also at greater risk.
Q: What can be done to lower risk of colorectal cancer?
A: In order to lower the risk of colorectal cancer, the American Society of Colon and Rectal Surgeons has recommended that regular colorectal cancer screenings start at age 50. The American Cancer Society has recommended yearly rectal exams and hemoccult card testing of the stools starting at age 50.
Screening for colorectal cancer is just as important as screening for prostate cancer with PSA levels, screening for cervical cancer with PAP smears, and screening for breast cancer with mammograms because colorectal cancer kills more Americans than any other cancer except for lung cancer. To lower the risk of developing colorectal cancer, studies have shown that we should adhere to a low-fat and high-fiber diet, minimize the use of alcohol and avoid the use of tobacco. Alcohol and tobacco in combination have been linked to colorectal cancer and other gastrointestinal cancers as well. It has also been recommended that exercising for at least 20 minutes, three to four days each week, and moderate exercise such as walking, gardening or climbing steps may help.
Q: What are the current screening methods for colorectal cancer?
A: Currently, recommended screening methods for colorectal cancer should include all men and women age 50 or older. For those with a family history of colorectal cancer, screening should start approximately 10 to 15 years earlier than the earliest documented cancer.
Currently, recommended screening methods include fecal occult blood testing, which is a simple chemical test that can detect hidden blood in the stool starting at age 40 on a yearly basis along with digital rectal exams. A baseline flexible sigmoidoscopy is recommended at age 50, which is a visual examination of the rectum and lower portion of the colon performed in the doctor's office.
Other screening techniques include the double-contrast barium enema, which is a barium x-ray test of the large bowel as well as a colonscopy, which is a visual examination of the entire colon, which can also be used to remove polyps. Colorectal cancer screening costs are covered by Medicare and many commercial health plans and studies have shown that by instituting adequate screening programs, at least 30,000 lives in this country could be saved every year by the removal of polyps and early cancers found through regular screening programs. You should find out from your healthcare provider which screening procedures are right for you, since the key to stopping this killer, colorectal cancer, is early detection.
