Colorectal Cancer

What is Colorectal Cancer?

Colorectal cancer is the third leading cause of cancer deaths in the United States. Approximately 150,000 new cases of colorectal cancer are diagnosed in the United States and 50,000 people die from the disease every year. But, it can be detected early, even before the onset of symptoms, and it’s preventable.

If awareness and screening increased, it’s estimated that 30,000 lives would be saved each year. That’s why it’s encouraged that everyone over 50, or those under 50 with a family history or other risk factors, be screened for colorectal cancer.

Most colon cancer is asymptomatic so age appropriate screening colonoscopy is the most important way to prevent colon cancer.

Symptoms like rectal bleeding, change in bowel consistency or frequency, lower abdominal or anal pain, and weight loss could be signs of colon cancer and usually warrant prompt evaluation with a colonoscopy.

Doctors aren’t sure yet what causes colorectal cancer, but there are some clues they can keep an eye on, like:

  • Polyps: These consist of lumps of precancerous cells which rest along the lining of the colon. They don’t always become cancerous, but it’s impossible for your doctor to know without removing it. They can easily be screened for and removed during a colonoscopy, or a similar procedure.
  • Inherited Gene Mutations: In some cases, colon cancer can be linked to inherited genes from a family member, as certain genes can increase an individual’s risk of cancer. The chance of this happening is small, but worth keeping an eye on.

There are two common forms of inherited colon cancer:

  1. Familial adenomatous polyposis (FAP): A rare disorder which causes the colon and rectum to develop thousands of polyps. If left untreated, FAP can greatly increase the risk of developing colon cancer by the age of 40.
  2. Hereditary nonpolyposis colorectal cancer (HNPCC), or Lynch syndrome: It increases the risk of colon cancer and other cancers. HNPCC causes a high risk of developing colon cancer by the age of 50.

If your doctor suspects the possibility of colon cancer, they may order tests including:

  • Colonoscopy: Your doctor will use a colonoscope, which uses a camera attached to a long, flexible tube, to examine the interior of your colon and rectum. If polyps or suspicious tissue are found, your doctor can remove or biopsy them using tools passed through the colonoscope.
  • CT Imaging: Your doctor will create an image of the interior or your colon through multiple CT scans. This is sometimes called CT colonography, or virtual colonoscopy. It is useful when the patient can’t undergo a colonoscopy.

Stages of Colorectal Cancer

If colon cancer has been diagnosed, your doctor can determine the staging through tests, such as imaging procedures, to determine the best course of action.

  • Stage I: The cancer has grown through the lining (mucosa) of the colon or rectum but hasn’t spread beyond the colon wall or rectum.
  • Stage II: The cancer has grown into or through the wall of the colon or rectum but hasn’t spread to nearby lymph nodes.
  • Stage III: The cancer has invaded nearby lymph nodes. It hasn’t affected other parts of the body.
  • Stage IV: The cancer has spread to distant organs, such as the lungs or liver.

The treatment recommended will depend on the stage of cancer, but the three primary options are:

  • Surgery:
    • Laparoscopic Surgery: During this procedure, your doctor will make several small incisions into the abdominal to insert instruments. The procedure is usually to remove a segment of the colon involved with the cancerous lesion to treat colon cancer at an early stage.
    • Partial Colectomy: Your surgeon removes an affected portion of the colon and reattaches the remaining healthy portions. This is recommended if the cancer has grown into or through the colon wall.
      • In some cases a Partial Colectomy may require a temporary or permanent colostomy, which involves creating an opening in the wall of the abdomen for the bowel to expel waste.
    • Surgery for Advanced Colon Cancer: This generally isn’t done to cure the cancer, but relieve symptoms, such as bleeding, pain, or blockages. These type of surgeries may be performed following or before chemotherapy.
  • Chemotherapy:
    • This treatment is the use of drugs to destroy cancerous cells. For colon cancer, it is usually given after or before surgery if the cancer has spread to the lymph nodes.
  • Radiation:
    • This treatment uses powerful energy sources, such as X-rays, to fight cancerous cells. Radiation therapy isn’t typically used for early-stage colon cancer, and it’s typically used in combination with chemotherapy.
  • Targeted drug therapy:
    • This treatment uses drugs that target specific defects which allow cancerous cells to grow. Targeted drug therapy can be used along with chemotherapy or by itself. It is typically reserved for patients with advanced cases.
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