Some Facts About Colorectal Cancer
The first thing you need to know about cancer of the colon or rectum, also called colorectal cancer or large bowel cancer, is this: It is the second most common cause of cancer deaths in men and women in the United States. Each year, nearly 130,000 people learn they have colorectal cancer. Usually they are men and women over the age of 50.
The second thing you need to know is that colorectal cancer is one of the most curable types of cancer. When detected early and promptly treated, people often can return to normal lives. Colorectal cancer frequently develops slowly over a period of years, sometimes beginning as a small polyp (a benign tumor that grows inward from the wall of a hollow organ such as the colon or rectum). Because of this, it is possible to detect the cancer before symptoms develop.
This web page is designed to give you the facts you need to understand and hopefully prevent getting colorectal cancer. Let's start by answering a basic question.
What is the Colon?
The colon, with is about five to six feet in length, is the lowest portion of the digestive system. It is sometimes called the large bowel or large intestine. The last eight to 10 inches of the colon is the rectum. After food is digested, solid waste moves through the colon and rectum to the anus, where it passes out of the body.
Tumors can develop anywhere in your colon or rectum. If colorectal cancer cells spread outside your colon or rectum, they often travel to nearby lymph nodes (lymph glands). Colorectal cancer can also spread to other parts of your body, such as the liver, lungs, brain, kidneys and bladder.
Are You at Risk for Developing Colorectal Cancer?
Everyone has some possibility of developing colorectal cancer, but some people have higher risk factors – those things that increase their chance of developing the disease. If you fall into any of the following groups, you should be aware that your risk for developing colorectal cancer is increased. However, not everyone at high risk develops colorectal cancer.
- A family history of colorectal cancer. As many as 20 percent of all
colorectal cancers have a genetic basis. This is particularly true if
you have two or three family members who develop the disease
(brother, sister, parents, grandparents, aunts or uncles).
- Familial polyposis. This is an inherited condition in which
hundreds of polyps develop in the colon and rectum. Over time,
these polyps can become cancerous. If you have this condition and
do not receive treatment, you will almost certainly develop colorectal
cancer.
- A personal history of intestinal polyps. Colorectal polyps should be
removed because they can become cancerous. If you have had one
colorectal polyp, you are likely to develop new ones. For this reason,
you should have regular follow-up exams.
- A history of ulcerative colitis or Crohn's disease. These diseases
cause inflammation of the lining of the colon. Your risk for colorectal
cancer is much greater than average if you have these diseases,
and your risk increases with the length of time you have either
disease.
- A personal or family history of breast, ovarian or uterine cancer.
- A diet high in fat, low in fruits and vegetables, and low in high-fiber
foods such as whole-grain breads and cereals.
What You Can Do to Prevent Colorectal Cancer
You may be able to prevent colorectal cancer by changing your diet and exercising regularly.
- Reduce your intake of foods high in fat. Less than 30 percent of your
total daily calories should come from fat.
- Increase your intake of food high in fiber. Your diet should contain
20 to 30 grams of fiber per day.
Early Detection of Colorectal Cancer
Most health problems are best treated when they are diagnosed early, and this is especially true of colorectal cancer. When colorectal cancer is detected early, it is easier for you to recover from treatment and you probably will not need a colostomy (a surgically created opening into the colon through the abdomen permitting body waste to be eliminated).
There are a number of screening tests recommended for the early detection of colorectal cancer. These are effective ways of detecting polyps, which can be removed before they become cancer. These tests are recommended for both men and women. Despite the common belief that the disease occurs more frequently in men, the fact is that its occurrence is nearly equal in women.
- You should have a digital rectal examination every year after age 40.
During this examination, you physician inserts a gloved, lubricated
fingerinto the rectum and gently feels for lumps. This test takes
less than a minute,and there is minimal discomfort. If you are a
man, this examination also checks for prostate cancer.
- You should have a stool blood test every year after age 50. You do
this test at home by collecting small samples of three consecutive
bowel movements and placing them on special cards. When you
are collecting the specimens, you will be instructed to follow
a special diet. A chemical is placed on the cards by a trained
health professional to check for hidden blood. Cancers and
polyps in the colon may bleed. This test checks your stool
for hidden blood, which may indicate the need for more testing.
- You should have a sigmoidoscopy exam every three to five years
beginning at age 50. During flexible sigmoidoscopy, your physician
directly examines the rectum and lower third of the colon by
inserting a thin, lighted hollow tube into the rectum. This
test requires some preparation with enemas. It takes about
20 minutes, and anesthesia is not required. If a polyp or
suspicious area is seen, you then must be sent for a colonoscopy
so that the entire colon can be checked and the polyp removed.
- If you have several risk factors or a strong family history of colon
cancer, your physician may recommend you have a colonoscopy or
double-contrast barium enema. During the colonoscopy, a long,
flexible hollow tube, similar to a sigmoidoscope, is inserted
through the rectum. This long tube can examine the entire colon.
If a polyp is found during the examination, it can be removed at
that time. Colonoscopy requires more preparation with enemas
than sigmoidoscopy, and it requires sedation. Colonoscopy is
generally done every five to 10 years, depending on the findings
and history. If you are at higher risk for colorectal cancer,
you need an examination of your entire colon. A double contrast
barium enema uses barium and air as contrast agents to visualize
the interior of the colon and rectum.
Be Aware of the Signs and Symptoms of Colorectal Cancer
Often there are no early signs or symptoms of colorectal cancer. That is why it is important for you to have regular check-ups for colorectal cancer to find it early, when treatment is most effective. When symptoms do occur, they may include:
- Stools that are narrower than usual.
- Diarrhea or constipation.
- Blood in or around the stool. It may be bright red or black in color.
- A feeling that the bowel does not empty completely.
- Unexplained weight loss.
- Constant tiredness.
Remember, these symptoms do not always mean cancer, and only your doctor can make a diagnosis.
Cancer Services at Saint Louis University Hospital
Saint Louis University Hospital's standing as an academic medical center puts it at the forefront in developing and providing the latest medical treatment and procedures for colorectal cancer patients.
Saint Louis University Hospital offers all the recommended screening and genetic tests in addition to novel surgical and medical therapies for advanced disease. SLUCare specialists who treat colorectal cancer include: gastroenterologists experienced in a wide range of tests and procedures such as advanced endoscopy with endoscopic ultrasound; oncologic and colorectal surgeons with a variety of experience including sphincter-sparing procedures; oncologists experienced with the latest drug therapies; and radiation oncologists who offer the latest in radiation therapies.
For more information on our services, call our Cancer Information Center at (314)577-8833.