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March is Colorectal Cancer Awareness Month

As the #2 Cancer Killer, Colorectal Cancer Deserves More Attention

According to the CDC, among cancers that affect both men and women, colorectal cancer (cancer of the colon or rectum) is the second leading cause of cancer deaths in the U.S. Each year, approximately 140,000 Americans are diagnosed with colorectal cancer, and more than 50,000 people die from the disease.

What is Colorectal Cancer?

The colon, also known as the large intestine, is approximately five to six feet long. It begins at the cecum and ends with the anus. The last 5 to 10 inches of the colon is known as the rectum—cancer located in the rectum is called rectal cancer.

According to the website Fight Colorectal Cancer, colorectal cancer (CRC) occurs when abnormal cells form tumors in normal tissues of the intestines and digestive system. The exact type of “colon” or “rectal” cancer found depends on where the abnormal cells first began and how fast they grew and spread. Colorectal cancer is the term encompassing both cancer types.

CRC may have no symptoms at first, but, as the tumor grows, it can disrupt the body’s ability to digest food and remove waste, causing potentially severe bowel and abdominal problems.

At first, the tumor is contained within the colon or rectum. This is called “local” CRC. Over time, cancerous cells may move to nearby lymph nodes, and eventually other parts of the body.

Stage III colorectal cancer means that cancer cells spread to lymph nodes. Late-stage colorectal cancer (stage IV or recurrent) means the cancer is advanced and cancer cells spread (metastasized) to form tumors in other areas of the body such as the liver or lungs.

Who’s at Risk?

While over 90% of colon and rectal cancers are found in people over the age of 50, anyone at any age can get CRC. People younger than 50 years of age should protect themselves by knowing their family cancer history and their own medical history.

Individuals with a family history of a certain cancer or with certain medical conditions may need to start colonoscopy screening earlier and be tested more often.

Age

Over 90% of those diagnosed with colorectal cancer are over age 50. As we age, we are more likely to grow polyps which have the gene changes that turn normal tissue into cancer.

Personal History of Polyps of Colorectal Cancer

If you have a personal cancer history of colon polyps or colon cancer, rectal cancer, ovarian cancer, endometrial cancer or breast cancer – you may be at an increased risk of colorectal cancer. You may also want to talk with your doctor about whether genetic testing is appropriate for you.

Inflammatory Bowel Disorders (IBD)

If you’ve been diagnosed with an inflammatory bowel disorder such as ulcerative colitis or Crohn’s Disease, you are at a higher risk for colorectal cancer. Talk with your doctor about when to begin screening.

Genetic Conditions

Two of the most commonly known genetic conditions put individuals at a higher risk for colon and rectal cancers: Familial Adenomatous Polyposis (FAP) and hereditary nonpolyposis colorectal cancer (HNPCC), also known as Lynch Syndrome. If you are diagnosed with a genetic syndrome you are at an increased risk for colon cancer. Speak with your physician about when screening is right for you.

Family History

If you or a family member has a history of colorectal cancer, or colon polyps, you may be at an increased risk for colorectal cancer. Generally, screening for family remembers is recommended to begin 10 years prior to the survivor’s age of diagnosis. (For example, if a loved one was diagnosed at age 52, family member screening needs to begin at age 42.)

If your family has a known genetic syndrome, screening may be recommended earlier. Talk to your doctor about the best option for you.

Everyone, no matter their age, should know the signs and symptoms of colorectal cancer and have a complete colonoscopy to rule out cancer if they have symptoms.

CRC Symptoms

Symptoms of the disease may go unnoticed in the early stages, according to the Cancer Treatment Centers of America, but, as the disease progresses, the symptoms may be easier to recognize and could severely increase with time. Symptoms can be broken down into two categories: Local and systematic.

Local symptoms of colorectal cancer include:

  • Constipation;
  • Diarrhea;
  • Changes in bowel habits;
  • Bleeding from the rectum or finding blood in stool; and
  • Unusual bloating, cramping, and discomfort.


S
ystemic signs of CRC affect the entire body and include:

  • Loss of appetite;
  • Severe weight loss;
  • Fatigue;
  • Jaundice;
  • Anemia;
  • Nausea; and
  • Vomiting.

Prevention Measures

Lifestyle

Low physical activity, obesity, smoking, and heavy alcohol use are all linked to a higher incidence of colorectal cancer.

Diet

A diet high in red meats (beef, pork, lamb) processed meats and fats may all be linked to colorectal cancer.

Preventing CRC

While colorectal cancer screening is the most important way to prevent colorectal cancer, certain lifestyle changes can reduce your risk for polyps and CRC. The following strategies may significantly decrease risk of the disease:

  • Don’t smoke.
  • If you do smoke, stop.
  • Increase your physical activity.
  • Maintain a healthy body weight.
  • Avoid overall body fat, especially fat around your waist.
  • Reduce how much red meat and processed meats you eat.
  • Use alcohol in moderation.

These additional strategies may also reduce your risk:

  • Increase foods that contain dietary fiber.
  • Include garlic in your diet.
  • Drink more milk if you can tolerate it.
  • Add foods with calcium.
  • Use alcohol in moderation if you are a woman.

Treatment and Survival Rates

Every person is different and responds differently to treatment. However, with prompt and appropriate treatment, the outlook for a person with CRC is hopeful. The Cleveland Clinic reports that the survival rate for people with the disease depends on the extent of the cancer at the time of diagnosis and the individual’s response to treatment. In addition, many new discoveries have the potential for improving the treatment of CRC, as well as the prognosis.

Several factors determine how well a person will do after treatment for colorectal cancer. They include:

Stage of Cancer

According to the National Cancer Institute, survival for Stage I colon or rectal cancer is approximately 9%. Survival for Stage II is between 72 and 85% and for Stage III, 44 and 83%. Chemotherapy may improve prognosis for Stage III cancer. Stage IV cancer has a poor prognosis; about 8% are alive at five years.

Number of Lymph Glands Involved

The lymph system is a circulatory system that includes an extensive network of lymph vessels and lymph nodes. The lymphatic system helps coordinate the immune system’s function to protect the body from foreign substances. The more lymph glands that were affected by the cancer, the more likely your cancer will recur. Chemotherapy may be needed in cases where lymph nodes are involved.

Spread to Other Organs

If the colorectal cancer is advanced, it may spread to other organs, such as the liver or lungs. In this case, additional chemotherapy or radiation may be needed to help delay the further spread of the cancer.

Quality of Surgery

This is most important for rectal cancers, where the surgery can be difficult.

Many people who have had colorectal cancer live normal life spans. The treatments available today offer good outcomes, but you may require several treatments or a combination of treatments (surgery, chemotherapy, radiation) to have the best chance of avoiding a recurrence of the cancer. Always tell your doctor about any changes in your health to ensure he is able to decide if you need any additional screening tests or treatment.

For more information on screenings for colorectal cancer, call the CCHC Endoscopy Center in New Bern, at (252) 514-6644. A team of doctors and other health care providers are ready to discuss any concerns you may have.

(Sources: The Centers for Disease Control and Prevention (CDC); FightColorectalCancer.org; Cancer Treatment Centers of America; Cleveland Clinic; National Cancer Institute; American Society of Colon and Rectal Surgeons; and Society of Gastroenterology Nurses and Associates, Inc.)