Colorectal Cancer

Colorectal Cancer

It is estimated that as many as 90% of colorectal deaths could be prevented if everyone ages 50 years or older were screened routinely.

We can’t emphasize enough that colorectal cancer is preventable, treatable and beatable if diagnosed at an early stage. Although it is the third most common type of cancer in the U.S. and currently remains the second leading cause of cancer death, it is also highly curable, and even preventable with proper screening.

You can take action and reduce your own risks!… More than 90% of colorectal cancer cases are diagnosed in people age 50 or older. It develops from precancerous polyps (abnormal growths) in the colon or rectum. Screening tests can find these precancerous polyps, so that they can be removed before they develop into cancer. Additionally, screening tests can also find colorectal cancer at an early stage when treatment works best. Still colorectal cancer causes 60,000 deaths annually, emphasizing the need for proper screening.

Should I be Screened for Colorectal Cancer?

If you are 50 years old or older, the answer is yes. Although there are several screening methods, colonoscopy is the most effective modality in colon cancer prevention. Colonoscopy will often be recommended for patients in the following situations:

  • Both men and women 50 years old or older with no symptoms or family history.
  • Patients younger than 50 who are at a higher risk due to a family history of colorectal, breast or uterine cancer.
  • Patients with blood in their stool, dark stools, or occult blood.
  • Patients with any significant change in bowel function (constipation, diarrhea, or change in consistency, size, and/or color of stool).
  • Patients with abdominal pain or weight loss.
  • Patients with a history of colon polyps or cancer.
  • Patients with a history of inflammatory bowel disease, such as Crohn’s disease or ulcerative colitis.

Why colonoscopy and not other colon testing methods?

Colonoscopy is considered the gold standard for colon testing. Other options include barium enema, sigmoidoscopy, virtual colonography and stool testing. The advantages of colonoscopy over the other modalities include:

  • A much better total visualization of the colon with a higher level of detail than other methods.
  • The ability to treat problems at the same time (i.e., biopsy, polyp removal, treatment of bleeding site). A finding on any other test would then require a colonoscopy for treatment.
  • The procedure is performed under conscious sedation for maximum patient comfort

What is a Colonoscopy?

Colonoscopy is an extremely safe and effective procedure for viewing the full lining of the colon and rectum. The colonoscope is a long, thin, flexible instrument with a camera at the tip for viewing. It is introduced through the rectum and advanced until it reaches the beginning of the colon (about 4 feet). Images from the colonoscope appear on a video monitor with a high degree of detail and magnification providing excellent visualization of the entire colon.

How is Colonoscopy performed?

Colonoscopy is performed under “conscious sedation”. This means the patient is given medicine through an IV so they are not awake, not aware, not in pain, and have no memory of the experience. Over 99% of patients relate a positive experience with the procedure. Typically, the exam will take less than 25 minutes, and patients are home usually within 1-2 hours. Patients may experience bloating and/or diarrhea for 1-2 days after the procedure.

On the day prior to the colonoscopy the colon needs to be prepared for the procedure. Patients may consume liquids all day. A special bowel prep is given to clean out stool from the colon. The day after colonoscopy patients can resume normal eating, medicines, and activities without any restrictions.

How Does Colorectral Cancer Treatment Work?

If colorectal cancer is not confined to be a polyp, proper cancer treatment involves surgery to eliminate the cancer and to achieve a cure. At times chemotherapy and radiation therapy may be required. If a cancer is diagnosed at an early stage the cure rate can be as high as 90%. However, if a cancer is diagnosed at an advanced stage the cure rate drops to 50% or even less. With minimally invasive surgery, including laparoscopy and robotic surgery, the recovery time after cancer surgery has become shorter than with open surgery. Thanks to laparoscopy and robotics many surgical procedures have become more precise given the improved visualization and the possibility to work in narrow spaces, like the lower pelvis. Also scars have become smaller and healing is faster and less painful. Using modern surgical techniques and instruments less than 5% of all colorectal cancer patients require a permanent colostomy, which is a surgically created opening that allows the excretion of stool into a bag like appliance.

Colorectal cancer is a preventable cancer. The first and most important step towards preventing colorectal cancer is getting screened. Any new changes of bowel habits, bleeding or pain should be discussed with a colorectal surgeon.

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