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- Cancer -

March 18th, 2018


What You Should Know About Colorectal Cancer

 

Colon

 

Symptoms of Colorectal Cancer

 

Colorectal cancer symptoms include fatigue, weight loss, abdominal pain, rectal bleeding, change in bowel habits, obstruction or perforation, and anemia. However, in early stages, colorectal cancer can be without symptoms.  Screening can detect colorectal cancer in these early stages when it is without symptoms.

 

Demographics of Colorectal Cancer

 

Colorectal cancer is the third most common cancer and the third most common cause of cancer deaths in the US. It is the most frequent gastrointestinal cancer.

The American Cancer Society estimates that 97,000 new cases will be diagnosed in the US this year. Incidence and mortality of colorectal cancer is highest in African-Americans and lowest in Hispanics. The incidence of the disease is about equal in men and women.

 

Risk Factors of Colorectal Cancer

 

Increased risk of colorectal cancer is associated with diets high in red meat and animal fat as well as diets low in fruits, vegetables, and fiber. Processed meats and organ meats are also more highly associated with colorectal cancer. The risk is increased in men and women who do not drink alcohol. It is also higher in obese men and, unexpectedly, in lean women. Increased risk is also associated with cigarette smoking, sedentary habits, and excessive alcohol consumption.

 

Consumption of one ounce of alcohol daily was associated with almost triple the risk of colorectal cancer. Carriers of a gene identified with Lynch syndrome have a 40% lifetime risk of developing colorectal cancer. Age is another risk factor for colorectal cancer and the median age at diagnosis is 68 years.

 

Finally, increased risk of colorectal cancer was associated with ulcerative colitis and Crohn Disease, and those with the gene for familial adenomatous polyposis. Have almost 100% risk of developing colorectal cancer by the age of 40.

 

Screening for Colorectal Cancer

 

Fortunately, colorectal cancer is highly amenable to screening. The disease takes many years to progress from premalignant lesion to cancer, so there is a wide time window in which early action can be taken.

 

The median age at diagnosis is 68 years. This is the reason that all current guidelines recommend routing screening begin at the age of 50 and occur every 10 years. More frequent colonoscopy may be required depending on the patient’s personal and family history as well as on the results of previous colonoscopies.

 

Although screening has already reduced deaths from colorectal cancer, full implementation of screening could reduce deaths by 50% more.

 

Colonoscopy

 

  • Colonoscopy involves your physician inserting a long flexible tube through the anus into the rectum and along the full length of the colon to the point where it joins the small intestine. The tube has channels, one of which is a fiber optic channel through which pictures and video can be taken. Another channel admits the passage of small flexible instruments that can be used to remove small polyps, biopsy tissues, and control any bleeding.

 

Although other technologies are emerging to visualize the colon, colonoscopy remains the gold standard since it allows removing a polyp and consequently definitively treating the precancerous condition.

 

Colonoscopy can be done with various degrees of anesthesia, making the procedure a comfortable outpatient experience.

 

Risk Reduction of Colorectal Cancer

 

Several behavioral alterations can reduce the risk of colorectal cancer. These are

  •        -Screening as recommended by your physician.
  •        -Adopt a diet low in red meat and animal fat.
  •        -Adopt a diet rich in fruit, vegetables, and fiber.
  •        -Reduce processed meats and organ meats.
  •        -Avoid excess alcohol consumption.
  •        -Cease smoking.
  •        -Keep physically active.
  •        -Avoid obesity (especially men).

 

Although earlier data suggested that calcium and vitamin D supplementation might reduce the risk of colorectal cancer, subsequent data showed that such supplementation did not reduce the recurrence of removed colorectal polyps.

 

Some data suggests that celecoxib, sulindac, and dimethylformamine can reduce the risk of colorectal cancer.  

However, aspirin seems to have similar effects with fewer side effects.

 

Treatment of Colorectal Cancer

 

Treatment of colorectal cancer can consist of surgery, radiation, and chemotherapy.

 

Surgery involves removal of the affected portion of the colon along with its areas of lymph drainage. It has the potential to be curative.

 

Radiation is used primarily to treat rectal cancer and metastases from colorectal cancer.

 

Chemotherapy includes both standard chemotherapy agents as well as biologic agents that are antibodies against biologic factors that promote tumor growth and vascularization.

 

Conclusion

 

In summary, colorectal cancer is one of the most common malignancies. However, it is also one of the most preventable. Screening as advised by your physician, along with dietary changes cessation of smoking, and weight reduction

will certainly reduce both incidence and deaths from this disease.

 

Thomas Falasca, DO

 

 

References

 

Dragovich, T. (2018, January 30). Colon Cancer. Retrieved March 18, 2018, from https://emedicine.medscape.com/article/277496-overview

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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