Colon Cancer
Also known as: Colorectal Cancer
What is it?
Colon cancer is one of the most preventable
forms of cancer. It almost always starts with
non-cancerous growths (called polyps) that
develop on the lining of the colon and rectum.
Polyps can become cancerous, but if they are
found early through screening tests they
can be removed and the cancer stopped
before it even gets started.
How common is it?
The lifetime probability of an average person
developing colorectal cancer is 6% (or about 1 in
20).
Colon cancer is the third most commonly
diagnosed cancer in the United States in both men
and women.
Colon cancer is the second leading cancer
killer, right behind lung cancer.
More women than men will be diagnosed with and
will die from colon cancer in the year 2000.
Who gets it?
Although colorectal cancer may occur at any
age, more than 90% of these growths occur in
people over the age of 40. The risk increases
with age; most people diagnosed with the disease
are in their 50’s or 60’s.
Certain conditions are associated with a
higher risk including a family history of polyps
or colorectal cancer; a personal history of
breast, uterine, or ovarian cancer; and
inflammatory bowel disease (ulcerative colitis or
Crohn’s disease).
What are the symptoms?
Many polyps and cancers of the colon or rectum
do not produce symptoms until they are fairly
large. That is why it is recommended that
screening for colorectal cancer should start
before symptoms occur – while polyps, if
present, are small.
The most common symptom is bleeding with bowel
movements. Blood may be seen in the stool, toilet
water, or on the toilet tissue.
Changes in bowel habits, such as new problems
with persistent diarrhea or constipation may
occur. The stool may look more narrow than usual.
Abdominal pain or unexplained weight loss may
be symptoms that occur as the disease progresses.
How can colorectal cancer be prevented?
Recent research suggests that a high fiber,
low-fat diet plays a role in prevention; how
great a role it plays is unclear. Fiber helps to
move waste through the colon and may even protect
cells in the lining of the colon from developing
into polyps. A good rule of thumb is that the
average adult should consume at least 25 – 35
grams of fiber daily. This amount can be obtained
by eating five half-cup servings of fruits and
vegetables every day. For adults, adding a
soluble fiber supplement is an easy and practical
way to obtain the recommended daily intake of
fiber.
Staying active and drinking at least 8
eight-ounce glasses of non-caffeinated fluid
daily also is good for digestive health.
By following the recommended screening
methods, many polyps and growths can be detected
early. Finding and removing colorectal polyps
with sigmoidoscopy and colonoscopy clearly
reduces the risk of their development into
cancers.
Diagnosis
Average risk:
Beginning at age 40, men and women who have
none of the risk factors described above should
be examined by their healthcare provider annually
with a digital rectal examination and a test for
blood in the stool.
At age 50 a flexible sigmoidoscopic
examination of the lower bowel should be
performed. With this procedure, a thin flexible
tube is passed into the anal opening to look at
the lower portion of the large bowel. Polyps or
growths of this area can be identified and
removed.
Or
A colonoscopy should be done every 10 years.
With this procedure, a thin flexible tube is
passed into the anal opening to look at the
entire large bowel. Polyps or growths of this
area can be identified and removed.
Or
A double contrast barium enema x-ray should be
done every 5 – 10 years.
Increased risk:
When personal or family history indicates that
you are at increased risk for colon cancer,
beginning at age 40 or earlier, the following is
indicated:
A total evaluation of the colon by colonoscopy
at intervals determined by your healthcare
provider.
Or
A double contrast barium enema x-ray and a
flexible colonoscopy as recommended by your
healthcare provider.
Treatment
If the cancer is located in the last few
inches of the rectum, there may be several ways
to treat it. Larger, non-cancerous polyps may be
removed through the anal opening. Most of the
larger cancers are removed through an abdominal
incision. Although the bowel is usually
reconnected after surgery, removal of the entire
rectum and anus may be necessary if the cancer is
located very close to the anal opening. In this
case a colostomy is created.
If the cancer is located higher up in the
colon, surgical treatment may be recommended. An
operation is usually performed through an
abdominal incision. The section of bowel
containing the cancer and the lymph nodes close
to it are removed. In most cases, the bowel is
reconnected so that normal bowel function is
restored. If the cancer has spread to the lymph
nodes or to other organs in the body, additional
treatment such as chemotherapy or
radiation therapy may be suggested.
What kind of surgeon can I talk with about
removing colon cancer?
Colon and rectal surgeons are experts in the
surgical and nonsurgical treatment of colon and
rectal problems. They have completed specialized
and advanced training in the treatment of colon
and rectal problems in addition to full training
in general surgery. In addition to treating
benign colorectal problems, such as hemorrhoids,
these specialists are experts in treatment of
colon cancer. They also perform routine screening
examinations and treat problems surgically, when
necessary.
At Penn State Milton S. Hershey Medical
Center, the Section of Colorectal Surgery is
available to treat colorectal disease. Through a
collaborative approach with the patient and
consulting physician,
Dr. Walter A. Koltun,
Dr.
Lisa S. Poritz, and Marjorie Lebo, MSN, CRNP
provide specialized care in the management of
colorectal disease. Appointments are available by
calling (717) 531-8887.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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