March is National Colorectal Cancer Awareness month, and serves as a reminder that this serious disease is preventable, treatable and beatable.
According to the American Cancer Society, colorectal cancer is the third leading cause of cancer-related deaths in women in the United States and the second leading cause in men. It is expected to cause about 50,260 deaths during 2017.
General and colorectal surgeon Beth-Ann Shanker, MD, shares insight about colon cancer, risk and prevention in this Q&A.
- How common is colorectal cancer?
Colon cancer is the second leading cause of cancer related death in the United States. However, early detection can impact survival.
- Who is most at risk? Is it genetic?
Most colorectal cancers occur in those without a family history of the disease. However, some individuals are at higher risk. Lifestyle choices can contribute to colon cancer including smoking, being overweight and little physical activity. Other factors cannot be controlled such as a personal or family history. In addition, certain genetic syndromes are associated with a higher likelihood of colon or rectal cancer such as Hereditary Nonpolyposis Colorectal Cancer or Familial Adenomatous Polyposis. Individuals with inflammatory bowel disease, ulcerative colitis or Crohn’s, are also at risk.
- How can I decrease my risk for developing colorectal cancer?
Screening is proven to reduce death from colorectal cancer. There are a number of screening options including stool testing, imaging and an endoscopy.
- What is a colonoscopy?
A colonoscopy is the most common medical procedure performed in the United States. It is a screening that allows the physician to examine the inside of the colon. A small endoscope is inserted into the anal canal and advanced under direct visualization to the first section of the large intestine, known as the cecum. During a colonoscopy, abnormal findings such as polyps can be completely removed, potentially preventing cancer.Patients prepare for the procedure the day before with a special bowel cleanse. During the exam, they are sedated and comfortable.
- Who is recommended to receive a colonoscopy?
Everyone should receive their first colonoscopy by age 50 if are no colorectal symptoms are present.If a first-degree relative has a history of colorectal cancer or polyps before or at age 60, or two or more first-degree relatives at any age, then a colonoscopy should begin at age 40, or 10 years prior to the youngest case, whichever is earlier.If there is a history of colorectal cancer or polyps in a first-degree relative aged 60 or older, or in at least two or more second-degree relatives at any age, then screening should begin at age 40.If there is positive genetic testing for familial adenomatous polyposis, Lynch syndrome or inflammatory bowel disease, a colonoscopy is performed at a younger age, and at more frequent intervals.Your doctor will help you determine what treatment plan is right for you.
- What are the benefits and risks of a colonoscopy?
A colonoscopy can prevent colon cancer, and is proven to decrease death as a result of colon cancer. There is a small risk of perforation, a hole in the colon, or bleeding from removal of a polyp or lesion.
- How is colon cancer treated?
Treatment depends on location and stage of the cancer. Early cancers may be cured with surgery alone. This is done by removing the diseased portion of colon, and making a new connection. Some cancers require additional treatment such as chemotherapy or radiation. This may occur before or after the surgery.
- What is a stoma?
A stoma or ostomy is a limb of intestine brought through the abdominal wall. They are often temporary, but may be permanent on certain occasions. An ostomy is created for a variety of reasons. Your surgeon will discuss this with you before surgery. If the surgeon determines that stool needs to be diverted from the new anastomosis (new bowel connection), a stoma may be placed. If the cancer involves part of the anal canal or anal sphincter muscles, a stoma will also be needed. Emergency surgery for a blockage or a rupture of the colon will require a stoma most of the time.
