This is one of a series of columns about health issues written by staff members of ProMedica Physician Group, Mercy Health Partners, University of Toledo Medical Center, and the Toledo Clinic.
Cancer of the colon and rectum is the second leading cause of cancer in the United States with roughly 150,000 newly diagnosed cases and about 50,000 deaths associated with this cancer every year.
The median age for colorectal cancer is around 71 years, however, 1 in 10 colorectal cancer occurs before the age of 50 and 1 in 20 occurs before the age of 45.
The colon and rectum are part of the large intestine. Cancer of the colon and rectum (colorectal cancer) start from the inner lining of the large intestine.
The inner lining of the colon and rectum can lead to the development of a benign growth of cells called a polyp. Over time, some of these polyps can lead to the development of cancer cells.
It is believed that it takes about 10 years for a polyp to develop into a cancer. Since over 95 percent of this cancer starts from a polyp, early detection and removal of these polyps by colonoscopy can lead to an entirely treatable disease.
Causes, risk factors
Advancing age is associated with the development of colon cancer. Patients with prior history of colon polyps or colon cancer have a higher risk for developing a new colorectal cancer.
Family history of colorectal cancer more than doubles this risk. Certain inherited disorders can increase the chance of developing colon cancer. Patients with a history of inflammatory bowel disease like ulcerative colitis or Crohn's Diesease also face an increased risk. Females with history of endometrial cancer run the risk of developing colorectal cancer too.
Dietary factors such as high fat and low fiber diets, consumption of red and processed meats might also be linked to colorectal cancer. Obesity, smoking, heavy alcohol use, and lack of exercise are also contributing factors to the development of colorectal cancer. Certain ethnic groups are at increased risk of developing colon cancer as well.'
In the majority of cases of colorectal cancer, patients have no symptoms. Presence of one of the following: Change in bowel habits, blood in the stool, unexplained anemia, abdominal pain, stools that are narrower than usual, and unexplained weight loss, should prompt further investigation by performing colonoscopy to rule out colorectal cancer. Early detection is the key to longer survival.
Several tests, including checking for occult blood, colonoscopy, barium enema, computer tomographic colonography, and flexible sigmoidoscopy are used in the detection of colorectal cancer and polyps.
Presently, colonoscopy is the most sensitive diagnostic and therapeutic test available. Colonoscopy is performed under sedation and is almost always painless. This procedure requires taking laxatives before the test to clean out the colon. Though the preparation for the colonoscopy is not comfortable, it's worth pursuing as it is the best test available currently. It is strongly recommended that everyone over the age of 50 should have a colonoscopy and then repeat it every 10 years.
If one is experiencing one of the symptoms listed above, or has a family history of colorectal cancer, a colonoscopy may be performed at an earlier age and more frequently.
If the diagnosis of colon cancer is made, the patient is referred to a surgeon for colon resection. After surgery, depending on the stage of the cancer, the patient might need chemotherapy and /or radiation treatment.
If you fit the profile of someone who should have a colonoscopy, then please take the initiative to have your family doctor refer you to a professional who performs colonoscopy, as it might save your life.
Dr. Sanjiv Bais, M.D., F.A.C.S, a graduate of the University of Pennsylvania School of Medicine, is board certified in colon and rectal surgery and has been in practice at the Toledo Clinic for 16 years. His special areas of interest include performing colonoscopy (screening and therapeutic) and colon resection (laparoscopic or open) for benign and malignant diseases of the colon and rectum.
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