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Colon and Rectal Cancer

Colon and rectal cancer (CRC) is the second leading cause of cancer death in the United States. Both men and women are at equal risk of developing the disease with a lifetime risk of 5%. Over 150,000 cases of CRC will be diagnosed this year.

The colon and rectum make up the large intestine, which measures approximately 6 feet. The basic function of the colon is to absorb water while the rectum acts as a reservoir for the body’s wastes.

The risk of CRC increases with age. Over 90% of colon cancers develop when patients are age 50 and older. Screening for average risk individuals should begin after turning 50 years old.

Known increased risk factors are:

  • Personal or family history of colon and rectal cancer or polyps
  • Inflammatory bowel disease
  • Certain genetic disorders
  • Personal history of breast or female genital tract cancer-screening should begin at a younger age
  • CRC is a silent disease that can present with little or no symptoms. Blood in the stool, a change in bowel habits, weight loss or abdominal pain that persists should be evaluated by your physician. Today, multiple tests are available for screening which include a simple stool test for blood, flexible sigmoidoscopy, colonoscopy, barium enema study and virtual colonoscopy. Discuss with your physician which study is the most appropriate for you.

    The goal of screening is detection of polyps which are the precursor of cancer in 90% of cases. Polyps are an abnormal outgrowth of the inside lining of the large intestine that can degenerate into cancer with time. This timeline may take up to 8-10 years. WIth an adequate screening schedule in place, polyps can be detected and removed, making CRC preventable in most cases.

    The mainstay of treatment for CRC is surgery, but can involve chemotherapy and radiation treatment. Surgery involves removing the segment of colon containing the cancer. This procedure can be accomplished through a traditional open incision on the abdomen or by a minimally invasive technique using a camera and video monitors. The obvious advantages with the minimally invasive approach are smaller incisions, less discomfort and shorter hospitalization. Not everyone is a candidate for a minimally invasive technique, though, and you should discuss the pros and cons of each approach with your surgeon. Treatment with chemotherapy or radiation may be indicated in the post-operative phase if the cancer has spread.

    Finally, CRC is a preventable disease with early detection and treatment. Make sure colon cancer screening is part of your next routine physical examination or a priority if you develop any of the above signs or symptoms.