Colorectal cancer is the third most common cancer in men and women. An estimated 131,000 Americans are diagnosed with this disease each year and some 55,000 die as a result of it. Certain genetic factors play a role in the development of this cancer. The specific cause of Colorectal cancer is unknown, however, environmental, genetic, familial factors and preexisting Ulcerative Colitis have been linked to the development of this cancer. It is more common among African-Americans.
CAUSES OF COLON CANCER
Age: Average age at the time of diagnosis is between 60-65, and the older we get the higher our risk of colorectal cancer.
Family History of colorectal cancer increases the risk of developing this illness in first- degree relatives. Certain familial conditions, like Familial Polyposis, is associated with a much higher risk.
Genetic factors clearly play a role in the development of colorectal cancers. Several genetic and inherited illnesses carry a very high risk of colorectal cancer: Familial Polyposis, Turcot syndrome, Gardner syndrome, Peutz-Jeghers syndrome, Juvenile Polyposis, Cowden's disease, Neurofibromatosis.
Ulcerative colitis , High Dietary Fat and Low Dietary Fiber can each increase the risk of this cancer.
SIGNS AND SYMPTOMS
This cancer may exhibit no signs in its early stages. Gradually, as the disease progresses, any of the following may be seen;
• Blood in the stool
• Diarrhea
• Constipation
• Bowel obstruction, causing nausea, vomiting and abdominal distention
• Abdominal pain
• Pelvic pain
• Anemia due to blood Loss
• Weight loss
• Loss of appetite
• Fatigue
STAGING
• Stage 1 or Duke A: When the cancer is limited to the inside of bowel
• Stage 2 or Duke B: When the cancer is larger and penetrates through the wall of the bowel to the outside layers
• Stage 3 or Duke C: When cancer has spread to the lymph glands in the abdomen
• Stage 4 or Duke D: When the cancer has spread to other organs -- liver, lungs, etc.
TREATMENT
The primary treatment of colon cancer is to surgically remove part or all of your colon. Suggestive polyps, if few in number, may be removed during colonoscopy.
Chemotherapy after surgery can prolong survival for people whose cancer has spread to nearby lymph nodes.
Radiation treatment after surgery does not help people with colon cancer, but it does prolong survival for people with rectal cancer.
• Given before surgery, radiation may reduce tumor size. This can improve the chances that the tumor will be removed successfully.
• Radiation before surgery also appears to reduce the risk of the cancer coming back after treatment.
PREVENTION
Your best prevention is to detect colon cancer and treat it early in its formation. People who have regular screening for colon cancer, including fecal occult blood tests, sigmoidoscopy or colonoscopy, and polyp removal, greatly reduce their risk of having a colorectal cancer.
Other things you can do to lower your risk include the following:
• Quit smoking. Smoking cigarettes has been clearly linked with higher risk of colon cancer (as well as many other conditions).
• Take an aspirin or baby aspirin every day. Because of potential side effects, this is not recommended for everyone. Talk to your health care provider first.
• Take a safe dose of folic acid (for example, 1 mg) every day.
• Engage in physical activity every day.
• Eat a variety of fruits and vegetables every day.
The US Agency for Health Care Policy and Research recommends screening for colon cancer in people older than 50 years who have an average risk for the disease and in people aged 40 years and older who have a family history of colorectal cancer. The agency recommends that one of the following screening techniques be used:
• Fecal occult blood testing every year combined with flexible sigmoidoscopy every 5 years
• Double-contrast barium enema every 5-10 years
• Colonoscopy every 10 years: Colonoscopy remains the most sensitive test for detecting colon polyps and tumors.
Once polyps have been identified, they should be removed. After you have had polyps, even one polyp, you should begin to have more frequent colonoscopies.
Appropriate preventive screening for people with ulcerative colitis includes the following:
• Colonoscopy every 1-2 years in the following cases:
o If you have known you have the disease for 7-8 years
o If the cancer involves the entire colon
o Beginning 12-15 years after the diagnosis of left-sided colitis
• Random colon biopsies taken during colonoscopy
People with ulcerative colitis in whom biopsies show premalignant changes should undergo surgical removal of their colons.
