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Colorectal Cancer

What we know and why we should be encouraged

By Sherry Mistro-Henn

Medically Reviewed by Dr. Johanna Bendell

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Colon cancer is the third most common cancer and the second most deadly. One in every 20 people will develop colorectal cancer, which begins as a polyp or mass in the lining of the colon or rectum. This mass can spread into the colon wall and then to other organs.

Known causes of colorectal cancer can be environmental or genetic. Lifestyles that include little physical activity, diets heavy with processed meats, long term smoking and heavy alcohol consumption place one at increased risk for cancer.  Family history of polyps, colorectal cancer, and chronic inflammatory bowel disease are factors as well.

Colorectal cancer can present symptoms like fatigue, constipation, diarrhea, or unusual or bloody stools. Abdominal cramping and bloating may be experienced, giving reason to seek medical attention.  Sometimes colorectal cancers may not cause any symptoms, so screening for colorectal cancer is important.

A colonoscopy can detect the presence of precancerous and cancerous polyps. Screening for patients at average risk for colorectal cancer begins at age 50 years, and even earlier for patients with certain risk factors or family history.  Colonoscopies can remove polyps that may form cancers and may catch cancers at an earlier stage where they can have a much higher chance of cure.  The overall incidence of colorectal cancer and resulting death rates have declined over the past 20 years.  Regular screening tests and healthier lifestyle choices may be the reason for this decline.

Treatment for colorectal cancer can be decided while considering the specific needs of the patient. Removing the cancer by surgery is the “gold standard” for curing colorectal cancer.  Laparoscopic and even robotic surgical technique is now widely used, reducing the amount of post-surgical pain and risk of infection.

Depending on the stage of the cancer at the time of diagnosis, the next options for treatment could be monitoring, chemotherapy, radiation, targeted therapy and immunotherapy. There are new and exciting drugs –both oral and IV administered- that have been approved following success in clinical trials.  Radiation uses high energy rays to shrink, and even kill, tumors.  Targeted therapy can interrupt the genetic changes that cause cancer to grow or attack the tumors in other ways besides traditional chemotherapy.  Immunotherapy helps one’s own immune system fight the cancer.

The best action that can be taken to lessen the risk of colorectal cancer is to stay physically active and choose a balanced diet with lots of fruits and vegetables. Regular annual screening after the age of 50 is important and the removal of precancerous polyps is essential for maintaining good health.