Updated March 24, 2020
The American Cancer Society estimates that nearly 150,000 American adults will be diagnosed with colorectal cancer in 2020, but it is possible to prevent and treat this disease in many cases.
Knowing your risk and receiving the recommended screenings are important first steps. In the following guide, Haroon Choudry, MD, surgical oncologist, UPMC Hillman Cancer Center, shares warning signs and facts about colorectal cancer.
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Facts About Colorectal Cancer
“Colorectal cancer occurs when malignant cells form in the tissues of the colon and rectum,” says Dr. Choudry.
More than 95 percent of colorectal cancer cases begin with precancerous growths called adenomatous polyps. Removing these growths before they become cancerous can reduce your risk of cancer. Doctors can find these growths only through regular colorectal cancer screenings.
“With early detection, doctors can successfully treat more than 90 percent of people with colon cancer,” Dr. Choudry says. “A colonoscopy is one test we use to detect polyps and colon cancers in the lining of the colon and the rectum, especially before polyps become cancers.”
Doctors can remove potentially cancer-causing polyps during a colonoscopy.
Average-risk people over age 50 should receive regular screenings, including a colonoscopy, every 10 years. Other screening options include:
- Flexible sigmoidoscopy
- Stool tests
- Virtual colonoscopy
Screening methods usually cause minimum discomfort, says Dr. Choudry. No matter what method of screening you use, the testing will help to significantly reduce your risk of dying from cancer.
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Preventing Colorectal Cancer
Along with regular screenings, there are other ways you can reduce your risk. Dr. Choudry notes that the following increase your risk of colorectal cancer:
- Heavy drinking
- High-fat, high-protein, low-fiber diet
Addressing these habits can decrease the risk of colon cancer by as much as 30 percent. Dr. Choudry advocates a balanced diet with plenty of fruits and vegetables. Hydration also aids in prevention by alleviating constipation and cleansing the bowels.
Warning Signs for Colorectal Cancer
Everyone, young and old, should keep these symptoms in mind: “Watch out for blood in your stool or a lot of black stools,” Dr. Choudry said. “And if you get blood work done and find out you are anemic, meaning your hemoglobin level is low, that can be an indication that a cancer is growing.”
Another important symptom is a change in your “stool caliber,” meaning the size or frequency of your stools. “If you used to have one bowel movement a day, and now you are not having one for days on end, that’s a red flag,” Dr. Choudry says.
Subtler signs include:
- Unexplained weight loss
Dr. Choudry says that although pain is not one of the bigger signs of colon cancer, you should take note of stomach discomfort. Pain is usually a symptom only of late-stage colorectal cancer.
If you notice a change in your bowel habits, you may want to schedule an appointment with your doctor to discuss the symptoms. If you’re over age 50, you’ll likely need a colonoscopy, but if you are younger and experiencing a change, you will probably just need to assess your diet or lifestyle.
It’s also crucial to tell your doctor about past digestive issues. Conditions like Crohn’s Disease or ulcerative colitis may increase your risk for colon cancer, but a past diagnosis of irritable bowel syndrome does not increase your risk.
Is Colorectal Cancer Treatable?
Though prevalent, colon cancer is treatable. Your doctor will discuss which of the several treatment options may be best for you.
“Treatment-wise, no colorectal cancer is the same, and a diagnosis affects each person differently,” Dr. Choudry says. “Treatment can involve surgery, chemotherapy, radiation therapy, or a combination of these treatments, and it may include clinical trials.”
Surgery for colorectal cancer
Surgery generally is the first option for early-stage colorectal cancer. Doctors can perform different procedures depending on the stage, size, and location of the tumor:
- Laparoscopic colonic resection: This minimally invasive procedure removes all or part of the colon and some surrounding lymph nodes. Doctors make keyhole-sized incisions and use advanced imaging and small instruments to remove the tumor. This allows for a shorter recovery time.
- Open colonic resection: This requires a larger incision. Surgeons remove all or part of the colon and some surrounding lymph nodes. Because a larger cut is required, recovery can take longer.
- Low anterior resection: This surgery for rectal cancer removes the part of the rectum with the tumor. Doctors then attach the colon to the remaining part of the rectum to keep normal bowel function.
- Abdominoperineal resection (APR): Surgeons remove the rectum, anus, and surrounding tissues like the sphincter muscle. The removal of the anus means the patient will need a permanent colostomy. The colon is attached to an opening in the skin of the abdomen, allowing stool to leave the body.
More advanced technologies have allowed for procedures that preserve normal bowel function, including:
- Local excision: This procedure requires no cuts through the abdomen; instead, doctors remove the tumor through the anus.
- Neoadjuvant therapy: Doctors use radiation and chemotherapy to shrink the tumor before surgery.
Chemotherapy for colorectal cancer
In chemotherapy, doctors use anti-cancer drugs or chemicals to kill or shrink the tumors. They can be used alone or in combination with surgery and radiation. You can receive chemotherapy both before surgery or after.
For colorectal cancer that has spread to the abdominal cavity, doctors can give high concentrations of chemotherapy to the cancer’s direct site. The procedure is known as hyperthermic intraperitoneal chemoperfusion (HIPEC).
Radiation for colorectal cancer
Radiation uses high-dose x-rays to kill or shrink cancer cells. It can be used alone or in combination with other treatments.
Use of radiation therapy is more common for rectal cancer than for colon cancer.
The UPMC Hillman Cancer Center provides world-class cancer care, from diagnosis to treatment, to help you in your cancer battle. We are the only comprehensive cancer center in our region, as designated by the National Cancer Institute. We have more than 60 locations throughout western Pennsylvania and Ohio, with more than 200 oncologists. Our internationally renowned research team is striving to find new advances in prevention, detection, and treatment.