Colorectal cancer ranks second in cancer-related deaths in the United States. The disease is the second most common cause of cancer deaths in men, and the third most common cause of cancer deaths in women.
Each year, health experts across the nation diagnose approximately 140,250 new cases — 97,220 colon cancers and 43,030 rectal cancers. As many as 50,630 Americans die of colorectal cancer every year.
Adults between the ages of 65 and 74 most often receive the colorectal cancer diagnosis. Despite these grim statistics, colorectal cancer is one of the few preventable cancers.
What is colorectal cancer?
Colorectal cancer occurs in the colon or rectum. The colon is the large intestine or large bowel, and the rectum is the passageway that connects the colon to the anus.
Colon cancer is a malignant growth or tumor in the colon or rectum. Most colorectal cancers originate as polyps, which are precancerous growths that can become cancerous if not removed.
What are the types of colorectal cancer?
There are two types: colon cancer and rectal cancer.
What are the stages of colorectal cancer?
Stage I: The cancer grows through the first few layers in the colon/rectum but not the lymph nodes or other organs. For this stage of colon cancer, surgery typically is the cure. Rectal cancer generally requires chemotherapy and radiation.
Stage II: The cancer grows into the outermost layers of the colon or rectum and into nearby tissues or organs. The cancer does not spread to the lymph nodes or organs in other parts of the body.
Stage III: The cancer grows into many layers of the colon and spreads to nearby lymph nodes but not to organs in other parts of the body.
Stage IV: This is the most advanced stage of colorectal cancer. Cancer spreads to organs in other parts of the body, most often the lungs or the liver. The cancer may not grow completely through the wall of the colon or rectum, and may or may not affect the lymph nodes.
What are the primary signs and symptoms of colorectal cancer?
Because polyps often are slow-growing, you may not notice colorectal cancer signs right away. These are the primary symptoms:
- Change in bowel habits (constipation/diarrhea).
- Rectal bleeding.
- Blood in the stool.
- Abdominal pain.
- Feeling that stools are narrower than usual.
- Unexplained weight loss.
How is colorectal cancer diagnosed?
Your HonorHealth doctor typically will diagnose this cancer by performing a colonoscopy. During your colonoscopy, your doctor will look for polyps (advanced adenomas) and remove them.
Following the removal of a lesion, a biopsy will confirm whether it is benign or cancerous.
What are the screening options?
A variety of screening methods are available to make it easier for patients to select the one that best fits their needs. HonorHealth doctors agree that the best screening test is the one that gets done.
- Colonoscopy, recommended every 10 years.
- Fecal immunochemical test (FIT), recommended every year.
- Multi-target stool DNA test, recommended every one to three years.
- CT colonography, or virtual colonoscopy, recommended every five years.
- Flexible sigmoidoscopy, recommended every 10 years with an annual FIT test yearly.
Why is screening important?
Colon cancer is one of the few preventable cancers. The more people doctors screen, the better the chance to dramatically decrease death from colorectal cancer. Despite the simple testing methods available, only 60 to 65 percent of people older than 50 undergo colorectal cancer screening.
Who should be screened?
Starting at age 50, you should schedule a colonoscopy every 10 years, even if you aren’t experiencing any symptoms. At that age, men and women are at average risk of developing colorectal cancer. If you have a strong family history of colon cancer or a family history of colon polyps, you should begin screening at age 40. If your family member was diagnosed with colorectal cancer before age 60, you should begin screening at age 40 or younger, depending on the age of your relative when he or she was diagnosed.
The American College of Gastroenterology recommends that African-Americans begin screenings at age 45 because of a higher risk for colon cancer in that population.
After age 75, you and your doctor can discuss the merits of colorectal screening. Generally, doctors don’t recommend screening colonoscopy for those older than 86.
What are colorectal cancer treatment options?
Treatments vary depending on the stage of colon cancer.
Surgery is often the first step in the treatment of earlier stages of colon cancer. During surgery, your doctor removes the piece of the colon that contains the cancer as well as surrounding tissues to make sure that the cancer has not spread to other organs or areas of the body.
Chemotherapy may be required after surgery, especially if the cancer has spread. Chemo can decrease the chance of the cancer recurring.
For rectal cancer, the treatment typically is chemotherapy and radiation (for earlier stages), followed by surgery. Earlier stages often can be cured with only chemo and radiation.
The five-year survival rate for people with stage I colon cancer is about 92 percent; the five-year survival rate for people with stage 1 rectal cancer is 87 percent, according to the National Cancer Institute.
Causes and risks of colorectal cancer
- Age: 50 and older.
- History of polyps or cancer.
- Inflammatory bowel disease, Crohn’s disease or ulcerative colitis.
- Family history of colorectal cancer.
How can you decrease your risk for colorectal cancer?
Almost 50 percent of colorectal cancers can be prevented. What can you do to prevent colon cancer or decrease your risk of forming polyps?
- Get screened at age 50 and every 10 years thereafter.
- Live a healthy lifestyle.
- Increase your physical activity.
- Avoid smoking tobacco.
- Avoid drinking alcohol.
- Avoid being overweight, especially around your waist.
- Reduce the amount of red and processed meats you eat.
- If you’re diabetic, control the condition; diabetic patients have a higher risk of colon polyps.
If you’re 50 to 59 years old, with a life expectancy of at least 10 years and not at an increased risk for bleeding, the U.S. Preventive Services Task Force recommends daily low-dose aspirin for primary prevention of colorectal cancer.
Does HonorHealth offer colorectal cancer support services?HonorHealth specialists will help you or your loved one on the journey from treatment to recovery, beginning with a cancer care navigator. The navigator will help connect you with the oncologists, surgeons and support services you need along the way.
HonorHealth also provides an expert panel, made up of gastroenterologists, colorectal surgeons, oncologists, radiologists, pathologists and nurses. The panel meets monthly to discuss challenging cases. This Colorectal Tumor Site Strategy Group promotes the discussion of cases to benefit patient care.
In addition to cancer treatment, the HonorHealth Virginia G. Piper Cancer Care Network offers patient support services including individual nutritional counseling; cooking classes; exercise and mind, body, spirit programs; and community events and screenings.