By Ernst Lamothe Jr.
Colorectal cancer occurs when there is growth of cancerous cells in the colon.
Your colon is a tube-like structure, the main part of the large intestine. It connects to the small intestine, which removes water, a few nutrients and electrolytes from partially digested food.
The American Cancer Society estimates that about one in 25 women and one in 23 men develops colorectal cancer during their lifetime.
“One of the main reasons why I chose gastroenterology is because I can see many conditions that preventative care can make an incredible difference in outcomes. Colon cancer is one of the best examples,” said physician Tanya Bruckel, assistant professor of medicine and gastrologist at UR Medicine.
With colon cancer being the third most commonly diagnosed cancer in the United States, Bruckel talks about five aspects of colorectal cancer and prevention that you need to know.
1. Get screenings
In 2021, there were about 150,000 colon and rectal cancers. “While those figures may seem high, the incident rate numbers have dropped since the concept of screening occurred,” said Bruckel. “Everything that we know is that colon cancer is one of the most preventable cancers. Because it begins with non-cancerous polyps, it can be easier to remove these growths before they become cancerous. We are seeing colon cancer in younger people.”
2. Get a colonoscopy
A colonoscopy is an exam used to detect changes or abnormalities in the large intestine colon and rectum.
“The procedure involves us taking a camera to look for these polyps and take them out. In order for us to be successful, you have to complete bowel preparation by taking a liquid laxative to cleanse your colon of any stool. Most patients do receive some type of sedative during the procedure so they are comfortable and do not experience any great pain. The majority of patients don’t remember anything,” she added.
When it comes to determining when your next colonoscopy can occur, it is often a conversation with your physician after the results.
“After you have your first colonoscopy, then that is when you can meet with your physician for recommendations,” she said. “The determination will be made from a combination of factors such as your risk profile which will determine if you receive it every five to 10 years.”
3. Stages of Cancer
Colorectal cancer grows from stage 0, which is the earliest stage to stage 4, the most advanced. At stage 0, the abnormal cells are only in the inner lining of the colon or rectum. At stage 1, the cancer grows through the inner lining and reaches the muscle layer of the colon or rectum. At stage 2, the cancer grows through the wall of the colon or rectum but won’t spread into nearby tissue or lymph nodes. At stage 3, the cancer will move to the lymph nodes but not to other parts of the body. At stage 4 the final stage, the cancer will spread to other major organs, such as the liver or lungs.
People with stage 1 and stage 2 colon cancer may experience symptoms like constipation, diarrhea, change in stool color or shape, blood in stool, bleeding from rectum, excessive gas, abdominal cramps and abdominal pain.
Some people with colon cancer may not even experience any symptoms in the earlier stage which makes it even more difficult to predict the condition.
But, the symptoms are noticeable in stages 3 and 4 such as excessive fatigue, weakness, weight loss, vomiting, and feeling like your bowel is not completely empty.
“There are treatments at all different stages where you may have to bring in cancer surgeons and expert oncologists,” she added. “But we all know that there are more options and better outcomes the earlier it is detected.”
4. Colonoscopy guideline changes
In May 2021, the U.S. Preventive Services Task Force issued new recommendations for colorectal cancer starting at an earlier age. “We used to recommend that general screenings would happen at age 50. But various gastrologist societies have recently changed the recommendation to age 45,” said Bruckel.
The recommended age was lowered from 50 to 45 because colorectal cancer cases are on the rise among young and middle-aged people. Deaths of people under age 55 increased 1% per year from 2008 to 2017, even though overall colorectal cancer rates have dropped.
5. It affects women too
Sometimes there has been confusion on if both genders are supposed to get colonoscopies because people mix up colons and prostates. The colon is part of your large intestine and your GI tract that turns your food into stool. The prostate is more of a male reproductive organ. While it lies in proximity to the colon, they should not be grouped together. “Like it or not, men and women are in this together. We both need colonoscopies,” said Bruckel.
In addition, she said family history could play a large role in early detection cases.
“If you know your mom, dad, siblings or grandparents had colon cancer, it is important to let your physician know. There are times where we recommend people having colonoscopies at age 30 in those cases,” said Bruckel.