Ask the Doctor: Colon Cancer

 Of all cancers affecting both men and women, colorectal cancer is the second-leading killer in the U.S., according to the Centers for Disease Control and Prevention. Unfortunately, it can be a silent killer and appear without any symptoms.

However, screening for colon cancer can help find the cancer at an early stage when it is still very treatable. This important and life-saving screening test is known as a colonoscopy. If you’ve never had a colonoscopy but have a general idea about it, you may be nervous about the procedure, what exactly it screens for and what the risk factors are for developing colon cancer.

Dr. Abbas Raza, an advanced gastroenterologist at INTEGRIS, answers a few commonly asked questions about colonoscopies, colon health and colon cancer.

What is colon cancer?

Colorectal cancer is cancer of the colon or rectum. Colon cancer occurs when cells in the lining of the colon or rectum form a cancerous tumor. Left untreated, the tumor can metastasize, meaning it can spread to other parts of the body.

What are the major risk factors for developing colon cancer?

The risk of developing colon cancer increases with age. Men are more likely than women to be diagnosed with colon cancer. Family or personal history with colorectal cancers, endometrial cancer, ovarian cancer and breast or colon cancer can increase the likelihood of developing colon cancer.

Other risk factors include a personal or family history of hereditary polyposis syndromes, familial polyposis and hereditary non-polyposis genetic syndromes. Pre-existing Gardner’s syndrome, Turcot’s syndrome and Peutz-Jegher’s syndrome are also considered risk factors.

Diet also affects your chance of developing colon cancer. Diets low in vegetables and high in fat, red meat and alcohol can increase the risk of colon cancer. Individuals who have inflammatory bowel diseases like ulcerative colitis and Crohn’s disease are also at a higher risk than average.

What is a colonoscopy?

A colonoscopy is a screening procedure that lets your doctor look closely at the inside of your colon. A flexible, long tube called a colonoscope is used to view the colon. The colonoscope is the width of a finger and has a small camera attached on its end.

The colonoscope is gently inserted into the anus and moves slowly and carefully through the rectum to the cecum, the first part of the colon. This procedure is done by a skilled gastroenterologist. Sedatives or other medication are usually given so that patients can feel more relaxed during the procedure.

Are any symptoms noticeable without a screening?

“Symptoms are usually non-specific,” says Dr. Raza. “Early stages are usually asymptomatic. These may include weight loss, malaise, abdominal pain, rectal bleeding, changes in bowel habits, constipation alternating with diarrhea or pencil thin stools.”

When should an individual start regularly receiving screenings for colon cancer?

“Individuals with an average risk of developing colon cancer should start receiving colonoscopy screenings at age 50,” says Dr. Raza. For those people of average risk, a doctor will usually recommend a colonoscopy screening every 10 years, although those with a previous personal history of colon cancer or an adenomatous (precancerous) polyp may need more frequent screenings. 

In addition, a doctor will usually recommend starting colonoscopy screenings earlier than age 50 if a person has an immediate family member (like a parent, sibling or grandparent) who has been diagnosed with colon cancer at any age, or an adenomatous (precancerous) polyp before the age of 60. In those cases, doctors will often recommend a colonoscopy screening at age 40, or 10 years before the age the immediate family member received the diagnosis.

What are the stages of the disease?

There are four stages of colon cancer: Stage I, Stage II, Stage III and Stage IV. With each stage, cancer progresses or spreads to other regions of the affected organ and other parts of the body. This spread, called metastasizing, can affect the type and aggressiveness of treatment.

·         In Stage I, the cancer is confined with the colon wall and hasn’t yet spread to nearby parts of the body or the lymph nodes.

·         Stage II is when the cancer may have spread through the colon’s lining but hasn’t spread to the lymph nodes.

·         Stage III colon cancer is when the cancer has spread to the lymph nodes, but not other parts of the body.

·         Stage IV occurs when the cancer spreads to other organs. The most common place for cancer to spread is the liver, but it can affect more distant parts of the body like the lungs or brain.

How is colon cancer typically treated?

The first three stages of colon cancer are treated with a procedure called curative surgical resection, which hopes to remove the tumor or portions of the tumor. Patients who have stage II and stage III colon cancer typically undergo chemotherapy as well to shrink the size of existing tumors.

In stage IV, the tumor could be too big for surgical removal, but Dr. Raza says treatment and the prognosis are improving over time.

“Prognosis of metastatic stage IV colon cancer has improved dramatically in the past few years,” Dr. Raza says. “Median survival is expected to be in the range of 30+ months with modern chemotherapeutic regimes.”

How can I help prevent or lower my chance of developing colon cancer?

Living an active, healthy lifestyle with a diet rich in vegetables can lower your risk for developing colon cancer, as can quitting smoking and drinking in moderation.

If you think you may at be risk for colon cancer, or have any questions about preventive care and screenings, make an appointment with an INTEGRIS gastroenterologist. The physicians and care teams will walk you through every part of the colonoscopy process.