By Ernst Lamothe Jr.
Colon cancer remains one of the most preventable cancers around.
It occurs when there is beyond control growth of cancerous cells in the colon.
Your colon is a tube-like structure in the large intestine connecting to the small intestine, which removes water, few nutrients and electrolytes from partially digested food. The American Cancer Society estimated that about one in 25 women and one in 23 men develop colorectal cancer during their lifetime.
“This is an important topic for discussion because colon cancer is the second most diagnosed cancer in men and third most common in women,” said Suri Karthikeyan, gastroenterologist for Oswego Health and board-certified physician. “Screening has significantly decreased the mortality rate because early detections create better outcomes.”
Karthikeyan talks about five aspects of colorectal cancer and prevention that you need to know.
1. Misconceptions
There are myriad misconceptions when it comes to colorectal cancer. Anything from only people with family history get colon cancer to the idea that it is always fatal. It may be curable when detected early. More than 90% of patients with localized colorectal cancer are alive five years after diagnosis. However, only around a third of all colorectal cancers are diagnosed at this early stage. Another myth is that the disease only strikes the older population.
“People think this is a disease of the elderly and that is untrue. We are seeing younger patients being diagnosed whether that is because of family history and being a genetic risk or other factors,” said Karthikeyan.
Karthikeyan also said he wants to discourage people to think that symptoms are the only reasons to receive a colonoscopy.
“You can’t wait for symptoms to develop before you start taking precautions,” he said. “We have to be proactive because it is difficult to have good outcomes by the time someone has rectal bleeding or abdominal pain.”
2. Get a colonoscopy
In 2021, there were about 150,000 colon and rectal cancers. A colonoscopy is part of a colon cancer screening program used to detect changes or abnormalities in the large intestine colon and rectum. During a colonoscopy, a long, flexible tube is inserted into the rectum. A tiny video camera at the tip of the tube allows the doctor to view the inside of the entire colon.
“We have to do everything we can to educate people to prevent colon cancer. We know with studies that people who have colonoscopies have extremely low mortality rates,” said Karthikeyan. “People perceive the prep as possibly painful, but the procedure is rather painless and patients are sedated without discomfort.”
3. You have options
There are a variety of tests that people can take if they don’t want to go through a colonoscopy. There are stool-based tests called fecal immunochemical test which checks stool for signs of cancer.
These tests are less invasive and easier to have done but need to be done more often. Another option is a virtual exam that looks at the structure of the colon and rectum for any abnormal areas by special imaging X-ray.
“FIT testing is 74% effective and virtual colonoscopy is 84% effective in detecting larger abnormalities but only 50% when it comes to detecting smaller polyps,” he added.
4. 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 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 may not 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.
“Stage 4 colon cancer means it has metastasized various organs and these patients have very little chance of cure in this condition,” he said.
5. Colonoscopy guideline changes
In May 2021, the U.S. Preventive Services Task Force issued new recommendations for colorectal cancer starting at an earlier age.
Now that we are seeing an increase of colon cancer between 40 and 50, the American Cancer Society has approved the age of colon cancer testing to 45.
The recommended age was lowered from 50 to 45 because colorectal cancer cases are on the rise among young and middle-age people. Deaths of people younger than 55 increased 1% per year from 2008 to 2017; even though overall colorectal cancer rates have dropped.
