Colorectal Cancer

Colorectal cancer occurs in the colon or rectum. These cancers are also called colon cancer or rectal cancer, depending on where they originate. Colon and rectal cancer are often grouped together, because they have similar features. Excluding skin cancers, colorectal cancer is the third most common cancer diagnosed in both men and women in the United States.

Knowing the signs and symptoms, risk factors, early detection methods and treatment options is important whether you were diagnosed with colorectal cancer or are taking proactive steps to reduce your risk.

Signs and Symptoms of Colorectal Cancer

If you notice any of these colon cancer symptoms, talk with your doctor right away:

• Bleeding from the rectum, blood on the stool or blood in the stool
• Change in bowel movements
• Diarrhea or constipation
• Feeling fatigued all the time
• General abdominal problems such as bloating, fullness or cramps
• Stools that are more narrow than usual
• Weight loss for no apparent reason
• Vomiting

People at Risk of Colorectal Cancer

• Age 50 and older
• Black community has the highest rates of colon cancer of any racial/ethnic group in the U.S.
• Drink alcohol in excess
  
• Eat a lot of red or processed meat
• Not physically active
• Overweight or obese, and carry fat around the waist
• Personal or family history of colorectal cancer or colorectal polyps
• Personal history of inflammatory bowel disease (such as ulcerative colitis or Crohn’s disease)
• Smokers
• Type 2 diabetes

Colorectal Cancer Diagnosis

If you have symptoms of colorectal cancer, or a screening test shows something abnormal, your doctor will recommend one or more exams and tests to find the cause. These can include:

• Physical exam
• Diagnostic colonoscopy
• Biopsy (performed during the colonoscopy)
• Blood tests
• Imaging tests, such as a CT scan or MRI

Colorectal Cancer Treatment

Treatment for colorectal cancer depends on many factors. Surgery is most common. Chemotherapy, immunotherapy or radiation may be administered before or after surgery, if needed. Here’s an explanation of each:

Colorectal Cancer Surgery

Colorectal cancer surgery refers to a range of surgical procedures used to treat colorectal cancer. These surgeries aim to remove the cancerous part of the colon or rectum, along with any nearby lymph nodes that contain cancer cells.

• Colectomy: A surgical procedure to remove part or all of the colon.
• Colostomy: A surgical procedure that creates an opening in the abdomen to allow stool to pass out of the body through a bag attached to the skin. This is done when the colon is damaged or blocked, preventing stool from passing through normally.

Chemotherapy for Colon Cancer

This type of cancer treatment involves using medications to kill cancer cells. These medications travel through the bloodstream, reaching cancer cells throughout the body. Chemotherapy may be used before surgery to shrink the tumor, after surgery to reduce the risk of cancer recurrence or to treat cancer that has spread to other parts of the body.

Immunotherapy for Colon Cancer

Immunotherapy is a type of cancer treatment that helps your body's immune system fight cancer. It works by boosting or changing how your immune system works so it can better recognize and attack cancer cells.

Radiation for Colon Cancer

Radiation therapy uses high-energy rays to damage cancer cells and stop them from growing and dividing. It can be used to treat various types of cancer, including colon cancer.

Colorectal Cancer Prevention

• Avoid too much red and processed meats, sugar-sweetened beverages or highly processed foods and refined grain products.
• Don’t smoke or use tobacco. If you do, quit smoking.
• Eat plenty of fruits, vegetables, beans and whole grains.
• Exercise at least 30 minutes a day, five days a week. Adults should get 150-300 minutes of moderate intensity, or 75-150 minutes of vigorous intensity activity, each week (or a combination of these). Reaching, or exceeding, the upper limit is ideal.
• Get screened according to guidelines. Certain screenings can prevent this cancer by removing polyps (grape-like growths on the wall of the large intestine, which is part of the colon) before they become cancerous.
• Limit alcohol intake. Alcohol is a known carcinogen, a substance capable of causing cancer. The more you drink, the greater your risk — even in small amounts.
• Maintain a healthy weight and waist size.

Colorectal Cancer Screening

Start screenings at age 45 if you’re at average risk for colorectal cancer. If you’re at increased risk, you may need to start regular screening at an earlier age and/or be screened more often. Continue screening through age 75 if you’re in good health with a life expectancy of 10 years or more. There are many types of tests that screen for colorectal cancer. Ask your provider which test fits your needs. Regular screenings can detect the disease when treatment is more likely to be successful.

Colonoscopy

Colonoscopy is the most common and effective method for screening for colorectal cancer. It allows for direct visualization of the entire colon, enabling the detection and immediate removal of polyps, which can become cancerous. If no polyps are found, the risk of developing colorectal cancer significantly decreases.

Cologuard

While colonoscopy is the gold standard, other screening options, such as Cologuard, are available and should be discussed with your doctor. Cologuard is a non-invasive test that can help detect colorectal cancer in its early stages. It checks your stool for DNA changes and blood that may indicate the presence of cancer or polyps. It's a simple at-home test that can be done in the privacy of your own home.

What Polyp Types Cause Colon Cancer

Not all polyps are created equal. While some are harmless, certain types have a higher risk of developing into cancer. Here's a breakdown:

• Adenomatous polyps: These are the most common type and are considered precancerous. Subtypes of adenomatous polyps include:
  
  • Tubular adenomas: These are the most common subtype and have a low risk of becoming cancerous.
  • Villous adenomas: These have a higher risk of becoming cancerous compared to tubular adenomas.
  • Tubulovillous adenomas: These have a moderate risk of becoming cancerous.
• Serrated polyps: These include sessile serrated polyps and traditional serrated adenomas, both of which can develop into cancer.

Genetic Counseling

If you have a family history of colorectal cancer, genetic counseling can help you evaluate whether you have an increased risk for developing cancer. Talk with your primary care provider to determine if this is a good option for you.

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