More than 143,000 new colorectal (colon and rectum) cancer cases are diagnosed in the US each year, and 52,000 Americans die each year from the disease. Colon cancer is responsible for 9% of all cancer deaths, and it is the most commonly occurring cancer in both men and women after lung cancer. (National Institutes of Health—National Cancer Institute, www.cancer.gov)
The importance of early detection and treatment can’t be overstated. Death rates of this cancer have declined since the 1980s, mostly due to improved screening and early detection, and then more effective treatment once the disease has been discovered.
According to the National Cancer Institute, if colon cancer is detected at its earliest stage, where it hasn’t metastasized (spread to other sites), the five-year survival rate is more than 90%. However, if it spreads to the lymph nodes, the survival rate drops to 69%; if the cancer is in other sites, the five-year survival rate is less than 12%.
The first step to early detection is to know your risk. The greatest risk factor for colon cancer is age. For the average person (with no family history of colon cancer), the age for first colonoscopy is age 50. At that point, each patient’s recommendation will be different as far as ongoing testing goes. But the age 50 benchmark is really important to meet.
Other risk factors for colon cancer include family history of the disease, as there are types of genes for colon cancer that can be inherited. Inflammatory bowel diseases, such as ulcerative colitis and Crohn’s disease, also increase risk for colon cancer.
Some risks can be managed. There is a correlation between a diet high in fruits and vegetables and a lower incidence of colon cancer. Some reports suggest that a diet low in red meat, animal fat and cholesterol may be protective against colon cancer.
Living a healthy lifestyle, which includes physical activity, avoidance of tobacco and excess processed foods, can help reduce your risk of colon—and other—cancers.
Recent research has shown a reduced incidence of colon cancer in people who take a daily 81-mg dose of aspirin. While aspirin therapy has been shown to possibly reduce the risk of heart attack as well as colon cancer, there are still possible risks with taking a daily aspirin that you should discuss with your doctor prior to beginning an aspirin regimen.
Colon cancer is detected primarily through colonoscopy. For this procedure, a patient is mildly sedated, and a gastroenterologist or other specialist inserts a flexible scope into the anus and it is gradually guided through the colon. The scope is used to visibly see any concerning spots or polyps. If there are small polyps present, they can actually be removed during the procedure. The process, while not entirely pleasant, isn’t as bad as many may fear. It’s relatively painless. There’s no reason to feel embarrassed. Physicians do these exams all the time. And it’s better to be a little embarrassed and potentially catch cancer early than to not be tested and find cancer too late!
Treatment for Colon Cancer
Colon cancer, like other cancers, is treated differently depending on the stage of the cancer and overall health of the individual patient. Colon cancer has four stages and they include:
- Stage 1 is localized to just the inner layers of the colon.
- Stage 2 means the disease is more advanced through the layers of the colon.
- Stage 3 involves the spread of the cancer to nearby lymph nodes.
- Stage 4 means the colon cancer has spread to more distant sites, such as the liver, bones, brain, etc. The lungs and liver are the most common sites of metastasis.
Surgery is typically the only therapy required to treat stage 1. For stage 2, surgery is required, but an oncologist may also recommend chemotherapy depending on the features of the type of cancer. Stage 3 is usually treated with surgery, and chemotherapy is typically recommended due to the fact that it’s shown to increase the length of survival and decrease disease recurrence. At stage 4, the vast majority of patients are treated with chemotherapy to control the disease. There are a few cases in which patients may benefit from surgery and chemotherapy.
Treatment for Rectal Cancer
Although they are similar in cause and features, rectal cancer is treated slightly differently than colon cancer. Many patients will undergo chemo and radiation to help preserve the function of the muscle at the bottom of the rectum. This can allow for better surgical results to treat the cancer, and may prevent the need for a colostomy (external pouch for bowels).