An Overview of Colon and Rectal Cancer

Colorectal cancer is the third major cancer in annual deaths (30,900) and second in new cases (72,000). It occurs slightly more often in women than men and mostly in women over age 50.

Three out of four of these cancer patients could be saved with early detection. Three effective early detection tests are: 1) the digital rectal exam, which should be part of your yearly health checkup after age 40; 2) the stool blood test every year after age 50; 3) the procto, after age 50, every three to five years following two negative tests one year apart.

Those who have a personal or family history of colorectal cancer, polyps, or inflammatory bowel disease are at an even higher risk of developing colorectal cancer. Having a parent or sibling with colon cancer or a polyp, for example, doubles a person's lifetime risk.

Only your physician can assess your risk level and whether you need to have any of these tests earlier or more often. Risks include personal or family history of colon and rectum cancer, personal or family history of polyps in the colon or rectum and ulcerative colitis. Symptoms such as bleeding from the rectum, blood in the stool, persistent change in bowel habits, or cramping abdominal pain should be reported to your physician without delay.

To guard against the major cancers threatening American women, you need to know about the highly effective and specific methods of prevention and early detection available today. Everyone has a different level of cancer risk, depending on such factors as age, personal and family medical history. Cancer risk also is affected by your lifestyle and health.

Symptoms
Symptoms of colorectal cancer include rectal bleeding, blood in the stool, abdominal pain, and a change in bowel habits. Some patients might experience only a general weakness due to the presence of iron-deficiency anemia. Any of those symptoms should alert individuals and physicians to the need for an evaluation. A lack of symptoms, however, does not mean a clean bill of health; many people have no symptoms when the disease first arises.

Prevention
Prevention and early detection are key factors in controlling and curing colorectal cancer. Indeed, colorectal cancer is the second most preventable cancer, after lung cancer. Colorectal cancer begins as polyps, which are small, benign (noncancerous) growths of cells that form on the inner lining of the colon. Over a period of several years, some of these polyps may grow larger and become cancerous. Most polyps never become cancerous, but since doctors don't know which ones will and which won't, they advise patients to embark on a regular screening program and have all polyps found and removed. Such screening programs have been proven to save lives by increasing the chances of detecting precancerous polyps and tumors in their earliest stages, when they are most curable.

Lifestyle and Colorectal Cancer
Certain lifestyle choices can also help to reduce a person's chances of developing colon cancer. Studies have shown that several dietary factors -- including a high-fat content and low-fiber content -- as well as factors such as obesity, a sedentary lifestyle, and alcohol and tobacco use, can increase a person's risk for cancer. To reduce the risk of colon cancer, it is best to follow a diet that is low in fat and high in fruits, vegetables, and fiber. It is also advisable to drink alcohol only in moderation, to abstain from tobacco use, and to exercise regularly. In fact, doctors estimate that 40 percent of all colon cancer cases could be prevented by following a good diet, avoiding obesity, and engaging in regular physical activity. The exercise regimen need not be particularly vigorous -- even moderate physical activity such as taking the stairs (instead of an elevator), raking leaves, and walking can help to prevent disease.

Treatment
When colorectal cancer is found, surgery is the most common treatment. For cancers that have not spread, it often provides a complete cure. Preventive chemotherapy, adjuvant chemotherapy (which targets any leftover, undetected cancer cells), and radiation therapy are often combined with surgical removal of the tumor to increase the likelihood of a cure.

Source: Patient education material from the American College of Obstetrics and Gynecology was used as a source of information to develop the content for this topic.