Key Insights: Updates in Colorectal Cancer
10 Key Questions About Colon Cancer
How Do I Know If I Have Colon Cancer?
Most people have no noticeable symptoms of colon cancer before diagnosis. But when colon cancer is detected early – before symptoms appear – it is often highly treatable, so screening tests, including colonoscopy, are very important and need to be done on a regular schedule. The tests, which commonly include a digital rectal exam, a fecal occult blood test, a barium enema, and a sigmoidoscopy and colonoscopy, allow doctors to look for signs of colon cancer, including blood hidden in the stool and abnormalities such as polyps inside the colon and rectum. The tests vary in how extensive and sensitive they are – ask your doctor which is right for you.
If colon cancer advances before it is detected by screening, these symptoms can occur:
- A change in bowel habits
- Diarrhea, constipation or feeling that the bowel does not empty completely
- Blood, either bright red or very dark, in the stool
- Stools that are narrower or darker than usual
- Abdominal pain
- Weight loss with no known reason
- Fatigue and/or pallor (symptoms of anemia)
What Kind of Doctor Do I See If I Think I Have Colon Cancer?
Whether you are concerned about symptoms or considering screening, your primary care physician will likely be the first doctor you see. Regular colon cancer screening is often recommended for people age 50 and older, but your doctor can help you review your own medical and family history and decide which tests are right for you and when and how often to have them. If screening tests indicate you may have colon cancer, you will most likely see a gastroenterologist for further evaluation and diagnosis, and a medical oncologist, a doctor who specializes in treating cancer, and/or surgeon if cancer is diagnosed.
How Did I Get Colon Cancer?
There is no single cause of colon cancer, but most begin as tiny, initially harmless growths called colorectal polyps that stick out of the lining of the large intestine. Not all colorectal polyps turn into cancer, but over time a type called adenomatous polyps may become cancerous, especially if they are bigger than one centimeter (about ½ inch) in size. Doctors often recommend colonoscopy to remove these types of polyps.
The following factors may put you at increased risk of developing colon cancer:
- Age 50 or older
- Family history of colon or rectal cancer, especially in a parent, sibling or child
- Personal history of colon, rectal, ovary, uterine or breast cancer; or of ulcers in the lining of the large intestine, called ulcerative colitis
- Hereditary conditions, including familial adenomatous polyposis and hereditary nonpolyposis colon cancer
- Personal history of polyps in the colon
- High intake of red meat and processed meats
How Does Colon Cancer Progress?
Healthcare professionals use a process called "staging" to describe cancer's progress. The stages of colon cancer depend on whether the disease has spread to other parts of the body, and if so, how far the cancer has advanced. In colon cancer, there are five stages:
- Stage 0:Cancer is confined to the innermost lining of the colon or rectum.
- Stage I:Cancer is in the second and third layers of the lining and inside the colon or rectum wall.
- Stage II:Cancer has spread to nearby tissue but not to lymph nodes.
- Stage III:Cancer has spread to nearby lymph nodes but not to other body parts.
- Stage IV:Cancer has spread to other parts of the body.
How Is Colon Cancer Treated?
Primary treatment for all stages of colon cancer is surgery to remove the cancerous and surrounding tissues. In early stages, doctors may remove cancer using instruments inserted through the anus. If the cancer is larger, surgeons may cut through the abdominal wall and remove the cancer, a small amount of healthy tissue and some lymph nodes before sewing the colon or rectum back together. Post-operatively, patients may also receive chemotherapy, sometimes in combination with radiation therapy, especially if the cancer has spread to other parts of the body.
Will My Colon Cancer Go Away?
The outlook for people with colon cancer often depends on the stage at which their cancer is treated. The American Cancer Society reports that more than 90 percent of people whose cancer is found before it has spread will live at least five years, a time period commonly used to measure cancer survival rates. After colon cancer has spread, the five-year survival rate is between 44 percent and 85 percent. The rate for people with advanced cases is 8 percent. These rates are derived from past research, however, and improved therapies may mean a better outlook for people diagnosed and treated more recently.
How Do I Make Sure My Colon Cancer Is Managed Well?
One of the best ways is to get treatment in the early stages of the disease. Most people older than 50 should consider having regular colonoscopies to detect potential colon cancer early, and people who have risk factors for the disease should consider having regular screening tests at younger ages. If you have colon cancer:
- Talk often with your medical team, and let them know if you're having any new symptoms.
- Eat plenty of fruits and vegetables, and limit high-fat foods, red meat, alcohol and salt-cured, smoked or pickled food.
- Exercise regularly.
- Get enough sleep. If you can't sleep at night, try daytime naps.
- Try to stay positive. Derailing negative thoughts can reduce your anxiety.
How Do I Stay Up to Date on Colon Cancer Research?
You can find the latest news about colon cancer research on HealthTalk and from non-profit and government-sponsored Web sites and research centers:
Where Can I Get Information on Living Well with Colon Cancer?
Your primary care physician or oncologist may be able to refer you to services such as nutrition counseling, physical or occupational rehabilitation, or counseling for psychological problems.
Video: Top 5 Questions Newly Diagnosed Colon Cancer Patient Should Ask Their Doctor
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