Colon cancer is an abnormal growth of the lining of the colon (also known as large intestine) that can spread to other parts of the body if it is not diagnosed or treated in a timely fashion.
Colon cancer is in the top 3 causes of death for men and women in the United States when taking a look at all cancer related deaths. However, the mortality rate has been decreasing over the past few decades as screening and treatment has greatly improved.
We still do not have much definitive data on the causes of colorectal cancer; however, we do know that age, family history, inherited disorders and racial background all play a role. Further, modifiable lifestyle issues can also increase the risk of colon cancer. A diet high in processed foods and low in fiber, a sedentary lifestyle, smoking and heavy alcohol consumption can all Increase the risk of any cancer including colon cancer. Further, obesity, history of other cancers, inflammatory bowel disease and type-2 diabetes can all increase risk.
Young onset is the term for colon cancer diagnosed in patients under 50. About 10% of colon cancers and close to 20% of rectal cancers are being diagnosed in people under the age of 50. This has been an upward trend in the past two decades despite overall rates of colon cancer have been declining since the 1970s. The incidence of young onset colon cancer has increased the most in the south, but no part of the US is spared. While we don’t know the exact cause, it tracks with a nationwide increase in obesity (especially in the South), poor dietary habits, poor exercise participation and a generally sedentary lifestyle.
Colon cancer is often asymptomatic until advanced disease is present. This is why screening examinations are so important in the prevention and treatment of colon cancer. However, there are surgeon signs and symptoms that should prompt evaluation by a colorectal surgeon or gastroenterologist. These include:
Colonoscopy is the gold standard test for the screening and diagnosis of colon cancer. Please see additional information on colonoscopy here. Several other screening tests exist to help in the diagnosis of colon cancer. These include flexible sigmoidoscopy, fecal occult blood testing, CT colonoscopy, and other stool testing such as Cologuard. Learn more about which is better – colonoscopy or Cologuard. If you are eligible for a screening or diagnostic test for colon cancer, it is best to discuss which test is the right test for you with your colorectal surgeon.
Most cases of colon cancer in the United States are diagnosed in patients older than 50, so increasing age is also a risk factor for the development of colon cancer. However, we are diagnosing colon cancer in younger patients in the United States over the past several years.
There has been in recent change in the recommended screening age for colon cancer. Several societies, including the American Cancer Society and the American Society of Colon and Rectal Surgeons now recommend the first screening colonoscopy at the age of 45, assuming there is no family history or symptoms.
Any patient with a family history of colon cancer should be screened 10 years prior to the age of diagnosis of their affected family member.
Any patient with significant symptoms that are not otherwise explained should also be evaluated for screening examination, regardless of age.
The most important thing to realize is that all stages of colon cancer are treatable even if you are diagnosed within the advanced stage of colon cancer initially.
After your diagnosis has been confirmed, you will likely visit with a colorectal surgeon and possibly a hematologist/oncologist depending on your initial clinical stage.
Your stage will be determined by biopsies obtained during colonoscopy as well as lab work and CT scans of your chest and abdomen/pelvis.
The initial treatment of most colon cancers is surgical removal of the affected portion of the colon and the associated lymph nodes. This is performed by a colorectal surgeon and can frequently be accomplished through minimally invasive techniques, like robotic surgery.
Removal of a portion of the colon rarely involves the creation of an ostomy or stoma. When robotic techniques are utilized, patients usually have a minimal amount of postoperative pain and are able to be discharged from the hospital in a matter of days.
After surgery, some patients will require chemotherapy depending on the final pathology of the removed portion of the colon.
If colon cancer is diagnosed at an advanced stage where the cancer has spread to other parts of the body, chemotherapy will serve as the initial treatment with potential surgery to follow.
After you have completed your initial treatment with surgery, chemotherapy, or both, surveillance examinations will be performed at regular intervals. This will include visiting with your colorectal surgeon or oncologist, examination in the office, lab work, CT scans, and colonoscopy.
The short answer is yes, colorectal cancer can be prevented. First, you must dedicate yourself to improvements in your diet, exercise and lifestyle in general. Second, getting regular screenings in the form of colonoscopies is the most effective way of catching pre-cancerous polyps or cancerous lesions as early as possible.