Colon and Rectal Cancer Screening and Treatment
Colorectal cancer is the second most common cancer in the United States among both men and women. It affects 140,000 people annually and causes 50,000 deaths. The average person has a one in 20 chance of developing colorectal cancer in his/her lifetime. This risk is increased if there is a family history of colorectal polyps or cancer, and is even higher still in those patients with a history of breast, uterine or ovarian cancer, and patients with a history of extensive inflammatory bowel disease such as ulcerative colitis or Crohn’s colitis. Although colorectal cancer may occur at any age, more than 90% of patients diagnosed with colorectal cancer are over age 40 and this risk doubles every ten years. Translated, this means that a person’s risk for developing colorectal cancer increases significantly with age.
What causes colorectal cancer?
It is generally agreed that nearly all colon and rectal cancer begins in benign polyps, called adenomas. These pre-malignant polyps, or growths, occur in the wall of the colon and/or rectum and may eventually increase in size and become cancer, or medically speaking, carcinoma. This is known as the “adenoma-carcinoma sequence”. Several factors have been mentioned in the literature that may increase a person’s risk for developing colorectal cancer and include: age, a diet high in fat and cholesterol, an inactive/sedentary lifestyle, obesity, smoking and environmental exposures.
What are the symptoms of colorectal cancer?
Unfortunately, polyps and early cancers do not produce any physical signs or symptoms. Therefore, symptoms usually indicate late or advanced disease. The most common symptoms of colorectal cancer are rectal bleeding and changes in bowel habits such as constipation or diarrhea. These symptoms are common in many other disorders of the gastrointestinal tract so it is very important to have a thorough examination should you experience them. NOT ALL RECTAL BLEEDING IS DUE TO HEMORRHOIDS. It is very important for patients to remember this and seek evaluation if they are experiencing rectal bleeding. Other symptoms such as abdominal pain, rectal pain and weight loss are usually late symptoms of colorectal cancer and quite possibly indicate advanced/extensive disease.
How is colorectal cancer diagnosed?
Evaluation of colorectal cancer is first begun with a complete history and physical exam, including a digital rectal exam and possibly testing the stool for blood. A colonoscopy is the most definitive test used to diagnose colorectal cancer. A colonoscopy is performed by a colorectal surgeon or other specialist in order to get a direct visualization of the inside of the colon and rectum. A colonoscopy is a safe, painless, outpatient procedure performed under a light sedation. Most patients undergo a gentle oral bowel prep/cleanse in preparation for a colonoscopy. A narrow, flexible tube with a lighted camera on its tip is passed from the rectum to the beginning of the colon, called the cecum. Polyps can be removed during a colonoscopy and biopsies of any growths or tumors seen can be done at this time and provide the definitive diagnosis. Based upon the findings on colonoscopy, your colorectal surgeon may recommend other testing such as blood work, a CT scan of the abdomen and pelvis, pelvic MRI and/or ultrasound. The best way to diagnose polyps and early colorectal cancers is to undergo routine screening colonoscopy.
How is colorectal cancer treated?
Nearly all cases of colorectal cancer require surgery. Radiation and chemotherapy are sometimes required in addition to surgery. If the cancer is diagnosed and treated in the earliest stages, approximately 80-90% of patients are restored to their normal health. The cure rate decreases to 50% or less when the cancer is diagnosed in the later/advanced stages. Less than 5% of all colorectal cancer patients require a colostomy or “bag”, thanks to modern technology. Dr. Paonessa prides herself in being able to maintain this standard of care in her own practice. Not only is she able to minimize the number of colostomies/”bags” created for her patients, but she performs a majority of her colorectal cancer surgeries using laparoscopic surgery. Laparoscopic colorectal surgery is a minimally invasive surgery in which small incisions are made to perform major surgery. This allows for shorter hospital stays, decreased incisional pain and earlier return to work and other activities.
Can colorectal cancer be prevented?
Colorectal cancer is one of the few cancers that is preventable. Obtaining a screening colonoscopy at regular intervals is the single best way to prevent colorectal cancer. Dr. Paonessa is able to review the guidelines for screening colonoscopy based upon your age, medical history and family history. Colonoscopy is a safe, reliable test with complication rates less than 1%. Dr. Paonessa is a skilled endoscopist who routinely performs screening and diagnostic colonoscopies with minimal or any discomfort. Patients are able to return to work the next day. Patients frequently awake after their colonoscopy and ask “When are we starting the exam?”, because it is so easy and painless.
Call Dr. Paonessa’s office today to schedule your screening colonoscopy or to discuss surgical options for treating colorectal cancer.