Colorectal Cancer

Colorectal cancer is a type of cancer that usually begins as a growth, known as a polyp, forming inside the large intestines in the colon or rectum. As the polyp grows it can become invasive and develop into a cancer. The conventional naming of a colon cancer or a rectal cancer depends on the part of the large bowel that the tumor originates in. Collectively they are referred to as colorectal cancer. Since nearly all colorectal cancer starts as a polyp, if we catch a pre-cancerous lesion or polyp and remove it, we can actually prevent colorectal cancer from occurring.

• Changes in bowel habits
• Blood in the stool
• Changes in the appearance of bowel movements
• Abdominal pain 
• Unexplained weight loss 
• Nausea, vomiting, diarrhea or constipation
• Fatigue 
• Incomplete bowel movements or stool that’s different in size, shape or color than your norm

• Being 45 years old or older 
• Having a family history of colorectal cancer or polyps 
• Having a personal history of colorectal polyps, ovarian cancer, uterine cancer, pelvic radiation or inflammatory bowel disease 
• Having certain inherited genetic changes 
• Consuming alcohol and/or smoking cigarettes 
• Obesity

• Physical activity
• Aspirin 
• Diets low in red meat and processed meat 
• Diets high in fruits and vegetables, calcium, folate 
• Normal body weight 
• Smoking cessation, limited alcohol intake
• Screening and polyp removal

Screenings for colorectal cancer can help find cancerous polyps at an early stage and remove them before they develop into cancer. They are recommended for those 45 and older. Doctors may perform:

• A colonoscopy to look inside the rectum and colon, or a virtual colonoscopy using X-rays
• A fecal occult blood test to check for signs of blood in stool
• A sigmoidoscopy to look inside the rectum and the lower portion of the colon (sigmoid) for polyps, abnormal areas or cancer
• A DNA stool test to check stool cells for genetic changes that might indicate colorectal cancer, polyps or blood in the stool
• CT colonography: an imaging study to look for polyps or masses

After a diagnosis, tests are performed to detect if cancer cells have spread outside the colon or rectum or to other parts of the body. Cancer can spread through nearby tissue, through vessels in the lymph system to lymph nodes and other parts of the body or via blood vessels to other organs. The stages of colorectal cancer are categorized from Stage 0 to Stage IV, with Stage IV indicating the cancer has spread to other parts of the body.

• Surgery to remove the cancer via an operation. This is the most common treatment type. This can often be done through minimally invasive means via laparoscopic or robotic techniques.
• Chemotherapy using drugs to stop the growth of cancer cells.
• Radiation therapy using high-energy X-rays and other types of radiation to kill or stop the growth of cancer cells.
• Targeted therapy using certain types of drugs, such as monoclonal antibodies, to target specific cancer cells.
• Immunotherapy using substances made naturally in the body or in a laboratory setting to boost the body’s natural defenses against cancer.

Overall, incidents of colorectal cancer are declining but researchers are seeing slight increases in incidents and death rates in younger men and women, ages 20 to 49 years old — most drastically in those 40-49 years old. Due to the rise in younger patients, screening guidelines have changed to recommend screenings start at age 45 for everyone and earlier for those with high-risk criteria such as family history. Experts have determined new treatments and increased screenings have led to an increase in survival rates. New methods to prevent colorectal cancer are currently being studied in clinical trials.