Each year more than 150,000 people in the United States learn they have cancer of the colon or rectum (also called colorectal or large bowel cancer). It is the second most common cause of cancer in the United States and accounts for more than 60,000 deaths annually.
Who is at Risk?
Although colorectal cancer can strike anyone, more than 90% of patients are over the age of 40. In addition to age, other risk factors include:
a family history of colorectal cancer and polyps;
ulcerative colitis;
colon polyps
Prevention and Diagnosis
Prevention and diagnosis of colorectal cancer requires evaluation of the colon in patients with and without symptoms. There are no blood tests clinically available to accurately detect the presence of colorectal cancer. Tests which evaluate the colon either by visual inspection or with x-rays include:
Flexible sigmoidoscopy
Colonoscopy
Double contrast barium enema
Fecal occult blood test
These tests may be recommended by your physician to investigate gastrointestinal symptoms or may be used as a preventive measure to detect precancerous growths, called adenomas or polyps. Early detection of colorectal cancer yields the best results in treatment. Identifying colon polyps and removing them has shown to decrease the risk of developing colorectal cancer.
Surgical Treatment of Colorectal Cancer
The most effective treatment of colorectal cancer is surgical removal. In the special case of small cancers found in polyps, removal of the polyp may be the only treatment needed; however, this type of treatment is recommended only after careful review of the pathology and with surgical consultation.
Minimally Invasive Surgery
During minimally invasive laparoscopic colon surgery, the surgeon makes a series of small incisions, typically ¼ inch to 4 inches, in the patient’s abdomen. A small video camera or “scope” is placed in one of the incisions, providing the surgeon with magnified view of the patient’s internal organ on a television monitor. Surgical instruments are place in the other incisions allowing the surgeon to work inside and remove portions of the diseased colon. The surgical technique also can be used to treat other diseases of the colon such as Crohn’s disease and diverticulitis.
Laparoscopic surgery offers benefits over traditional “open” surgery which include quicker recovery time, shorter hospital stay, less pain and scarring.
Abdominal Surgery
Most colorectal cancers are removed by an abdominal operation. The vast majority are done without the need for a colostomy. Surgery is the primary treatment for colorectal cancer because when it is performed for cure, it completely removes the primary cancer and allows for the staging, or evaluation, of the risks for cancer spread.
Even if the cancer has spread, surgery will provide the best opportunity to relieve uncomfortable symptoms and prevent either bowel obstruction or bowel bleeding. Sections of the colon and rectum are removed along with the lymph glands that are associated with the particular part of the bowel.
Team Approach
Although surgery is the primary therapy for colorectal cancer, a team approach is essential for continuing care. Each colorectal cancer patient has their case discussed at a weekly meeting. At this meeting, colorectal surgeons, medical oncologists, radiation oncologists, pathologists, gastroenterologists and clinical nurse specialists review the treatment plans for each patient. These plans include a review of the most recent techniques and clinical studies that may benefit the patient.
Each year more than 150,000 people in the United States learn they have cancer of the colon or rectum (also called colorectal or large bowel cancer). It is the second most common cause of cancer in the United States and accounts for more than 60,000 deaths annually.
