What you need to know about colorectal cancer

Colorectal cancer. Those are two words no one wants to hear. According to the American Cancer Society, colorectal cancer is the third most common cancer in the United States with nearly 102,480 new cases of the disease diagnosed in 2013. Fortunately, the death rate from colorectal cancer has been dropping over for more than 20 years due to early screenings and improved treatments.

Undergoing testing to diagnose colorectal cancer may be necessary because of abnormal results from a screening exam or if there are symptoms of the disease, such as a change in bowel habits, abdominal pain, weakness, rectal bleeding or blood in the stool.

Diagnosis may begin with a complete medical history and physical examination. Endoscopic tests to check for colorectal polyps also may be necessary, including a sigmoidoscopy or colonoscopy (procedures used to see inside the colon and rectum), and imaging tests such as a barium enema, double contrast barium enema or virtual colonoscopy. A biopsy is done on any abnormal-looking tissues that are removed during a colonoscopy to confirm the diagnosis of colorectal cancer.

Other imaging tests may be required to determine if a suspicious area is cancerous, learn if the cancer has spread or find out if treatment has been effective. These tests include computed tomography, ultrasound, magnetic resonance imaging, positron emission tomography and angiography.

Once colorectal cancer had been diagnosed, treatment will be determined based on the stage and type of cancer, how far it has spread, overall health, side effects of treatment and long-term prognosis. Surgery usually is recommended for early stage colon cancer. The procedure calls for the removal of part of the colon and nearby lymph nodes. Some stage 0 or early stage 1 tumors can be taken out by removing the base of the polyp or the superficial cancer and a small margin of surrounding tissue.

Colorectal cancer also may be treated with three different types of radiation therapy, which use high-energy rays or particles to destroy cancer cells.

  • External-beam radiation therapy focuses radiation on the cancer from outside the body;
  • Endocavitary radiation therapy delivers radiation through a hand-held device placed into the anus; and
  • Internal radiation therapy (brachytherapy) involves placing small pellets of radioactive material next to or directly into the cancer.

Chemotherapy, which involves administering drugs either into a vein or orally, can be part of a colorectal cancer treatment plan as well. Neoadjuvant chemotherapy may be given along with radiation before surgery to try to shrink some rectal cancers. Adjuvant chemotherapy is given after surgery in case the cancer returns.

It is important to discuss potential side effects of treatment with your doctor. Most side effects should decrease after treatment, but steps can be taken to reduce or relieve them.

For more information about diagnosing and treating colorectal cancer, talk with your doctor or visit the American Cancer Society Web site at www.cancer.org.

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Get Early Cancer Screening Programs for Prevention

Most cancers start with abnormal cells growing out of control. Sometimes you will experience symptoms, but often you will not. That is why regular early cancer screening programs and self-examinations are so important. Finding and treating cancer in its earlier stages is much easier, and potentially life-saving, than waiting until the cancer has spread to other parts of the body.

In 2017, there were an estimated 1,688,780 new cancer cases diagnosed and 600,920 cancer deaths in the U.S. Cancer remains the second most common cause of death in the U.S., accounting for nearly 1 of every 4 deaths. Screening tests are available for many forms of cancer, including colorectal, breast, cervical and prostate.

Early Cancer Screening Programs for Men and Women

Both men and women are encouraged to undergo colorectal cancer tests beginning at age 50 (or earlier if they have risk factors for developing the disease). Screening tests for colorectal cancer include:

  • Stool tests, which tests for blood in the stool
  • Flexible sigmoidoscopy, which allows the doctor to check the rectum and lower part of the colon
  • CT Colonography (Virtual Colonoscopy), which uses an X-ray to find abnormal spots
  • Colonoscopy, which allows the doctor to examine the entire colon

Screening for Women

 There is a current debate in the United States over the best time to begin screening mammograms for breast cancer. The U.S. Preventive Services (USPTF) has recommended that the biennial screening mammography for women should be done between the ages of 50 to 74 years. The recommendation among other health experts has not changed, including the American Cancer Society and the American College of Surgeons.

They continue to recommend that women should begin having annual mammograms at age 40, or earlier if they are at higher risk. The decision about when to start regular, biennial screening mammography should be a result of your individual discussion with your physician. Monthly self exams help women know the normal state of their breasts.

Another screening recommended for women is a Pap test to detect pre-cancerous cells in the cervix or cervical cancer. The test should be done at least every three years between ages 21 and 29, and at least every five years from age 30 to 65. After age 65, women who have had normal results in the past may no longer need screenings. Treatment is available to prevent cervical cancer from developing or when it is found early.

Cancer Screening for Men

Men can be screened for prostate cancer as early as age 40 if they are at high risk for developing the disease. Having a first-degree relative with prostate cancer or being African-American may increase a man’s chances of having prostate cancer. Screening for the condition may include a digital rectal exam or a prostate-specific antigen blood test. Men also are encouraged to examine their testicles on a routine basis to check for testicular cancer. Any lump or swelling should be reported to a physician as soon as possible. Testicular cancer is not common, but it is one of the most treatable forms of cancer.

Screening recommendations can vary for different cancers and depend on the patient’s medical history, family history and lifestyle. Doctors may advise patients to be screened regularly or at a younger age if they are inactive, use tobacco products, drink alcohol or eat a high-fat diet. For more information about cancer screenings, talk with your doctor.

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