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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What to Know About Cervical Cancer

Cervical cancer used to be the leading cause of cancer death among women in the United States according to the Centers for Disease Control and Prevention. However, the number of cases and deaths have decreased significantly in the past 40 years. Today, it is the fourth most common cancer in women. This decline can be attributed to more and more women getting regular Pap tests, which can find cervical precancers. If detected early and managed effectively, cervical cancer is one of the most successfully treatable forms of cancer.

What Is Cervical Cancer?

The cervix connects the uterus (womb) to the vagina (birth canal). It is the place where the baby grows during pregnancy. Cervical cancer occurs when cells in this region change or slowly grow out of control. Although all women are at risk for cervical cancer, this disease most often affects women over age 30.

Exposure to certain types of the human papillomavirus (HPV) is the main cause of cervical cancer. HPV is a common virus that spreads from person to person through sexual contact. At least half of sexually active people will have HPV at some point in their lives and are able to fight the infection or simply resolve on its own and cause no symptoms, but persistent infection can cause cervical cancer in women.

Not all types of HPV cause cervical cancer. Some types cause genital or skin warts and other skin disorders.

What Are the Risk Factors for Cervical Cancer?

Anything that increases your chance of getting a disease is called a risk factor, but it does not necessarily mean you will get cancer in the same way that not having risk factors does not mean that you will not get cancer.

Other risk factors for cervical cancer include the following:

  • Having HIV (the virus that causes AIDS)
  • Having weakened immune system due to long-term immunosuppression from taking medicine to help prevent organ rejection after a transplant
  • Being sexually active at a very young age
  • Having multiple sexual partners
  • Smoking
  • Using birth control pills for a long time (five or more years)
  • Having given birth to three or more children
  • Being exposed to the drug diethylstilbestrol (DES) while in the mother’s womb

What Are the Symptoms of Cervical Cancer?

Since cervical cancer develops slowly over time, there are usually no signs and symptoms early on but it may cause vaginal bleeding and pelvic pain later on, including:

  • Vaginal bleeding after sexual intercourse, between periods or after menopause
  • Unusual vaginal discharge
  • Pain during sexual intercourse

What are the Stages of Cervical Cancer?

A four-stage system is used to assess how far the cancer has spread and whether it has reached other nearby organs.

  • Stage 1: Cancer cells have formed and is found in the cervix only.
  • Stage 2: The cancer has now moved to the upper two-thirds of the vagina or to the tissue around the uterus, but not as far as the walls of the pelvis or the lower part of the vagina. It may or may not affect nearby lymph nodes.
  • Stage 3: Cancer cells are present in the lower part of the vagina or the walls of the pelvis and/or has caused kidney problems and/or involves lymph nodes.
  • Stage 4: The cancer has spread beyond the pelvis and has spread to the lining of the bladder or rectum. It has spread to other parts of the body, including the liver, bones, lungs and lymph nodes.

Treatments include surgery, chemotherapy and radiation therapy depending on the kind of cervical cancer and how far it has spread.

What Can I Do to Reduce My Risk?

Women as early as the age of 21 can get screened regularly to lower the risk for cervical cancer. There are two screening options to help prevent or detect cervical cancer early.

  • Pap test (or Pap smear) – this procedure involves gently scraping cells from the surface of the cervix and vagina using a cotton, a brush or a small wooden stick to look for precancers that may develop into cervical cancer if they are not treated appropriately.
  • HPV test – this laboratory test is used to check the DNA or RNA for certain types of HPV infection that can cause cell changes. The test may be done using the sample of cells removed during a Pap test.

What is the HPV Vaccine?

The HPV vaccine protects against the types of HPV that commonly cause cervical cancers and prevents new HPV infections. However, it does not treat existing infections or diseases. The HPV vaccine works best when given before exposure to HPV.

The vaccine is recommended for preteens aged 11 to 12 years but can be given starting at age 9. It is not recommended for everyone older than age 26 years because HPV vaccination in this age range provides less benefit, as more people have already been exposed to HPV. Those who have received an HPV vaccine should still get screened for cervical cancer regularly.

It is important to get the recommendation of your treating physician to properly assess your eligibility for an HPV vaccine. If you experience any of the symptoms mentioned earlier, seek medical attention immediately.

World Health Organization
Centers for Disease Control and Prevention
National Cancer Institute

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