What is Colon Cancer?
Colon or colorectal cancer is abnormal or uncontrolled cell growth in the colon and/or rectum, also known as the large intestine. Colon cancer usually develops from abnormal growths on the surface lining of the colon or rectum. These growths are called polyps and if untreated, they can grow to become cancer. Colon cancer is the number two killer among cancers in the United States, with more than 53,000 people dying each year as a result of this disease.
If detected early, it is usually treatable and can often be cured. Many cases of colon cancer can be avoided by the detection and removal of polyps before they become cancerous. Colon cancer typically affects older adults with 90% of cases reported in adults over age 50. Along with age, factors increasing the risk of colon cancer include a family history of colon cancer and inflammatory bowel disease (Ulcerative Colitis or Crohn’s disease). It is estimated that 60% of the deaths caused by colon cancer could be prevented through regular screening protocols.
What are Symptoms of Colon Cancer?
Colon cancer can develop, grow and spread to other parts of your body with few or any symptoms present. Some symptoms of this disease may include:
- Blood in or on the stool, toilet tissue or toilet water
- A change in bowel habits
- Stools that are narrower than usual
- General, unexplained and persistent abdominal (tummy) discomfort
- Unexplained weight loss
These symptoms can also be associated with other diseases and medical conditions. If you have any of these symptoms, it is recommended that you discuss them with your doctor. Your physician can recommend a diagnostic plan or testing that best suits your specific symptoms.
How is Colon Cancer Diagnosed?
Colonoscopy is the diagnostic tool of choice for colon cancer detection and screening. Colon cancer screening is the routine testing of patients who have no symptoms of disease using guidelines developed by the American Cancer Society and the American College of Gastroenterology. It is recommended for all adults age 50 and older, and at a younger age for individuals with risk factors, including a family history of colorectal cancer. There are three primary methods utilized alone or in combination to screen for colon cancer. These include:
- Fecal Occult Blood Testing (FOBT): This test involves obtaining a small scraping of stool, which is swabbed onto a specially provided card and returned to your physician or a laboratory where it is tested to determine if blood is in your stool. Small traces of blood may be detected in the stool even if it is not visible to the naked eye. Approximately 4% of people with a positive FOBT will be found to have colon cancer upon further testing. More likely, the positive blood in the stool is coming from a less serious problem such as a peptic ulcer, gastritis, inflammation of the colon (colitis), polyps or other easily treatable problems. Any positive FOBT requires further testing to determine the source of the blood. The absence of blood on FOBT (a negative test) alone is not adequate to assure that there is no colon cancer present. The FOBT must be accompanied by either a flexible sigmoidoscopy or colonoscopy at the proper recommended intervals. It is recommended that fecal occult blood test screening be performed once each year beginning at age 40.
- Sigmoidoscopy: This screening procedure involves a short, thin, flexible tube being inserted into the rectum and advanced into the lower third of the colon to inspect for polyps or cancerous growths. Biopsies from polyps identified, or other tissue samples from the lining of the rectum or colon, may be taken for further evaluation by a pathologist to determine if the tissue is cancerous. The physician performing this procedure may also take photos or videos to show you the results and place in your medical records. A sigmoidoscopy is of limited value because a polyp or cancer will not be detected if it is located in the upper two thirds of the colon beyond the reach of this instrument. If a polyp is found, your doctor will recommend a full colonoscopy to remove the growth and inspect the entire colon for other growths. A sigmoidoscopy is recommended for screening every 5 years after age 50 and is usually performed in your doctor’s office within 5-10 minutes.
- Colonoscopy: A colonoscopy is the most accurate and thorough screening procedure usually performed by a gastroenterologist to view the inside of your colon and rectum. The specialists at the Ambulatory Center for Endoscopy and Colonoscopy, LLC(ACE.) perform thousands of colonoscopy screenings each year. Using a thin, elongated, tube-like instrument called a colonoscope or “scope,” the physician can visually study the lining of the colon. Because the colonoscope is flexible, it bends within the curves of your colon and has steering controls to allow the gastroenterologist to view specific portions of the colon’s lining. The colonoscope can also push air into your colon to expand the area and allow the physician to get better views. Patients are often given a gentle intravenous sedative to relax them during the examination and keep them pain free. Some patients prefer to remain awake and may observe their procedure on a video monitor. If polyps are found, they can be removed at the time of your colonoscopy and sent to the laboratory for analysis. The physician will likely take photos or videos during the procedure to show you results, document findings in your medical record or provide to other physicians and specialists for further evaluation. A colonoscopy is recommended for screening every 10 years beginning at age 50 or more frequently if you have other risk factors.