Colon cancer occurs when cancer cells form in the tissues of the colon (the first four to five feet of the large intestine). Rectal cancer occurs when cancer forms in the tissues of the rectum (the last several inches of the large intestine). Cancer that starts in either of these organs may also be called colorectal cancer. An estimated 102,480 cases of colon cancer and 40,340 cases of rectal cancer are expected to be diagnosed in the U.S. this year, with an estimated 50,830 deaths (both colon and rectal cancer combined). Colorectal cancer is the fourth most common cancer in women (after skin, breast and lung cancer).
5 steps to protect your colon
- Stay active. People who exercise regularly (up to 30 to 60 minutes daily) have a lower risk of colorectal cancer, according to numerous research studies. Research has shown that adults who increase their physical activity (either the intensity, amount of frequency) can reduce their risk of developing colon cancer by 30 to 40 percent compared to those who are inactive, regardless of their body mass index (BMI). The people who are the most active reduce their risk the most, and high-intensity exercise (running, swimming, cycling) seems to have the greatest protective effect. Scientists speculate the physical activity helps fight colon cancer through its role in helping decrease the amount of time potential carcinogens are in the colon.
- Eat healthy. Studies show that a diet high in whole grains, fruits and vegetables and low in red and processed meat or other high-fat foods (especially those with saturated fats) may help reduce the risk of developing colorectal cancer. Getting enough nutrients like calcium, folate and fiber is also important in lowering your risk.
- Get a colonoscopy. Most doctors recommend getting a colonoscopy beginning at age 50 (earlier if you have a family history of colorectal cancer). The procedure is usually repeated every 10 years. During this exam, your doctor will use a flexible, lighted tube to look at the interior walls of the rectum and the entire colon. Samples of tissue may be collected for closer examination. Or your doctor may identify colorectal polyps, which are growths on the inner wall of the colon or rectum. Most are benign, but some, called adenomas, are considered precancerous. Finding and removing polyps can help reduce the risk of colorectal cancer.
- Consider medications. Research shows that taking an aspirin every day for at least five years can decrease the risk of colorectal cancer and the risk of death from colorectal cancer. However, aspirin can also cause bleeding in the stomach, intestines, or brain. Other studies have shown that hormone replacement therapy (HRT) using both estrogen and progesterone lowers the risk of colon cancer in postmenopausal women. But again, there are also distinct risks associated with hormone replacement, including a possible increase in breast cancer, heart disease and blood clots. Speak to your doctor about your risk factors and possible medication use.
- Know your risk factors. Colorectal cancer occurs more frequently as you get older, with more than 90 percent of people diagnosed after age 50. The average age of diagnosis is 72, according to the National Cancer Institute. People who have a close relative (parent, brother, sister, or children) who has developed colorectal cancer are somewhat more likely to develop the disease themselves, especially if the cancer was diagnosed at a relatively young age. Changes in certain genes increase the risk of colorectal cancer, including Hereditary Nonpolyposis Colon Cancer (HNPCC) and Familial Adenomatous Polyposis (FAP). HNPCC is the most common type of inherited colorectal cancer, accounting for about 2 percent of all cases. FAP is considered more rare, accounting for less than 1 percent of all cases. People who have inflammatory bowel disease (either ulcerative colitis or Crohn’s disease) for many years are also at increased risk.
Ask Your Doctor
In addition to a colonoscopy, your doctor may recommend other screening tests to help detect polyps or cancer.
- A digital rectal exam, often part of a routine physical examination, allows your doctor to feel inside your rectum for abnormal areas. A fecal occult blood test (FOBT) looks at stool to determine whether tiny amounts of blood are present.
- A sigmoidoscopy looks at the inside of the rectum and lower part of the colon with a lighted tool (called a sigmoidoscope); if polyps are found, your doctor will remove them.
- A virtual colonoscopy uses special x-ray equipment to look at pictures inside the colon and rectum. This test is less invasive than a standard colonoscopy but its effectiveness is still not known.
- A double contrast barium enema (DCBE) is a series of x-rays of the entire colon and rectum, taken after the patient has an enema with a barium solution; air is then pumped into the rectum. It allows your doctor to see the colon and rectum on the x-rays, however it may miss small polyps along the digestive tract.
If a test shows an abnormality, additional blood or screening tests may be ordered. A biopsy may be performed through a colonoscopy to determine whether there is cancer present. If you do have cancer cells, your doctor may do tests to determine whether they have spread within the colon or to other parts of the body. Colon cancer can range from stage 0 (abnormal cells found only in the mucosa of the colon wall) to stage 4, where the cancer has spread to other organs or lymph nodes.
There are many different treatments for colon cancer. The most common is surgery to remove the cancer. You may also be given radiofrequency ablation, using a special probe with tiny electrodes to kill cancer cells. Cryosurgery uses an instrument to freeze and destroy abnormal tissue. Some colon cancer patients are also given chemotherapy and radiation to kill cancer cells and keep them from growing. Targeted therapies, using drugs or other substances to identify and attack cancer cells without harming normal cells, is also often employed.
There is a high risk of recurrence among colorectal cancer patients, so it’s important to stay in touch with your doctor with regular checkups. Talk to your doctor about a long-term treatment plan.
At North Shore-LIJ Cancer Institute, we treat the entire person, not just the cancer. And because each diagnosis is unique, we customize a treatment plan to fit your specific needs. We’ll have questions. You’ll have questions. Together, we’ll have a dialogue that continues throughout your care so you have an active role in deciding next steps, making choices and selecting the best treatment options available
Find a cancer specialist at the North Shore-LIJ Cancer Institute.