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Colorectal Cancer

Colorectal cancer is the second leading cause of cancer death, and both men and women are at risk. Colon cancer is associated with lifestyle choices: exercising, eating a healthy diet high in vegetables, fruits, and whole grains, and maintaining a healthy weight are a few simple steps people can take to reduce the risk of colon cancer. Obesity, physical inactivity, consumption of red meats and processed meats, a high fat, low-fiber diet, smoking, and alcohol use are all associated with an increased risk of colon cancer. Other risk factors include a personal or family history of colon polyps (precancerous growths) or cancers, a personal history of inflammatory bowel disease, or a hereditary colorectal cancer syndrome.

Screening

Anyone can get colon cancer although it is most frequently diagnosed in those over age 50. In 2018, the American Cancer Society updated its guideline for colorectal cancer screening. The recommendations call for screening to begin at age 45 for those at average risk of developing colorectal cancer; those at higher risk should be screened sooner. Researchers have seen an increasing risk of colorectal cancer in younger adults, who are more likely to be diagnosed with the disease in its later stages. If you are over age 45, discuss your personal colorectal cancer prevention strategy with your primary care provider.

The most widely recommended preventive test is a colonoscopy, the process of looking at the internal lining of the colon with a camera. Other screening options such as fecal testing for blood or DNA and virtual colonoscopy are available, although these alternative methods cannot be used to remove polyps if they are found.

Screening colonoscopies are performed at all Valley Health hospitals and the Endoscopy Center at Winchester Medical Center. Several Valley Health specialists including gastroenterologists and general surgeons perform colonoscopies.

Anyone of any age who is experiencing symptoms of colorectal cancer should consult their primary care provider.

The most common signs and symptoms include:

  • Change in bowel habits, such as diarrhea, constipation, or narrowing of the stool, that last for more than a few days
  • Rectal bleeding
  • Dark stools or blood in your stools
  • Cramping and/or abdominal (belly) pain
  • Weakness and fatigue
  • Unintended weight loss
  • A feeling that you need to have a bowel movement that is not relieved by doing so

Diagnosis and Treatment

The goal of colorectal cancer screening is to remove polyps inside the colon or rectum before they become cancerous, or to detect cancers at an early, curable stage. This is effective because it generally takes 10-15 years for a cancer to develop, usually after progressing through the polyp stage. Diagnosis of colorectal cancer may require further evaluation and follow-up such as a biopsy.

Surgery remains the primary treatment for most patients diagnosed with cancer of the colon or rectum. Treatment options such as chemotherapy and radiation can be used before or after surgery. Every patient’s ideal treatment plan is different.

Surgery

Minimally invasive surgery is being used increasingly for treatment of colorectal cancer. At Winchester Medical Center, we offer advanced surgical treatments including robot-assisted techniques. While not all patients are candidates for robotic surgery, the advanced technology may expand the number of patients eligible for a minimally invasive operation for colorectal cancer.

Radiation Therapy

Radiation can be used before rectal cancer surgery to shrink a tumor and make it easier to remove. It can also be used after surgery to kill any cancer cells left behind. Sometimes it is used in combination with chemotherapy. Radiation is not commonly used to treat colon cancer.

Chemotherapy

Chemotherapy drugs are administered through an IV and, similar to radiation therapy, may be given before or after surgery.

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