USF-COM
Department
of Family Medicine
Patient Education Information on...
Index of
Patient Education Topics
What is Colorectal Cancer?
Colon and rectal cancers develop in the digestive tract, which is the long
hollow tube in your body with many turns and folds that digests the food
we eat, absorbing nutrients and leaving solid waste matter as feces or
stool. Colon makes up approximately five feet of the distal digestive
tract. It further connects distally to the very short segment rectum,
just before the anus, where the feces is passed.
Colon cancer and rectal cancer have many features in common. Sometimes
they are referred to together as colorectal cancer.
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Why is it Important?
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Colon and rectal cancers account for about 9% of
new cases of cancer and 10% of all deaths from cancer each year.
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About 94,100 new cases of colon cancer and 37,100 new cases of rectal cancer
will have been diagnosed this year.
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24,000 women and 22,600 men will have died this year from colon cancer
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The death rate from colorectal cancer declining over past 20 years due
to screening and improved treatment.
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Majority of cases occur after the age of 50.
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Who is at Risk?
There is no single cause of colon cancer, however, there are certain risk
factors that make a person more likely to develop colorectal cancer.
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Family history of colorectal cancer.
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A personal history of colorectal polyps. Polyps are small growths in the
colon or rectum that can become cancerous.
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A personal history of inflammatory bowel disease, where colon is inflammed
over a long period of time and may have ulcers in the lining.
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Aging: 90% of people with colorectal cancer are older than 50.
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A high-fat or low-fiber diet.
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Physical inactivity.
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What are the Symptoms?
Colon cancer may be present in the absence of any symptoms. However,
if you experience any of the following symptoms you should see your doctor
immediately.
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Rectal bleeding/ the presence of blood in stool.
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Feeling that the bowel does not empty completely.
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Recent changes in the normal pattern of bowel habits, especially in persons
over 40.
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What is Screening?
Screening for cancer is examination (or testing) of people for early signs
of a certain type of cancer even though they have no symptoms. Scientists
have studied patterns of cancer in the population and things we do in our
lives that may cause cancer. This information helps doctors recommend
who should be screened for certain types of cancer, what types of tests
those people should have, and how often these tests should be done.
If your doctor suggests certain cancer screening tests as a part of your
health care plan, this does not mean he or she thinks you have cancer.
Screening tests are done when you have no symptoms. If you have signs
or symptoms of cancer, your doctor will order certain tests to see whether
you have cancer. These are called diagnostic tests.
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What does Colorectal Cancer Screening Involve?
There are three effective tests that can detect colorectal cancer simply,
safely, and with little discomfort.
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Digital Rectal Examination: The doctor inserts a gloved finger into
the rectum to feel for anything abnormal.
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Fecal Occult Blood Test: This is a simple at-home procedure.
Special cards are coated with a stool sample and returned to the physician
or lab. This test examines a patient’s stool for occult (hidden)
blood.
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Sigmoidoscopy: This is an examination in which a doctor uses a thin,
flexible tube with a light to look inside the rectum and colon for polyps
or abnormal areas. If a polyp is found, the doctor may remove it
and send it to a lab where it can be examined for cancerous cells.
This test may be somewhat uncomfortable, but it should not be very painful.
Other tests:
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Colonoscopy: This is very similar to sigmoidoscopy, except that
the tube is much longer, and allows the doctor to see much more of the
colon’s lining.
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Double Contrast Barium Enema: Barium sulfate, a chalky substance,
is given via the anus to partially fill up the colon. Then air is
inserted to cause the colon to expand. X-ray films are then taken.
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When and How Often Should
I be Screened for Colorectal Cancer?
The American Cancer Society has the following guidelines for an early detection
program. Beginning at age 50, both men and women should follow this
testing schedule:
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Yearly Fecal Occult Blood Test, plus
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Yearly Digital Rectal Exam, plus
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Sigmoidoscopy every 3-5 years, or
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Colonoscopy every 10 years, or
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Double Contrast Barium Enema every 5-10 years.
These guidelines apply only to people without symptoms or significant risk
factors. Those symptomatic or with any of the risk factors mentioned
previously should see their doctor to determine if they should begin colorectal
cancer screening earlier and/or undergo screening more often.
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What if Cancer is Found?
If cancer is discovered, then your primary health care provider will refer
you to see a specialist who may conduct further studies, or repeat a study
already done by your primary health care provider. He or she then
will discuss with you the options. The treatment and outlook for
cancer depend, to a large extent, on whether the cancer has spread and
how far. For early cancer, surgery may be all that is needed.
For more advanced cancer, other treatments such as chemotherapy or radiation
therapy may be required. There are certain side effects that may
come with chemotherapy. Some of these include upset stomach, vomiting,
loss of apetite, loss of hair, mouth or vaginal sores, and more infections.
Delay in treatment may lead to further complications, which arise from
spread of the cancer to various parts of the body. It is important
to consider your overall physical health and your own situation in life
in choosing treatment
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What About Prevention?
Even though the exact cause of colorectal cancer is not known, it is possible
to prevent many colon cancers. Following screening guidelines can
lower the number of cases of the disease and can also lower the death rate
from colorectal cancer by detecting the disease at an earlier, more treatable
stage.
People should manage the risk factors that they can control, such as…
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Diet: avoid high-fat, low-fiber foods; eat more fruits, vegetables, and
whole grain foods.
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Exercise: even small amounts of exercise is helpful.
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Recent studies have shown that Estrogen replacement therapy for post-menopausal
women and low dose aspirin may reduce the risk of colorectal cancer.
Ask your doctor if you may benefit.
Since some colorectal cancers can’t be prevented, finding them early is
the best way to improve the chance of a cure and reduce the number of deaths
by this disease.
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Where Can I Get More Information?
There are several web sites on the Internet about colorectal cancer:
You can also call
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American Cancer Society @ 1-800-ACS-2345, or
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National Cancer Institute @ 1-800-4-CANCER.
You can talk to your doctor or health care professional about cancer screening
and whether it would be likely to help you.