By Ernst Lamothe Jr.
Colon cancer remains one of the most preventable cancers around. Colorectal cancer occurs when there is overgrowth of abnormal cancerous cells in the colon.
Your colon is a tube-like structure in the large intestine connecting to the small intestine, which removes water, few nutrients and electrolytes from partially digested food. The American Cancer Society estimated that about one in 25 women and one in 23 men develops colorectal cancer during their lifetime.
“Unfortunately, colon cancer has the third most cancer-related death and it is quite preventable when identified in pre-malignant form,” said physician Jessica Martinolich, clinical assistant professor with the Jacobs School of Medicine at the University of Buffalo and affiliated with UBMD Surgery.
“With this being one of the few cancers where we have the ability to screen before it develops, that is why early detection is so essential.”
Martinolich talks about five aspects of colorectal cancer and prevention that you need to know.
1. Misconceptions
There are myriad misconceptions when it comes to colorectal cancer. Anything from only people with family history get colon cancer to the idea that it is always fatal. Colorectal cancer may be curable when detected early. Over 90% of patients with localized colorectal cancer are alive five years after diagnosis. However, only around a third of all colorectal cancers are diagnosed at this early stage.
Another myth is that the disease only strikes the older population.
“This is something that is not true. We are finding younger and younger patients get diagnosed with colon cancer,” said Martinolich.
2. Get a colonoscopy
In 2021, there were about 150,000 colon and rectal cancers. A colonoscopy is an exam used to detect changes or abnormalities in the large intestine colon and rectum. During a colonoscopy, a long, flexible tube is inserted into the rectum. A tiny video camera at the tip of the tube allows the doctor to view the inside of the entire colon.
“The prep for a colonoscopy can be time consuming, but it can also be life changing,” said Martinolich. “It is a fairly quick procedure that can be performed in less than an hour and then you can go home. The next day you can go back to your regular activities and it is very low risk.”
There are also tests where you can send your stool to a testing site and it is screened for blood as well as chemicals that can detect abnormalities of cells within the colon.
3. Stages of cancer
Colorectal cancer grows from stage 0, which is the earliest stage to stage 4, the most advanced. At stage 0, the abnormal cells are only in the inner lining of the colon or rectum. At stage 1, the cancer grows through the inner lining and reaches the muscle layer of the colon or rectum. At stage 2, the cancer grows through the wall of the colon or rectum but won’t spread into nearby tissue or lymph nodes. At stage 3, the cancer will move to the lymph nodes but not to other parts of the body. At stage 4 the final stage, the cancer will spread to other major organs, such as the liver or lungs.
People with stage 1 and stage 2 colon cancer may experience symptoms like constipation, diarrhea, change in stool color or shape, blood in stool, bleeding from rectum, excessive gas, abdominal cramps and abdominal pain.
Some people with colon cancer may not even experience any symptoms in the earlier stage which makes it even more difficult to predict the condition. But, the symptoms are noticeable in stages 3 and 4 such as excessive fatigue, weakness, weight loss, vomiting, feeling like your bowel is not completely empty.
“Stage 1 and 2 means the cancer is isolated and hasn’t spread out of the colon,” she added. “If cancer spreads outside the colon wall, then it will likely spread to the lymph nodes.”
4. Colonoscopy guideline changes
In May 2021, the U.S. Preventive Services Task Force issued new recommendations for colorectal cancer starting at an earlier age. “Before we used to tell patients they can begin screenings at age 50. But that is one of the reasons why they have lowered the recommended age to 45 years old, especially if you are beginning to see any symptoms or have a family history,” said Martinolich.
Deaths of people younger than 55 increased 1% per year from 2008 to 2017, even though overall colorectal cancer rates have dropped.
In addition, she said family history could play a large role in early detection cases.
“One very important thing that cannot be overlooked is patients with family history. That would include primary or secondary from mother and father to aunts, uncles and grandparents,” said Martinolich. “You should definitely discuss this with your primary care physician.”
5. It affects women, too
Sometimes there has been confusion on whether both genders are supposed to get colonoscopies because some people mix up colon and prostates. The colon is part of your large intestine and your GI tract that turns your food into stool. The prostate is more of a male productive organ. While it lies in proximity to the colon, they should not be grouped together.
“The colon is both in males and females and they are diagnosed at the same rate across the board,” she added. “People often confuse the colon and prostate. Men should worry about colon and prostate cancer and women should worry about colon or vaginal cancer.”