What is Colorectal Cancer?
The term “
Colorectal Cancer” is an umbrella term used to describe, both, Colon Cancer and Rectal Cancer. Below, you can see the anatomy of the colorectal system (everything in green). As you can see below, the colon has four sections.
- The Ascending Colon: begins where the small intestine attaches to the colon and extends upward on the right side of a person’s abdomen.
- The Transverse Colon: where the colon crosses the body from the right to the left side.
- The Descending Colon: continues downward on the left side
- Sigmoid Colon: joins the descending colon to the rectum, which in turn joins the anus.
Over the course of 10-15 years, polyps can develop in the colon. A
Polyp is a growth of tissue that develops in the lining of the colon or rectum that can become cancerous. One-third to one-half of all people will develop a polyp at some point in their lives.
When caught early, most polyps can be removed easily.
If a polyp is determined to be cancerous, it will be categorized by what Stage it is currently in. The Stage will affect what types of treatments are available. The Stages are as follows:
- In Situ: Cancers that have not yet begun to invade the wall of the colon or rectum; these pre-invasive lesions are not counted in cancer statistics.
- Local: Cancers that have grown into the wall of the colon and rectum, but have not yet extended through the wall to invade nearby tissues.
- Regional: Cancers that have spread through the wall of the colon or rectum and have invaded nearby tissue, or that have spread to nearby lymph nodes.
- Distant: Cancers that have spread to other parts of the body, such as the liver or lung.
In this image, the smallest green cancer polyp on the far left is considered In Situ. The next two are considered Local. The next cancer polyp is considered Regional (notice how it has broken the wall of the colon/rectum and has green cancerous material in the nearby lymph node). Finally, the largest polyp is considered Distant (not only has it grown in size, blocking much of the colon/rectum, it has also spread and could be found in other parts of the body).
What are the risk factors?
Family history can be a significant risk factor. For instance, individuals with immediate family members who have had colorectal cancer are 2 to 3 times more likely (than individuals without a family history) to develop it themselves.
Hereditary factors also play a role for some individuals. People diagnosed with Familial adenomatous polyposis (FAP) or Lynch syndrome have a very high risk for developing colorectal cancer.
Personal medical history may also have an effect. If an individual has had colorectal cancer previously (even if the previous cancer was entirely removed), they are more likely to develop cancer again (especially if the first cancer was diagnosed at age 60 or younger). Other medical conditions raise the risk of developing colorectal cancer, such as inflammatory bowel diseases (ulcerative colitis, Crohn disease, etc.) and diabetes (especially among individuals with Type II, and men).
Physical inactivity is considered one of the biggest risk factors for developing colorectal cancer. The more activity a person engages in, the less likely they are to develop colorectal cancer. It is hard to ignore such a strong correlation!
Being overweight or obese is associated with a higher risk for developing colorectal cancer, especially in men.
Diet plays a crucial role (after all, food is what is passed through the digestive system). The dietary recommendations are to consume a healthy diet with an emphasis on plant sources, limit consumption of red and processed meats, eat a variety of vegetables and fruits, choose whole grains in preference to processed grains, and be sure to consume a healthy amount of calcium.
Other factors such as using tobacco products and drinking alcohol also can increase the risk of colorectal cancer.
What is the Importance of Screening Regularly?
The goals of screening for colorectal cancer are:
- The prevention of cancer through the
detection of pre-cancerous growths, and...
- The diagnosis of cancers at an early stage.
There are multiple ways to be screened for colorectal cancer, so be sure to discuss them with your doctor. Here is an overview of some screening methods:
Colorectal Cancer Screening
It is important to note that there are minimal to no symptoms of colorectal cancer in the early stages. Symptoms only start to become noticeable once an individual reaches later stages, at which point it become harder to treat. Keep reading for an explanation of this graph!
This graph shows the five year survival rates depending on when the cancer was identified. For instance, we will use the example of a Non-Hispanic White Woman. First, locate the graph on the right. Then, locate the dark green bars (there will be 4 of them total, on the left side of each group of bars). This graph is divided by stage of cancer. For instance, when looking at the “Local” group of bars, you see that the green bar extends almost to the 90 mark. That means that Non-Hispanic White Women have an almost 90% chance of surviving at least 5 years after being diagnosed with Local Stage Colorectal Cancer. The next group of bars to the right is the “Regional” set. You will notice that Non-Hispanic White Women have an almost 70% chance of surviving at least 5 years after being diagnosed with Regional Stage Colorectal Cancer. Moving one more bar set to the right, you will see that Non-Hispanic White Women have an almost 12% chance of surviving at least 5 years after being diagnosed with Distant Stage Colorectal Cancer. Notice how the survival rates decrease dramatically as diagnosis reaches the later stages.
The good news, however, is that regular screening methods often catch pre-cancerous polyps and cancerous growths in the Local Stage.
This is why regular screening methods are so important!
Here we can see that between 61.1% – 66.0% of Utahns 50 years or older are getting screened regularly for colorectal cancer. Although this is higher than much of the U.S., the national goal is to get 75% of Americans (3 our of every 4 people) screened regularly. Since NOT A SINGLE STATE meets these guidelines, there is a lot of work to do! Be sure to get screened and to promote screenings among your family and friends.
CONSISTENTLY, people always say that colonoscopies are no big deal, but the PREP is the worst part. Always follow your doctor’s instructions, but patients usually have to drink a large amount of certain liquid solutions to clear out the colon, in order to provide the clearest image for the colonoscopy. Also, patients usually are instructed to not eat any solid foods for the entire day beforehand. Although this can be a lot to ask of someone, here are some tips to making this prep easier.
Don't Forget to Laugh!
Sure, colonoscopies and colorectal screenings may not be fun, but they are essential for early detection and prevention of colorectal cancer. Since you never know what the doctors will find, you should be prepared for anything.