Dayton Colon & Rectal Center

Cancer/Polyps

Colorectal cancer/polyps--cancer of the colon and rectum--is the second most common cancer in the United States, striking 140,000 people annually...and causing 60,000 deaths. It is the second leading cause of cancer-related deaths in the United State for both men and women combined. That's a staggering figure when you consider the disease is preventable, can be successfully treated, and is potentially curable if diagnosed in the early stages.

Who is at Risk?
Colorectal cancer/polyps strikes men and women with almost equal frequency. Though colorectal cancer/polyps may occur at any age, more than 90 percent of the patients are over age 40, at which point the risk doubles every ten years. The general population faces a lifetime risk for developing the disease of about 5 percent. In addition to age, a family history of colorectal cancer and polyps increases the chance of developing the disease to 10 to 15 percent. Also at high risk are individuals with a personal history of ulcerative colitis, colon polyps or cancer of other organs, especially of the breast or uterus. The risk rises to over 50 percent in people with ulcerative colitis and those whose family members harbor specific genetic mutations.

African-Americans and Hispanics are more likely to be diagnosed with colorectal cancer/polyps in advanced stages. Incidence rates for colorectal cancer/polyps in these groups has been on the rise--colorectal cancer/polyps has increased 46 percent among African-American men and 10 percent among African-American women. Alaska Native women have the highest mortality from colorectal cancer/polyps of any other racial and ethnic group in the United States.

Surpassing both breast and prostate cancers in mortality, colorectal cancer/polyps is second only to lung cancer in numbers of deaths in the United States.

How Does It Start?
It is generally agreed that nearly all colon and rectal cancer begins in benign polyps(mushroom-like growths on the lining of the colon and rectum). These pre-malignant growths occur on the bowel wall and may eventually increase in size and become cancer. Polyp-related colorectal cancer can be prevented. Removal of benign polyps before they become cancerous may prevent cancer from developing. This is one aspect of preventive medicine that really works!

What are the Symptoms?
Colorectal cancer/polyps is often a silent disease, developing with no symptoms at all. When symptoms do occur, the most common are rectal bleeding, blood in or on the stool, and changes in bowel habits, such as constipation or diarrhea. (These symptoms are also common in other diseases so it is important you receive a thorough examination should you experience them.) Additional symptoms may include: stools that are narrower than usual, general stomach discomfort (bloating, fullness, and/or cramps), vomiting, the feeling that the bowel does not empty completely, frequent gas pains, and constant tiredness. Abdominal pain and weight loss are usually late symptoms indicating possible extensive disease. If you have any of these symptoms for more than two weeks, see your doctor or health professional immediately.

Unfortunately, many polyps and early cancers fail to produce symptoms. Therefore, it is important that your routine physical includes colorectal cancer detection procedures once you reach age 40. Those detection methods are a digital rectal exam and a chemical test of stool for blood. A sigmoidoscopy - the inspection of the lower bowel with a lighted tubular instrument - should be part of routine physical check-ups.

How is Colorectal Cancer/Polyps Treated?
Colorectal cancer/polyps requires surgery in nearly all cases for complete cure. Radiation and chemotherapy are sometimes used in addition to surgery. Between 80-90% are restored to normal health if the cancer/polyps is detected and treated in the earliest stages. The cure rate drops to 50% or less when diagnosed in the later stages. It is estimated that approximately 40,000 lives a year could be saved through widespread adoption of colorectal cancer/polyps screening and early treatment in men and women. Thanks to modern technology, less than 5% of all colorectal cancer/polyps patients require a colostomy, the surgical construction of an artificial excretory opening from the colon.

Can Colon Cancer/Polyps be Prevented?
There are steps that reduce the risk of contracting the disease. To lower your risk of colorectal cancer/polyps, the American Society of Colon and Rectal Surgeons recommends that you:

1.	Get regular colorectal cancer/polyps screenings after age 50. Between 80-90% of colorectal cancer/polyps patients are restored to normal health if their cancer/polyps is detected and treated in the earliest stages. Since there are very few symptoms associated with polyps or early colorectal cancer, regular screening is essential. Current screening methods include fecal occult blood testing (a simple chemical test that can detect hidden blood in the stool), flexible sigmoidoscopy (a visual examination of the rectum and lower portion of the colon, performed in a doctor's office), double contrast barium enema (barium x-ray), colonoscopy (a visual examination of the entire colon) and digital rectal exam. Colorectal cancer/polyps screening costs are covered by Medicare and many commercial health plans. The risk of developing colorectal cancer/polyps increases with age. All men and women aged 50 and older are at risk and should be screened. Some people are at a higher risk and should be screened at an age younger than 50, including those with a personal or family history of inflammatory bowel disease; colorectal cancer or polyps; or ovarian, endometrial, or breast cancer.

2.	Eat a low-fat, high-fiber diet. Though not definitely proven, there is some evidence that diet may play a significant role in preventing colorectal cancer/polyps. As far as we know, a high fiber, low fat diet is the only dietary measure that might help prevent colorectal cancer/polyps.

3.	If you use alcohol, drink only in moderation. If you use tobacco, quit. If you don't use tobacco, don't start. Alcohol and tobacco in combination are linked to colorectal and other gastrointestinal cancers.

4.	Exercise for at least 20 minutes 3 to 4 days each week. Moderate exercise such as walking, gardening, or climbing steps may help.

Colorectal cancer is extremely preventable if benign polyps that lead to cancer are detected and removed by an outpatient procedure called Colonoscopy. In addition to removing the polyps, the long flexible tubular instrument used in the procedure provides a more thorough bowel examination.

Finally, you must be aware of changes in your bowel habits and make sure bowel examinations are included in routine physicals once you fall under the "high risk" category.

Can Hemorrhoids Lead to Colon Cancer?
No, but hemorrhoids may produce symptoms similar to colon polyps or cancer. Should you experience these symptoms, you should have them examined and evaluated by a physician, preferably by a colon and rectal surgeon.