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Colon & Rectal Center: Frequently Asked Questions
What is colorectal cancer?
Colorectal cancer is a malignant tumor of the large intestine,
also known as the colon, with the last portion known as the rectum.
Of the cancers affecting the large intestine, approximately 70
percent develop in the colon and 30 percent in the rectum. Roughly
95 percent of colorectal cancers are adenocarcinomas, which are
cancers of the glandular cells that line the inside of the colon
and rectum. Colorectal cancers typically develop slowly over a
period of several years, starting with pre-cancerous changes in
the inner lining of the colon or rectum, and can grow through
some or all of the tissue layers in the intestinal wall. The tumor
as it grows can then spread into the lymphatic system to lymph
nodes or through blood draining into the veins to spread to other
organs.
How many people get colorectal cancer?
Statistics from the American Cancer Society, show that this year,
it is estimated that there will be about 105,500 new cases of
colon cancer and 42,000 new cases of rectal cancer in the United
States, together causing more than 57,000 deaths. In Maryland,
there are more than 2000 cases per year. These cancers occur in
both men and women about equally, and 90% are found among people
who are over the age of 50.
Recent research has found a gene linked to colon cancer in approximately
6% of Ashkenazi Jews. A mutation in the APC gene places one at
increased risk of developing colon cancer, and some have suggested
that Ashkenazi Jews with a familial history of colon cancer be
tested for this specific mutation. The gene test requires a sample
of blood. Results are available within one to two weeks and the
cost of the test is around $200. When such a test is positive,
regular colonoscopic examination, usually from age 35 onward,
is imperative.
What causes colorectal cancer?
While we do not know the exact cause of most colorectal cancer,
there are certain known risk factors. A risk factor is something
that increases a person's chance of getting a disease:
- Family history: Ten percent of all colon
and rectal cancers are hereditary. Relatives of people who have
had colorectal cancer are at increased risk of developing the
disease themselves. Some of these families may have a colorectal
cancer syndrome such as familial adenomatous polyposis (FAP)
or hereditary nonpolyposis colorectal cancer (HNPCC). People
with FAP typically develop hundreds of polyps in the colon and
rectum. Cancer nearly always develops in one or more of these
at some time. HNPCC, on the other hand, develops in people at
a young age without their first having many polyps.
- Personal history of colorectal cancer: Even
when a colorectal cancer has been completely removed, new cancers
may develop in other areas of the colon and rectum.
- Personal history of polyps: Some types of
polyps such as adenomatous polyps increase the risk of colorectal
cancer, especially if they are large or there are many of them.
- Personal history of inflammatory bowel disease:
The literature clearly shows that the presence of either Ulcerative
colitis or Crohn's colitis, over a long period of time, with
active disease lead to a higher incidence of Colon or Rectal
Cancer.
- Aging: About 9 out of 10 people with colorectal
cancer are 50 years of age or older.
- A diet mainly from animal sources: A diet
made up mostly of foods from animal sources can increase the
risk of colorectal cancer. Many fruits and vegetables contain
substances that interfere with the process of cancer formation.
The American Cancer Society recommends eating at least five
servings of fruits and vegetables every day, as well as servings
of other foods from plant sources such as breads, cereals, grain
products, rice, pasta, or beans.
- Lack of exercise: being even somewhat active
lowers the risk of colorectal cancer.
- Obesity: Being very overweight increases
a person's colorectal cancer risk. Having excess fat in the
waist area increases this risk more than having the same amount
of fat in the thighs or hips.
- Smoking: Most people know that smoking causes
lung cancer, but recent studies show that smokers are 30% to
40% more likely than nonsmokers to die of colorectal cancer.
What are my chances of getting colon
or rectal cancer during my lifetime?
Estimated
Lifetime Risk of Developing
Colorectal Cancer (CRC)* |
| Family History |
Lifetime Risk of CRC |
| No family history of colorectal cancer |
2% |
| One affected first degree relative (parent, sibling,
child) |
6% |
| One affected first degree relative and two affected
second degree relatives (grandparent, aunt or uncle) |
8% |
| One first degree relative affected under age 45 |
10% |
| Two affected first degree relatives |
17% |
| HNPCC (mutation carrier) |
70% |
| FAP (mutation carrier) |
100% |
*Chart from the National Cancer Institute
What can I do to prevent getting colon
or rectal cancer?
- Eat a diet rich in fruits, vegetables, whole grains and low
in fat
- Exercise
- Don't smoke
- Recent studies indicate that Aspirin, Calcium and Selenium
prevent the recurrence of polyps. These are early but promising,
and need further evaluation.
- Screening
- Digital rectal exam, and stool checks for occult blood starting at age 40
- If you have a family history of colon or rectal cancer you should consider colonoscopy
at about 15 years prior to the age that the affected person was first diagnosed with their tumor
- FAP start colonoscopic surveillance in your teens
- HNPCC start colonoscopic surveillance in your twenties
- Anyone age 50 or greater should have a baseline screening colonoscopy
How is colorectal cancer treated?
Surgery is the main treatment for most stages of colorectal cancer.
For cancers that have not spread, and even for many that have,
it can be curative. Surgical treatment at times is combined with
chemotherapy for colon cancers that have spread to local lymph
nodes or to other organs. Radiation therapy with chemotherapy
is often used to treat rectal cancers prior to surgical intervention.
Advances in the treatment of colorectal cancer in recent years
have helped improve overall survival rate. Again, early detection
leads to the best outcomes.
Should I consider virtual colonoscopy?
Mercy’s Radiology Department does offer interested patients
the option of virtual colonoscopy. Virtual colonoscopy has been
effective in diagnosing medium to large polyps as well as traditional
colorectal probes, though smaller polyps are more difficult to
detect, making virtual colonoscopy, at this time, an adjunct to
traditional colonoscopy which is generally preferred for the patient.
Virtual colonoscopy works by using CT scanning to display images
of the colon as if the viewer were seeing the inside of it through
an endoscope, the instrument used in traditional colonoscopy.
It does not require sedation, although it does require the same
bowel-cleansing preparation as the older method.
Now Accepting New Patients.
Most Insurances Accepted.
Please call for an appointment.
Phone: 410-783-5800
Tollfree: 1-800-MD-Mercy (1-800-636-3729)
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