Colorectal Cancer Screening and Treatment
Early detection is key
Physicians always stress to patients the importance of early detection for cancer, advising that the sooner cancer is found and treatment is started, the better the outcomes. But for colorectal cancer, there’s a unique story to tell. Proper screening finds cancer in the early stages, when it’s most treatable. It detects the adenomatous polyps that can be precursors to cancer and provides an opportunity for those precancerous growths to be eliminated. Cancers of the colon and rectum can literally be stopped from developing.
Colorectal carcinoma is a neoplastic growth of the mucosa of the lining of the colon and rectum. Most of these cancers are adenocarcinomas and nearly 90 percent of these tumors occur in patients after the age of 50. Colorectal cancer is the third most common cancer diagnosed and totals nearly 133,000 cases per year in the U.S., according to the American Cancer Society (ACS). This breaks down to approximately 93,000 cases of colon cancer and almost 40,000 cases of rectal cancer.
What are the signs and symptoms?
Unfortunately, colorectal cancer is often symptomless, though patients should report any of these symptoms to their primary care physician for possible follow-up:• Blood in the stool• A change in bowel habits• A change in the size, shape or caliber of the stool• Abdominal pain• Unexplained weight loss
Parameters for ScreeningRecommendations by the ACS are based on three risk categories: average, moderate and high. While gender does not seem to be a risk factor, age is, and risk increases after age 50. Average risk is defined as all people 50 years or older who do not have any personal or family history of adenoma, carcinoma or predisposing disease. This category encompasses 70 to 80 percent of the U.S. population. The recommendations state that people who are considered average risk undergo screenings between ages 50 and 75.
Individuals at high risk should start screenings earlier and have more frequent follow-ups. People considered to be at higher risk include those with a family history of polyps, colon cancer or uterine cancer; individuals with inflammatory bowel disease; anyone with a personal history of polyps; and persons with inherited syndromes such as familial adenomatous polyposis and hereditary nonpolyposis colorectal cancer, also known as Lynch syndrome. In addition, recent studies show that because African-Americans have a higher risk of colon cancer, they may want to start screenings at age 45.
“Researchers at Stony Brook and many other U.S. and international institutions continue to delve into the causes, prevention and treatment of colorectal cancers. But it’s important to remember that research has proven that screening of colon cancer saves lives. Having precancerous polyps removed before disease develops is an important intervention that reduces the chances of having colon cancer.”
-Vincent Yang, MD, PhD, Simons Chair and Professor, Department of Medicine
The Stony Brook ApproachAt Stony Brook, colonoscopies are considered the gold standard in screening for colorectal cancer. Two types of colonoscopies are offered: optical or traditional colonoscopy and computed tomography (CT) colonoscopy, also known as virtual colonoscopy.
For the full issue: Cancer Today • Spring 2015