While colorectal cancer is fundamentally preventable, treatable and beatable, as many as 50,000 Americans die each year of colon cancer. Robert Summers. MD, director of clinical programs for the gastroenterology division at University of Iowa Hospitals and Clinics, talks about colorectal cancer:
What causes colon cancer?
We believe it has to do with changes in the genes that regulate the growth of the lining cells of the large intestine. This causes unregulated and unchecked overgrowth of these cells, which are first polyps and then colon cancer.
Who is most likely to develop colon cancer?
Those at high risk are people who have colonic polyps, the little growths or lumps that grow in the lining of the bowel. They seem to be the precursors of colon cancer. Also, at high risk are people who have had inflammatory bowel diseases—ulcerative colitis and Crohn’s disease and those who have first-degree relatives who have had colon cancer. The first-degree relatives include parents and siblings of the individual.
Is there anything we can do to prevent colon cancer from developing?
At this time, we think there are both genetic and environmental factors. Obviously, one can’t do anything about their genetic background or their family history. There may be things that will reduce their risk, such as eating a low-red meat diet, eating plenty of vegetables and fruits. Aspirin, and, surprisingly, calcium supplements seem to be able to reduce the risk of cancer as well. However, none of these preventive risks are reliable and we have to look at it in a different way to have any real impact on the development of colon cancer.
Does colon cancer have any symptoms?
The symptoms, unfortunately occur mostly when the disease is quite advanced. These symptoms include:
- Bleeding from the gastrointestinal tract
- Severe anemia
- Change in bowel habit
- New development of abdominal pain
However, in the earliest and the most curable stage of the disease, there are no symptoms and that’s the reason why we strongly recommend screening colonoscopy examinations.
How is colon cancer diagnosed?
We feel that the best test is a colonoscopy. It’s a long tube with a light on the end and video camera that can be advanced through the entire colon. We feel it’s the best test because it is the most accurate and polyps can be removed during the procedure. If cancer is suspected, we can biopsy the cancer. There are other ways, such as barium enema and what’s called a CT scan or virtual colonoscopy, but these aren’t in as widespread use as colonoscopy.
Who should have a colonoscopy?
We’ve already talked about the people who are at higher risks, and people who have suspicious symptom. Most importantly, we feel people should have colonoscopy when they reach the age of 50 because this is when the development of polyps and cancer really becomes quite frequent.
Why is it so important to detect and remove polyps early?
If people have a through colonoscopy beginning at the age of 50 and at 10-year intervals, we could probably prevent 90 percent of colon cancers. That’s why it’s so important. The polyps can be removed before they develop into colon cancer.
What is the message you’d like people to remember with regard to colon cancer?
It's a preventable disease in the vast majority of cases. If people get a screening colonoscopy at the recommended intervals and any polyps are removed, we could eliminate at least 90 percent of the cases of colon cancer.
How can someone schedule a colonoscopy? Can a general physician recommend one?
Yes, that's what is usually done. I think many primary care physicians are getting on board with the idea of recommending preventive care using colonoscopy to prevent colon cancer, like the way pap smears screen for cervical cancer and mammograms screen for breast cancer in women. This is becoming much more commonly accepted by physicians and by patients. |
