That's The Bottom Line
Community Health Works
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Colon cancer usually strikes without symptoms. If caught early, polyps that develop in the digestive tract can typically be removed as benign. Despite this, colon cancer is the second leading cause of cancer death in the United States. To combat this disease we encourage people over the age of 50 to have a regular colonoscopy. By joining efforts of the CDC to increase the number of people over the age of 50 who receive a screening colonoscopy from 60% to 80%, we encourage all people who qualify to have a screening. We even have programming and funding to help uninsured people receive a colonoscopy. Through promoting screening colonoscopies we are hoping to prevent colon cancer before it becomes a life or death situation. That’s the bottom line.

 

What is Colorectal Cancer?

Colorectal cancer is a collective term for cancers of the colon and rectum. Since cancers of the colon and rectum share many common features, they are often referred to as colorectal cancer. The colon and rectum are parts of the digestive system. Together, they form a long, muscular tube called the large intestine. The colon is the first four to five feet of the large intestine and the last four to six inches is the rectum. Once food is chewed and swallowed, it travels through the esophagus to the stomach. In the stomach, it is partially digested and transferred to the small intestine. The small intestine continues digesting the food and absorbs most of the nutrients. The food then travels to the large intestine. The waste then moves from the colon into the rectum and passes out of the body through an opening called the anus during a bowel movement.

Colorectal cancers develop slowly over a period of several years. Most of them begin as a non-cancerous polyp, a growth of tissue on the lining of the colon or rectum. Polyps are also known as adenomas. Over 95 percent of colorectal cancers are adenocarcinomas, which arise from cells that line the inside of the colon and the rectum. Removing the polyp early may prevent it from becoming cancerous. Colorectal cancer affects both men and women and most often occurs in people over 50 years of age. It is the third most commonly diagnosed cancer and cause of cancer death among Georgian men and women. The Georgia Comprehensive Cancer Registry estimates that over 4,300 new cases of colorectal cancer will be diagnosed statewide in 2009 and about 1,300 Georgians will die from this disease.


How is Colorectal Cancer Detected?

Screening is the process of looking for cancer in people who have no symptoms of colorectal cancer. Regular screenings for colorectal cancer can find cancer early (when it is most likely to be curable). Screenings can also prevent colorectal cancer by finding polyps and removing them before they turn cancerous. Tests that are used for screening colorectal cancer can by divided into two groups:

Tests that find both colorectal polyps and cancer: These tests look at the structure of the colon to find any abnormal areas.

  • Flexible sigmoidoscopy: During this test, a doctor uses a sigmoidoscope to look inside the rectum and the lower section of the colon. The sigmoidoscope is a flexible lighted tube about 2 feet long with a video camera on the end. Images from the inside of the colon and rectum are displayed on a monitor. The tube is used to detect polyps and if any polyps are found, they are removed. The procedure to remove polyps is called polypectomy
  • Colonoscopy: During this test, a colonoscope is used to look inside the entire length of the colon and rectum. The colonoscope is similar to a sigmoidoscope, but is longer. The doctor may also use the colonoscope to assist with the removal of polyps
  • Double-contrast barium enema (DCBE): During this test, barium sulfate (chalky liquid) and air are used to show an outline of the colon and rectum. X-ray pictures are taken of the colon and rectum which can show abnormal areas. If any suspicious areas are seen, a colonoscopy may be performed
  • CT colonography (virtual colonoscopy): This test is a more advanced form of a computed tomography (CT) scan. The CT scan takes multiple pictures of the colon and then combines all the pictures in order to create a 2-dimensional or 3-dimensional view of the inside of the colon and rectum. This test is considered less invasive than the colonoscopy, however if any abnormalities are found, a colonoscopy may be needed in order to determine if a cancer is present


Tests that find cancer: These tests involve testing the stool (feces) for signs that cancer may be present. These types of tests are considered to be less invasive and easier.

  • Fecal occult blood test (FOBT): Damaged blood vessels from polyps or cancers may release a small amount of blood into the feces. The FOBT detects blood in stool that may not be visible. Before the test, certain medications and foods cannot be consumed because they may interfere with the test. The screening test is given as a take home kit and stool samples are taken and returned to a doctor’s office for testing. If the test detects blood, a colonoscopy is performed to determine the source. Other conditions such as hemorrhoids or ulcers may also cause blood to be detected.
  • Fecal immunochemical test (FIT): This test is also used to detect blood in the stool. The FIT is also performed at home but may be easier to use since there are no medication or dietary restrictions that are required to be followed before taking the test (unlike the FOBT). After the stool samples have been collected, the samples are returned to the doctor’s office for testing.
  • Stool DNA test (sDNA): Colorectal cancer cells may contain DNA mutations on certain genes. These genes are often shed in the stool, which enables tests to detect them. The sDNA test looks for certain abnormal sections of DNA from cancer or polyp cells. This test is new and how often to be tested has not yet been established when the disease has advanced.



What are the Symptoms of Colorectal Cancer?

Signs and symptoms of colorectal cancer include:

  • A change in bowel habits such as diarrhea, constipation, or narrowing of the stool that lasts for more than a few days
  • A feeling that the bowel does not empty completely
  • Rectal bleeding or blood in the stool
  • Persistent cramping or abdominal pain
  • Weakness and fatigue
  • Unexplained weight loss

Other conditions such as hemorrhoids and inflammatory bowel (IBD) disease may also have symptoms that mimic colorectal cancer. If you have any of the above symptoms, it is very important to talk to your doctor because it could be a sign of a serious medical condition such as colorectal cancer.

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