Colorectal Cancer

What is Colorectal Cancer?

Colorectal cancer is a type of cancer that affects the colon or rectum, which are parts of the digestive system.

Who’s at risk for Colorectal Cancer?

Colorectal cancer can affect anyone, but it is more common in individuals over the age of 50, as well as those with a family history of the condition. Other risk factors may include a history of inflammatory bowel disease, a sedentary lifestyle, and a diet high in red meat and processed foods.

What causes Colorectal Cancer?

Colorectal cancer develops when cells in the lining of the colon or rectum undergo mutations that cause them to grow and divide uncontrollably, eventually forming a tumor. The precise cause of these mutations is not completely understood, but several factors have been identified that may contribute to the development of colorectal cancer:

Genetic factors: Some individuals have a family history of colorectal cancer or inherit genetic mutations that increase their risk of developing the disease. Examples include familial adenomatous polyposis (FAP) and Lynch syndrome (hereditary non-polyposis colorectal cancer or HNPCC), which are inherited conditions associated with a higher risk of colorectal cancer.

Age: The risk of developing colorectal cancer increases with age, with most cases diagnosed in individuals over the age of 50. However, recent trends have shown an increase in colorectal cancer incidence among younger adults as well.

Lifestyle factors: Several lifestyle factors have been linked to an increased risk of colorectal cancer. These include a diet high in red and processed meats, low in fruits and vegetables, physical inactivity, obesity, smoking, and excessive alcohol consumption.

Personal history of polyps or colorectal cancer: Individuals who have had adenomatous polyps (non-cancerous growths in the colon or rectum) or a previous diagnosis of colorectal cancer are at an increased risk for developing the disease again.

Inflammatory bowel disease (IBD): Chronic inflammatory conditions of the colon, such as ulcerative colitis and Crohn's disease, can increase the risk of developing colorectal cancer.

Type 2 diabetes: Individuals with type 2 diabetes have an increased risk of developing colorectal cancer, possibly due to shared risk factors such as obesity and insulin resistance.

Environmental factors: Exposure to certain environmental factors, such as radiation therapy for previous cancers or exposure to cancer-causing substances in the workplace, may also increase the risk of developing colorectal cancer.

How does Colorectal Cancer start?

Colorectal cancer may develop slowly over time, and symptoms may not become apparent until later stages of the disease. The condition can lead to a range of symptoms, including changes in bowel habits and unexplained weight loss.

What are the symptoms of Colorectal Cancer?

The symptoms of colorectal cancer can vary widely from person to person, but common symptoms may include:

1. Changes in bowel habits, such as diarrhea or constipation
2. Blood in the stool
3. Abdominal pain or discomfort
4. Fatigue
5. Unexplained weight loss
6. Anemia

How is Colorectal Cancer diagnosed?

Colorectal cancer diagnosis involves a multi-step process to accurately identify the presence and extent of the disease. The initial steps typically include:

1. Medical history and physical examination: The healthcare provider will ask about any symptoms, personal and family history of colorectal cancer or related conditions, and lifestyle factors that may increase the risk of developing the disease. A physical examination, including a digital rectal exam, may be performed to check for any abnormalities.

2. Colonoscopy: A colonoscopy is a common diagnostic procedure in which a long, flexible tube with a camera attached (colonoscope) is inserted into the rectum and advanced through the colon to examine the entire large intestine. The healthcare provider can visualize any abnormal growths, such as polyps or tumors, and take tissue samples (biopsies) for further analysis.

3. Imaging tests: In some cases, additional imaging tests may be recommended to further assess the extent of the disease or rule out other possible conditions. These tests may include computed tomography (CT) scans, magnetic resonance imaging (MRI), positron emission tomography (PET) scans, or abdominal ultrasounds.

4. Biopsy: A biopsy involves removing a small sample of tissue from the suspicious area, which is then examined under a microscope by a pathologist to determine if cancerous cells are present. Biopsies are often performed during a colonoscopy, but other methods such as endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) may be used if necessary.

5. Blood tests: Blood tests, including a complete blood count (CBC) and carcinoembryonic antigen (CEA) test, may be ordered to provide additional information about the patient's overall health and to help monitor the disease.

6. Molecular testing: In some cases, molecular testing may be performed on the biopsy sample to identify specific genetic or molecular markers that can provide information about the cancer's aggressiveness, prognosis, and potential treatment options.

Once a diagnosis of colorectal cancer is confirmed, further tests may be conducted to determine the stage of the cancer and help guide treatment decisions. These tests may include additional imaging studies or a laparoscopic examination to assess the extent of the disease within the abdomen.

How can Colorectal Cancer be treated?

Treatment for colorectal cancer may involve a combination of surgery, radiation therapy, and chemotherapy. The specific treatment plan will depend on the stage and location of the cancer, as well as the individual's overall health.

What complications may occur with Colorectal Cancer?

Untreated colorectal cancer can lead to serious complications, such as metastasis (the spread of cancer to other parts of the body) and bowel obstruction. The condition may also impact a person's quality of life, leading to social isolation and other mental health issues.

How can I prevent Colorectal Cancer?

Preventing colorectal cancer involves maintaining a healthy lifestyle, including regular exercise, a diet high in fiber and low in red meat and processed foods, and avoiding tobacco and excessive alcohol consumption. As of  September 2021, the American Cancer Society recommends that individuals with an average risk for colorectal cancer begin screening at age 45 and continue until age 75, with the frequency and screening method depending on the chosen test (such as colonoscopy every 10 years, or stool-based tests annually). For those aged 76-85, screening decisions should be made on an individual basis, considering factors like overall health and screening history. Always consult with your healthcare provider for the most current guidelines and personalized recommendations.

While some risk factors, like age and genetics, cannot be changed, modifying lifestyle factors can significantly reduce the overall risk of colorectal cancer. This includes maintaining a healthy diet rich in fruits, vegetables, and whole grains, engaging in regular physical activity, maintaining a healthy weight, avoiding smoking, and limiting alcohol consumption. Additionally, regular screening for colorectal cancer can help detect precancerous polyps and early-stage cancers, increasing the chances of successful treatment and survival.

Long-term management of Colorectal Cancer

Long-term management of colorectal cancer involves ongoing monitoring of symptoms and regular follow-up with healthcare professionals. It is important to work closely with healthcare professionals to develop an individualized treatment plan that addresses the specific needs of the person with colorectal cancer.

What is recent research saying about Colorectal Cancer?

Recent research has focused on identifying potential new treatments for colorectal cancer, as well as exploring the role of genetics and lifestyle factors in the development of the condition. There is also ongoing research into the effectiveness of different types of screening and surveillance for colorectal cancer.

Where can I go for more information on Colorectal Cancer?

The American Cancer Society and the National Institute of Diabetes and Digestive and Kidney Diseases provide up-to-date information on colorectal cancer, including diagnostic criteria, treatment options, and ongoing research.