March Is National Colorectal Cancer Awareness Month

Senior patient with his wife and doctor

The good news is that Doug's colonoscopy is over. The even better news is that Dr. Joshi was able to remove several polyps during the procedure, and that could protect Doug from colon cancer.

Colorectal cancer, more commonly called colon cancer, is cancer that begins in the colon (large intestine) or rectum (anus). Of the types of cancer that affect both men and women, colon cancer is the second-leading cause of cancer deaths in the United States, taking the lives of more than 50,000 people each year. Yet many of these deaths could be prevented.

Who is at risk of colon cancer?

Colon cancer is more common the older we get. Beyond age, other risk factors include:

  • A history of colorectal cancer.
  • A history of polyps — clumps of cells that grow on the colon wall which can turn cancerous, and are where most colon cancers begin.
  • A family history of the disease.
  • Bowel diseases such as ulcerative colitis, Crohn’s disease or inflammatory bowel disease (IBD).
  • Certain genetic factors.

The most important step we can take to lower our risk of colorectal cancer is to get the recommended screening tests. We also can make lifestyle changes that will lower our risk:

  • Don’t drink too much alcohol.
  • Don't smoke.
  • Maintain a healthy weight.
  • Get the recommended amount of exercise.
  • Eat a healthy diet with lots of fruits, vegetables and whole grains, and limited red and processed meats (see "The CDC Tells Seniors: Eat Your Fruits and Veggies!” in this issue of the Caring Right at Home online newsletter to find some great tips).

What are the symptoms of colon cancer?

Sometimes people with colon cancer may notice:

  • Blood in the stool.
  • Changes in bowel movement patterns.
  • Gas pains, bloating or cramps that don't go away.
  • Weight loss for no known reason.
  • Fatigue.

If these symptoms persist for more than a week, report them to your doctor. Most likely they don't indicate cancer, but it's better to be safe than sorry.

But the main thing to know is that most people who are diagnosed with colorectal cancer had noticed no signs until the disease had progressed to a less-treatable stage. That's why screening is so important. Even better, screening doesn't merely detect colon cancer. During a colonoscopy, the doctor can remove polyps, abnormal growths where colon cancer often begins.

Who should be screened, and when?

For people with the risk factors listed above, screening at a younger age may be recommended. But for most people, periodic screening is advised between the ages of 50 and 75. The Centers for Disease Control and Prevention (CDC) says that people aged 76 to 85 should talk to their doctor about whether they should continue to be screened, and that screening is not recommended for people older than 85. Talk to your doctor about the type and frequency of screening that's right for you.

How do doctors test for colorectal cancer?

Currently, there are four main types of screening for colon cancer. The CDC explains that there is no single "best test" for each person. Each type has advantages and disadvantages. Follow your doctor's recommendation on the type and frequency of test that's best for you. Screening might include:

  • Stool tests. Several types of tests can detect blood or other substances in the stool (fecal matter). These tests can be performed at home. Some types should be performed once per year; others every three years.
  • Flexible sigmoidoscopy. In this test, the doctor uses a small, thin, flexible tube to view the lower third of the colon.
  • Virtual colonoscopy. This newer, less-invasive test uses x-rays to allow the doctor to see images of the colon. Patients are advised to get this screening every five years.
  • Colonoscopy. This is the test that provides the best view of the whole colon. The doctor uses a longer, flexible, lighted tube to inspect the entire colon. During the procedure, the doctor can remove some early-stage cancers, as well as polyps that could become cancerous. It's recommended once every 10 years, or more often if anything unusual is found.

If virtual colonoscopy, flexible sigmoidoscopy or stool tests reveal an abnormality, a colonoscopy will most likely be recommended to further investigate. Most insurance plans and Medicare cover screening. Review your health insurance plan to learn the specifics of what is covered and what you might have to pay.

Your colonoscopy: what to expect

Many people shudder at the thought of a colonoscopy, but the procedure has a worse reputation than it deserves. Most patients choose to be sedated or anesthetized during their colonoscopy, so they aren't even aware of what’s going on. Interestingly, doctors today report an uptick in patients who chose to remain conscious during the procedure — talk to your doctor about your options. Remember, if you choose anesthesia, you'll need someone to drive you home when you're done.

For most people, the most challenging part of a colonoscopy is bowel preparation. To totally empty your colon so your doctor can get a good look, you'll be on a restricted diet for a day or two, and then you'll need to drink a large amount of a laxative substance over the course of hours (you will want to be at home for that!). It's important to follow the doctor's instructions carefully so your colon will be totally clean. Failure to follow the diet as instructed could mean you have to do the whole thing over again.

The beauty of a colonoscopy is that unlike other diagnostic tests for cancer, a colonoscopy actually helps prevent cancer. If the doctor removes some polyps, you'll get a pathology report; if the polyps are of the type that may be precancerous, your doctor will probably recommend you have your next colonoscopy sooner. If the doctor finds cancer, treatment can begin promptly.

How is colorectal cancer treated?

Treatment options for colon cancer include surgery, chemotherapy and radiation treatments, or a combination of treatments. The earlier colon cancer is caught, the better the outcome. According to the American Cancer Society, when colorectal cancer is caught early, a person has a five-year survival rate of more than 90 percent.

Raising awareness

CDC colon cancer awareness brochure

Experts say the survival rate for colorectal cancer is better these days — partly because better treatment is available, but also because more people are getting screened. Yet embarrassment and fear keep many others from getting that all-important early diagnosis. Even though Americans are happy to wear pink breast cancer awareness t-shirts, you just don't see many folks wearing colorectal cancer awareness garb.

It's time to change that! Be part of the solution. Ask your over-50 relatives if they've received the recommended screening. If you've been screened, serve as a role model for younger family members by telling them. When you come back to work the next day after your colonoscopy, don't make up a vague "doctor appointment" story — tell it! By bringing this topic into "polite company," you could save a life.

For more information about colorectal cancer, visit the website of the Centers for Disease Control and Prevention, where you can download a free brochure, Colorectal Cancer Screening Saves Lives.

Image at bottom right courtesy of the Centers for Disease Control and Prevention (CDC)

The information in this article is not intended to replace the advice of your healthcare provider. Talk to the doctor about health tests and screenings that are right for you.

Right at Home, Inc. is a national organization dedicated to improving the quality of life for those we serve. We fulfill that mission through a dedicated network of locally owned providers of in home care services.