Most cases of colon cancer begin as polyps—small, non-cancerous (benign) clusters of cells that become cancerous over a considerable length of time. Small polyps seldom produce noticeable symptoms, therefore colonoscopy screening is recommended for most patients, beginning at age fifty, every ten years. This schedule of screening allows your physician to identify and remove polyps before they become cancerous. Some medical conditions are associated with a higher risk for colon cancer including a family history of polyps or colorectal cancer, a personal history of breast, uterine, or ovarian cancer, and inflammatory bowel disease (ulcerative colitis or Crohn’s disease). It is recommended that these patients be screened sooner and more frequently as their physician recommends. By following these screening recommendations, 90% of colon and rectal cancers can be prevented.
Symptoms of colon cancer may include:
- rectal bleeding or blood in the stool
- change in bowel pattern
- weight loss; and/or
- abdominal pain.
Treatment for colon cancer depends on the stage of cancer. If cancer is just beginning to develop within a polyp, and the base of the polyp is found to be non-cancerous, further treatment beyond polyp removal may not be necessary.
In more invasive types of cancer that have grown into or through the colon wall, it will be necessary for the surgeon to perform a colectomy—surgery to remove the cancerous portion of the colon. This operation can usually be done laparoscopically, or in some cases, using a minimally invasive robotic technique using the da Vinci® Surgical System. In most cases, once the diseased part of the colon is removed, the remaining ends of healthy colon are reconnected. When this is not possible, a colostomy will be performed which involves creating a surgical opening in the abdominal wall where the remaining colon empties waste products into a special bag called a colostomy bag. This colostomy may be temporary (to allow for healing) or permanent.
Based on the finding of the pathologist post-surgically, chemotherapy may be recommended based on the depth of invasion of the tumor and on whether there is metastatic cancer to the surrounding lymph nodes. Metastatic cancer is cancer that has left its place of origin and traveled through the body to other locations. The most common site of first spread is the lymph nodes that surround the colon. The liver is the second most common site of metastases. While metastatic cancer is mostly treated with chemotherapy, isolated cases of liver-only metastases can be dealt with surgically without chemotherapy.
Radiation therapy is rarely used in early-stage colon cancer, but is a routine part of treating rectal cancer. Drugs that target specific defects that allow cancer cells to proliferate are typically only available to people with advanced colon cancer. Targeted drugs may be given in conjunction with chemotherapy. Not all people benefit from the use of targeted drugs.
Colon cancer, while a formidable disease, is a very preventable cancer with the proper use of screening by colonoscopy accompanied by healthy lifestyle choices including a high-fiber, low-fat diet and regular exercise.
If you are interested in being screened for colon cancer or polyps, call our office at (815) 717-8730 to direct-schedule your colonoscopy (without the need for a pre-screening appointment).