Office of Cancer Control and Prevention

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Colorectal Cancer

 

What is it?

  • Colon and rectal cancers develop in your large intestine, the lower part of your intestinal tract. Most begin as small, noncancerous (benign) clumps of cells called adenomatous polyps. Over time some of these polyps become cancerous.
  • Colorectal cancer is preventable through regular testing, and through the removal of polyps (adenomas) in the colon, which often grow into cancerous tumors. You can greatly reduce your risk of getting colorectal cancer by making healthy choices and taking a few simple and easy steps - steps which could save your life.
  • For more information http://www.mayoclinic.com


What puts me at risk?

  • Inflammatory intestinal conditions. Long-standing inflammatory diseases of the colon, such as ulcerative colitis and Crohn's disease can increase your risk.
  • Family history. You're more likely to develop colorectal cancer if you have a parent, sibling or child with the disease. If many family members have colon or rectal cancer, your risk is even greater.
  • Sex and race. In the United States men are at higher risk of colon cancer than are women; and, blacks have a greater risk than other racial groups. Between 1973 and 1992, colon cancer increased by 40 percent among black men and 16 percent among black women. But since the incidence of colon cancer is far less in Africa than the rest of the world, the risk appears to be associated with living in an industrialized nation, rather than with race per se.
  • Diet. Researchers have long believed that eating a low-fiber diet - a diet that doesn't include many fruits, vegetables or whole grains - greatly increases your risk of colon cancer. A diet high in fats, especially the saturated fats found in red meat, butter, dairy foods, and coconut and palm oils, seems to increase your risk of colon cancer as well as your risk of heart disease.
  • Smoking and alcohol. Smoking seems to increase your risk of colon cancer. Drinking alcohol in excess also may increase your risk. The combination of smoking and excessive drinking makes it even more likely you'll develop colon cancer.
  • A sedentary lifestyle. If you're inactive, you're more likely to develop colon cancer, although not rectal cancer. This may be because when you're inactive, waste stays in your colon longer. Getting regular physical activity may actually cut your risk of colon cancer in half.
    http://www.mayoclinic.com/invoke.cfm?id=DS00035
    For more information on family history, log onto:
    U.S. Surgeon General’s Family History Initiative

Preventing Cancer

  • Eat plenty of fruits and vegetables.
  • Get recommended amounts of calcium and folic acid.
  • Limit fat, especially saturated fat.
  • Limit alcohol consumption
  • Stop smoking.
  • Stay physically active and maintain a healthy body weight.
  • Consider hormone replacement therapy.
    http://www.mayoclinic.com

Screening for Early Detection

Several methods are currently in use to screen for colorectal cancer:

  • The fecal occult blood test (FOBT), flexible sigmoidoscopy (flex sig) or sigmoidoscopy, double contrast barium enema (DCBE), and colonoscopy are methods used to screen for colorectal cancer . A digital rectal exam (DRE) should be done before a sigmoidoscopy or colonoscopy, but it is not recommended as a screening method when used alone. The FOBT is not specific to colorectal cancer or polyps, but may be used to determine whether a more specific test is needed. A sigmoidoscopy provides a view of the rectum and part of the distal colon and has been shown to reduce colorectal cancers of that site by up to 59%.
  • Only the colonoscopy and double contrast barium enema (DCBE) can provide a view of the entire colon and rectum, and these are therefore the only screening tests able to detect cancers of the proximal colon. The colonoscopy, however, has higher sensitivity than the DCBE; it has been shown to detect new cancers by up to 66%. New screening tests on the horizon include virtual colonoscopy, immunochemical testing, and genetic-based fecal screening. (See table for a summary of current colorectal cancer screening options.)

Treatment Options

Three types of standard treatment for colon and/or rectal cancer are used. These include the following:

  • Surgery-
    • Local excision: If the cancer is found at a very early stage, the doctor may remove it without cutting through the abdominal wall. Instead, the doctor may put a tube through the rectum into the colon and cut the cancer out. This is called a local excision. If the cancer is found in a polyp (a small bulging piece of tissue), the operation is called a polypectomy.
    • Resection: If the cancer is larger, the doctor will perform a colectomy (removing the cancer and a small amount of healthy tissue around it). The doctor may then perform an anastomosis (sewing the healthy parts of the colon together). The doctor will also usually remove lymph nodes near the colon and examine them under a microscope to see whether they contain cancer.
    • Resection and colostomy: If the doctor is not able to sew the 2 ends of the colon back together, a stoma (an opening) is made on the outside of the body for waste to pass through. This procedure is called a colostomy. Sometimes the colostomy is needed only until the lower colon has healed, and then it can be reversed. If the doctor needs to remove the entire lower colon, however, the colostomy may be permanent.
  • Chemotherapy- Chemotherapy works by interfering with the cells ability to function and reproduce, usually by affecting DNA synthesis and/or function. It may be injected into the blood stream or taken as tablets.
  • Radiation therapy: The use of x-rays and other forms of radiation in an attempt to destroy malignant cells and tissue. There are various forms or methods, most now conducted with computers.
  • Other types of treatment are being tested in clinical trials. These include the following:
    • Biological therapy- This treatment uses materials produced by the body or manufactured in a laboratory to boost, direct, or restore your body's natural defenses against disease. One type of biological therapy called biological response modifier (BRM) therapy, or immunotherapy, is sometimes used to treat cancer.
    • Chemotherapy (for rectal cancer only)

For more detailed information, please visit: http://www.cancer.gov/cancertopics/types/colon-and-rectal

For information on finding a doctor or treatment facility, log onto: http://www.cancer.gov/cancertopics/factsheet/Therapy/doctor-facility

Clinical Trials

Coping with Cancer

Children Coping with Parents with Colorectal Cancer

  • Learn more about all different types of cancers.
  • Questions that children might have dealing with cancer.
  • Books to help children understand more about certain cancers.
  • Stories from other children.
  • Camps and foundations.

For more information- CancerSourceKids
http://www.cancersourcekids.com

Statistics

Comprehensive Cancer Control Plan
New Jersey State Cancer Registry

More Information