Colorectal Cancer: Are You at Risk?

March is Colorectal Cancer Awareness Month. This is a great time to review the risk factors, symptoms, screening methods and treatments.

What is colorectal cancer?

First it is important to identify the functions of the colon, rectum and anus. The colon is called the large intestine or large bowel. Its primary function is to solidify body waste into stool, store it and then eliminate it from the body. The rectum is the passageway that connects the colon to the anus. The anus is the opening at the end of the digestive tract through which solid waste is expelled from the body.

When cells in the colon or rectum grow out of control, cancer can develop. Sometimes abnormal growths, called polyps, form in the colon or rectum. Over time, some polyps may turn into cancer.

What are the risk factors?

“Age as well as a combination of lifestyle and genetics factors can play a role in colorectal cancer,” said Hazem F. Elkassas, MD, a board-certified internal medicine and medical oncology physician with Penn Highlands Oncology/Hematology. “It is important to note that even people who have multiple risk factors may not develop colorectal cancer while some people with no known risk factors will develop the cancer.”

While the risk increases as people age, other risk factors include:

• A personal or family history of colorectal polyps or cancer
• Genetic syndromes such as familial adenomatous polyposis (FAP), which may develop as early as the teenage years, or hereditary non-polyposis colorectal cancer (Lynch Syndrome), which is more likely to develop before age 50
• Inflammatory bowel disease such as ulcerative colitis or Crohn’s disease
• Lifestyle factors may include:
  • Lack of regular exercise and physical activity
  • A diet low in fruit and vegetables
  • A diet low in fiber and high in fat or processed meats
  • Obesity
  • Alcohol consumption
  • Tobacco use

What are the symptoms?

Colorectal cancer might not present any immediate symptoms, but it may cause one or more of the following:

• A change in bowel habits that lasts for more than a few days such as diarrhea, constipation or narrowing of the stool
• A feeling that you need to have a bowel movement that’s not relieved by having one
• Rectal bleeding with bright red blood
• Blood in the stool, which might make the stool look dark brown or black
• Cramping or abdominal belly pain
• Weakness and fatigue
• Unintended weight loss

How is colorectal cancer detected?

When cancer is found early -- when it's small and hasn't spread – it often allows for more treatment options. While the Food and Drug Administration (FDA) has approved stool screening tests that can be performed at home and sent to a lab, a colonoscopy is still one of the most effective ways to detect colorectal cancer.

During a colonoscopy, the patient is sedated so that the rectum and entire colon can be examined using a colonoscope. This flexible lighted tube is inserted through the anus into the rectum. It includes a lens for viewing and a tool for removing tissue. During a colonoscopy, any abnormal growths in the entire colon and the rectum can be removed.

The National Institutes of Health recommends that people of average risk begin colorectal screenings at age 45 and continue every 10 years. People at increased risk may be advised to begin earlier and have more frequent screenings.

What are the treatments?

“Many factors are considered when determining the best treatment for a person with colorectal cancer,” explained Dr. Elkassas. “We evaluate the stage of the cancer, its location and the patient’s overall health.”

Treatment options may include:

• Surgery to remove the cancerous portion of the colon or rectum
• Chemotherapy
• Radiation therapy

Once a person completes their therapy, they are continuously monitored to detect any recurrences.

For cancer care, people throughout Pennsylvania turn to the Hahne Cancer Centers at Penn Highlands Healthcare which provide comprehensive cancer care including surgery, chemotherapy and radiation therapy. Penn Highlands’ oncology physicians provide outpatient diagnostic testing, chemotherapy, immunotherapy and hematology services. For more information, visit www.phhealthcare.org/service/colonoscopy.