Pancreatic Cancer Awareness month began with somber and sobering news as America’s beloved game show host, Alex Trebek, lost his fight with Pancreatic Cancer. The statistics regarding Pancreatic Cancer are downright frightening, as only 5 to 10 percent of the 58,000 people diagnosed with the disease this year will live past 5 years. With such a high mortality rate, it is important for men and women to educate themselves and also to raise awareness of the perils of this aggressive disease before it’s too late.
What Does The Pancreas Do?
The pancreas is an essential organ that is about 6 inches long and rests in the middle of your abdomen. It serves two important functions that ultimately impact the entire body. First, the pancreas helps produce enzymes that aid in the digestion of the foods that we eat. This is called the exocrine function. Second, the pancreas produces hormones, like insulin, that help regulate blood sugar levels. This is called the endocrine function. A healthy pancreas is vital to the proper functioning of several other key organs, including the brain and liver.
Are There Different Types of Pancreatic Cancer?
While there are several different types of pancreatic cancer, they fall into two larger groups: Exocrine Pancreatic Cancer and Neuroendocrine Pancreatic Cancer.
Exocrine Tumors: Over 90% of all cancers diagnosed in the pancreas are adenocarcinomas, or exocrine tumors. They usually form in the exocrine cells that are located in the pancreas ducts and carry digestive enzymes out of the pancreas. Due to a mutation in the cell’s DNA, these cells grow out of control and form an aggressive malignant tumor that impacts both the functions of the pancreas and the organs that depend on it to properly function themselves.
An adenocarcinoma can also be found in several other types of cancer, including lung, colon, esophageal, prostate, and breast, as they form in glands that secrete fluids.
Neuroendocrine Tumors: This type of cancer is much less common than exocrine tumors and generally has a better prognosis. While the exocrine cells make up the majority of the pancreas, the endocrine cells serve an important function as well. They produce vital hormones like insulin and glucagon, ultimately releasing them straight into the blood. Tumors produced from endocrine cells are also called islet cell tumors as they tend to be found in small clusters in the pancreas.
What are the Early Warning Signs of Pancreatic Cancer?
Unfortunately, early warning signs are rarely seen or noticed in regards to Pancreatic Cancer. The symptoms don’t often present themselves until the cancer is further along into the 3rd and even 4th stages. Some patients experience and notice symptoms earlier on in the disease, but the common nature of these symptoms indicates a different, more common type of ailment to them. Some of these symptoms include:
- Loss of appetite
- Vomiting and nausea
- Feelings of fullness
- Poor digestion of fats, carbohydrates and proteins
- Unintentional weight loss
Other, more serious symptoms include:
- Severe back pain
- Severe abdomen pain
- Blood clots
- Liver or gallbladder enlargement
There is currently no recommended screening for average risk people for Pancreatic Cancer, making this disease an even more difficult task to identify and treat before it is too late. There are some screening options for high risk individuals (people with multiple family members with pancreas cancer and some genetic conditions including BRCA-2 mutation).
How is Pancreatic Cancer Diagnosed?
If there is no screening yet, how is Pancreatic Cancer diagnosed? Well, after presenting your symptoms to a professional at GI Associates, if there is a concern of pancreatic cancer, several tests may be considered.
- Imaging Tests: An imaging test will help the physician visualize your organs, such as the pancreas. Some techniques used to diagnose pancreatic cancer are ultrasound, magnetic resonance imaging (MRI), computerized tomography (CT), and positron emission tomography (PET) scans.
- Endoscopic Ultrasound: Endoscopic ultrasound uses a special ultrasound device to create images of the pancreas from within. A device will be passed through a flexible, thin tube called an endoscope, and down your esophagus, into your stomach, to capture images.
- Removing a Tissue Sample for Testing. This is typically done via endoscopic ultrasound. The physician uses ultrasound to guide insertion of a needle through the stomach into the pancreas. A small piece of tissue called a biopsy is removed and examined under a microscope. This is typically a painless procedure because the patient is sedated.
- Blood Test: Pancreatic cancer sheds specific proteins, and they are a tumor marker to see if pancreatic cancer is present. One of the tumor marker tests that are used in pancreatic cancer is known as CA19-9; however, the test isn’t always reliable. A blood test should not be the only form of testing for this reason, but some doctors measure this level before, during, and following treatment.
Once a diagnosis is made, cancer treatment will depend on each individual. Some forms of cancer treatment are surgery, medication, chemotherapy, and radiation therapy. Always alert your doctor if you have new symptoms that persist. While you don’t want to assume all symptoms could be cancer, it’s important to stay in tune with your body so you know what’s normal for you and what is not.
If you have questions about pancreatic cancer or have experienced a prolonged period of time with any of the symptoms listed above, schedule a visit with a professional today. Don’t delay, as this is one disease where consistent checkups, early and often, could save your life.
Cancer Screening: The Choice is Yours
When it comes to colon cancer, getting screened is an essential part of your wellness plan. The key is to do something and you have screening options.
Average risk screening colonoscopy starts at age 50 (or 45 by some sources) and is recommended every 10 years until the age of 75. If polyps are found on colonoscopy, the interval of recommended colonoscopy may be shortened.
If colorectal cancer runs in your family or you have certain underlying conditions, you may need to get tested earlier. Talk to your doctor about what is best for you.
Know your options
Colonoscopy is the most common test to detect colon cancer, as well as the most reliable. Other tests include stool DNA tests, flexible sigmoidoscopy, double barium enema, and CT colonography. Based on your personal health history, your doctor can recommend the right test for you.
A colonoscopy is the only colorectal cancer screening option that both detects and prevents colorectal cancer. As a routine, preventative screening, colonoscopies are covered by most insurance plans which often means little or no out-of-pocket cost to you!
Prior to a procedure, you complete a bowel preparation process that cleans out the colon to enable your doctor to see the lining of your rectum and colon. During a colonoscopy, your doctor gently inserts a colonoscope, which contains a tiny video camera at its tip, through the rectum into your large intestine. Your doctor examines the lining along the entire length of your large intestine.
If your doctor sees abnormal growths of tissue called polyps, tiny instruments are inserted through the colonoscope to remove them. The tissue samples are sent to a pathologist to evaluate whether they are benign, precancerous, or malignant. Screening colonoscopy is recommended every 10 years between 45 and 75 years of age may be more frequently based on your findings and risk factors. If you’d like to learn more about what to expect before a colonoscopy, check out our video here.
Occasionally, patients have reservations about getting a colonoscopy, or there may be reasons to consider alternative screening methods. At the advice of your doctor, you might also be able to consider one of these alternatives:
2. Fecal Immunochemical Test (FIT): FIT detects hidden blood in the stool, which can indicate the presence of cancer. When a FIT test is positive a colonoscopy is usually recommended. FIT tests are recommended annually for average-risk patients, age of 50 and over, with no symptoms.
3. Stool DNA Tests: The stool DNA test looks for abnormal DNA associated with colon cancer or colon polyps. The test also detects hidden blood in the stool, which can indicate the presence of cancer. If a stool DNA test is positive a colonoscopy is usually recommended. The stool DNA test is recommended for average-risk patients with no symptoms and is usually recommended every 3-5 years.
The stool DNA test is not recommended for higher-risk patients with a personal history of colon polyps or cancer, or who have inflammatory bowel conditions, diarrhea, blood in their urine or stool, bleeding hemorrhoids, rectal bleeding, or are menstruating. It is important to note that colonoscopy performed due to a positive stool DNA test is often classified as a diagnostic service by most payers.
4. CT Colonography (also referred to as virtual colonoscopy): A small tube is placed in the rectum and air is pumped into the colon to inflate the bowel. A special computer program creates both 2-dimensional x-ray pictures and a 3-dimensional view of the inside of the colon and rectum, which lets the doctor look for polyps or cancer. If the test is positive a colonoscopy is usually recommended to remove the growths. Preparation is the same as a colonoscopy. This test may be recommended when the completion of a colonoscopy is not possible. It is usually recommended every 5 years.
5. Flexible Sigmoidoscopy: Similar to colonoscopy, this test uses a thin flexible tube with a camera to examine the rectum and left side of the colon. Whereas colonoscopy examines the entire length of the colon, sigmoidoscopy is a partial exam. The preparation is the same as a colonoscopy. When considering colon cancer screening options, flexible sigmoidoscopy is not as complete as a colonoscopy and therefore is not widely recommended for screening purposes. It’s typically repeated every 5 years.
6. Double Barium Enema: This is also called a lower GI tract radiography, in which a barium solution and air are introduced into the colon, and a series of x-rays are taken of the entire colon and rectum. Double Barium Enema is often performed in combination with flexible sigmoidoscopy. If either of these tests is positive a colonoscopy is usually recommended.
Early detection of colorectal cancer is crucial and potentially lifesaving. The most important step you can take is to get screened. GI Associates is proud to offer options to our patients so that together we can determine the best plan for you.
Preventative screenings like colonoscopies are typically covered by insurance and so don't have any costs to you. If you have any concerns about coverage or payment for colon cancer screening services, our GI Associates Financial Counselor will work with you to help understand your benefits.
Find out if your heartburn could actually be due to gastroesophageal reflux disease.
What are the signs of GERD (gastroesophageal reflux disease)? While most people can describe having occasional signs of heartburn or acid reflux, it’s not commonly a chronically occurring condition. You may notice it after eating particular foods or if you eat right before bedtime. But if you are dealing with these symptoms a couple of times a week or if they are affecting your quality of life then it may be more serious than heartburn.
What Is GERD?
Every time you swallow food your stomach produces acid to aid in digestion. In a healthy gastrointestinal system, a valve opens to allow food and liquid to pass from the esophagus to your stomach. In those with GERD, the valve may not close fully or may open too often, which can cause stomach acids to travel back up into the esophagus. If this happens regularly, the lining of the esophagus can become irritated and even damaged.
What Are The Symptoms Of GERD?
While everyone will probably experience heartburn at some point during their lifetime, if you have GERD you will likely deal with frequent or persistent heartburn. Everybody is different when it comes to their symptoms. Other frequent symptoms of GERD include:
- Sore throat
- Problems swallowing
- Chronic bad breath
- A sour or bitter taste in the mouth
When Should I See A Gastroenterologist?
It isn’t always easy to know when it’s time to visit the specialists at GI Associates. Of course, if you’ve been dealing with heartburn that occurs two or more times during the week, if your heartburn is getting worse, if you have trouble swallowing, or if heartburn wakes you up at night then it’s important that you get your symptoms evaluated. Any of these signs of GERD should be confirmed by your doctor.
How Is GERD Treated?
The goal of treatment is to reduce the symptoms and you’re your esophagus a chance to heal. You may need to make lifestyle changes such as changing what and when you eat, sleep positioning, and potentially weight loss if obesity is a factor.
Certain medications may also be prescribed to help you manage your symptoms and to help repair the damage done to the esophagus. Surgery is only recommended when all other treatment options have failed.
Are you dealing with nagging, gnawing heartburn that just doesn’t seem to go away? If so, then it’s time you turned to the experts at GI Associates.
Heartburn is a very common discomfort that most people will experience at some point. But what if it won’t go away? At what point does heartburn become a cause for concern?
How To Identify Heartburn
Heartburn has nothing to do with your heart. It’s a condition that occurs in the esophagus when a small amount of stomach acid escapes your stomach and sits in your lower esophagus. The acids create an uncomfortable burning sensation that, because of its location near the heart, has been given the name “heartburn.”
Mild heartburn can pop up on occasion for a variety of reasons, but sometimes it can hinder your regular daily activity. If it gets that intense, or it seems like it won’t go away or is consistent over many days, it is important to have it checked.
What Happens If You Have Frequent Heartburn?
The esophagus is prone to several conditions and disorders. Sometimes considered “frequent” heartburn, Gastroesophageal reflux disease (GERD) occurs when the valve in the esophagus doesn’t work properly. GERD can also cause acid regurgitation when the acid from the stomach comes up through the esophagus and sometimes into the mouth.
A few potential concerns that can result from untreated GERD or frequent heartburn are Barrett’s Esophagus and potentially a type of cancer called adenocarcinoma. Barrett’s esophagus occurs when the esophageal lining changes, becoming more like the tissue that lines the intestines. Your doctor will test for Barrett’s esophagus with an upper endoscopy and may order additional tests as needed. This assessment is very important because undetected and untreated Barrett’s esophagus can lead to esophageal cancer.
Although rare, Adenocarcinoma is increasing in frequency, making it more important than ever to have heartburn symptoms checked out. Experts aren’t sure exactly what is causing the increase in adenocarcinoma cases, and the increase has been seen mostly in white males, with the average patient being 67 years of age.
How Can I Decrease My Heartburn?
Often, GERD symptoms occur because of diet or obesity. Eliminating carbonated beverages, caffeine, and fatty or spicy foods can help reduce the frequency of heartburn. Losing weight may also help. Some people may find relief with over-the-counter antacids, although they should not be considered a long-term solution. Anyone with persistent heartburn needs to have their condition diagnosed.
Some common causes of heartburn include:
- Types of food/Diet
- Snacking near bedtime
- Regular use of blood pressure medications, particularly those used for blood pressure, certain muscle relaxers, or pain relief
- Frequently drinking carbonated beverages, coffee, tea, or alcohol
Avoiding these can help reduce your symptoms or frequency of heartburn. If you’re experiencing frequent or debilitating heartburn that has begun to affect your daily life, don’t mistake it as “normal.” Make an appointment with GI Associates today!
Who wants more BBQ? Can you think of anybody who doesn’t look forward to cooking out in the summer? How horrible when the enjoyment is interrupted with discomfort or gut pain?
Before missing out on some of the upcoming summer fun, there are some things you should know about ahead of time. Here’s what you need to know about bloating.
What Is Abdominal Bloating?
Not knowing what’s happening with your body can be disconcerting; humans are generally emotionally distressed with the “unknown” or when having to deal with something they can’t explain. So, if you’re feeling something uncomfortable or painful, you don’t have to wait.
One relatively common and often non-threatening situation we can experience is that of abdominal bloating.
Abdominal bloating can be both annoying and disruptive. People often feel down or lethargic when they’re bloated. The pressure in your abdomen and pain that comes with it can be enough to make you wonder if something is really wrong.
The causes of bloating can differ, but the effect is usually the same—excess gas in the digestive tract. Depending on how much air is trapped in your stomach and large or small intestine, you can experience a wide range of potentially embarrassing or uncomfortable symptoms. In addition to pain in the abdomen, symptoms can include increased belching and flatulence or even the visible swelling of the abdomen.
As uncomfortable as it may be, a single bout of pain and bloating is not typically a cause for alarm. However, it can be extremely painful, and some patients even find themselves in the emergency room. If the symptoms persist or recur frequently, it may be time to meet with a doctor. There are some serious conditions that can cause abdominal pain and bloating and the symptoms should not be ignored.
What Causes Bloating?
Knowing the potential causes of bloating, you may be able to narrow down exactly what’s happening and take steps to bring relief or even prevent it in the first place.
Here are some of the possible reasons you might be feeling bloated and gassy:
- Over-eating: As simple as it sounds, eating too much is one of the most common causes of abdominal bloating. Our stomachs are still relatively small; so when we eat huge volumes of food, space gets filled up. Digesting some foods can create intestinal gas and makes for a combo that can make you feel bloated.
- Eating too quickly: It’s important to be aware of how quickly you’re eating. When you scarf your food down, you are inevitably swallowing air along with the food; this air can get trapped in the stomach and build up, leading to bloating.
- Carbonated beverages: Drinking a lot of carbonated, fizzy drinks like soda can lead to bloating. The carbon dioxide in the beverage gets released in your digestive tract, and the excess gas can lead to bloating.
- FODMAP foods: This funny-sounded acronym stands for “Fermentable Oligo-, Di-, Mono-saccharides And Polyols,” a fancy way of referring to some foods that aren’t absorbed well by the small intestine. Foods like beans, broccoli, cauliflower, wheat, lentils, brussels sprouts, cabbage, garlic, onions, apples, and pears, while generally healthy and recommended, can cause bloating for some people - particularly those with IBS (irritable bowel syndrome).
- Fatty foods: Foods heavy in fat can take longer to digest. A longer digestion time, especially in conjunction with other foods and beverages that promote bloating, can leave you feeling overly full and bloated for hours.
- Inactivity: In general, physical activity is beneficial for digestive health because it strengthens the abdominal wall and helps digested food move through your digestive tract. Too much inactivity can add to the body’s propensity to be bloated and gassy.
- Sugar alcohols: Sugar alcohols are found in sugar-free chewing gum and foods that utilize artificial sweeteners like sorbitol. Having too much in your diet can lead to bacteria in your large intestine producing excess gas.
- Constipation: This can further complicate things because some of the methods often used to treat constipation - eating high-fiber foods, for example - can inadvertently add to the feeling of being bloated. Often, the best solution is to increase your water intake and physical activity.
- Too much sodium: Water retention can be caused by too much salt. When you’re retaining water, you can feel a bloating sensation in your abdomen and potentially in your extremities.
- Lactose intolerance: A common food allergy, lactose intolerance, has symptoms that often include bloating, gas, diarrhea, and other digestive health issues.
- Celiac disease: Celiac disease has been on the rise in prevalence in recent years. This condition is defined by the inability to digest gluten, a type of protein found in many cereal grains.
- Fructose intolerance: The sugar found in fruits is occasionally difficult to digest for some people. Similar to other types of food intolerance, bloating is often accompanied by other gastrointestinal discomforts.
- Intestinal disorders: Some intestinal disorders, like IBS, SIBO Crohn’s disease, or ulcerative colitis, occur in the small and large intestine and often include bloating. In most cases, however, bloating will be just one of the numerous symptoms that point to an intestinal disorder.
- Smoking: In addition to the excess air you inevitably swallow while smoking, the toxins in cigarette smoke can irritate the lining of your stomach and actually add to the feeling of being bloated.
- Alcohol: Excessive alcohol can also cause bloating because of the negative impact it has on healthy gut bacteria.
- Malignancy--serious disorders
When Should I Talk to My Doctor About Stomach Bloating?
If your symptoms persist or are accompanied by other changes in your body, it may be time to talk to your doctor. For example, when chronic bloating is associated with sudden, unintentional weight loss, it can be a sign of a more serious digestive disorder.
Serious conditions related to stomach bloating can range from irritable bowel syndrome to more life-threatening conditions such as cancer. In cases like these, diagnosing the root cause of your bloating may require talking to a specialist, such as a gastroenterologist.
If you have been suffering from ongoing bloating that does not respond to dietary or lifestyle changes, take advantage of the convenience of a TeleMedicine appointment to start a discussion with your doctor instead of waiting. Your doctor will be able to suggest an alternate course of action or advise you to make a physical appointment for further discussion and examination.
GI Associates has introduced TeleHealth and can meet with you virtually in the comfort of your own home. If you would like to have the advice of a doctor to discover the best course of action moving forward, simply call our office at 877-442-7762.
If your parents, siblings, or kids have been diagnosed with colorectal cancer, it’s important for you to be screened- regardless of your age.
Recent studies show that first-degree relatives of patients with colorectal cancer or advanced colorectal polyps:
- Are at a higher risk for advanced colorectal polyps and colorectal cancer themselves
- May require more frequent testing or screening
- Should be in close communications with their doctor
What are polyps?
While they typically don’t cause symptoms, polyps are growths on the inside walls of the colon that protrude into the colon passageway. Polyps range in size from a small dot to several inches. Men tend to develop them more than women. We know that most colorectal cancers come from polyps. So, if polyps are found and removed before they become cancerous, about 75-90 percent of cases of colorectal cancer can be prevented.
It is possible to experience some signs of polyps, particularly if the polyps are located on the rectum. Some symptoms of colonic polyps to be mindful of include:
- Blood on toilet paper after wiping
- Blood in the stool
- Pain, constipation, or diarrhea that lasts upward of a week
- Nausea and vomiting
These symptoms can point to a number of different causes, so to be sure, it’s important to visit your doctor.
Lifestyle Changes and other identifiers:
There are certain conditions and even lifestyle choices that may increase the risk of polyps or colon cancer. These include smoking and overconsumption of red meat (particularly in women).
If you have diabetes, are overweight, or have other bowel diseases like Crohn’s disease, ulcerative colitis, or inflammatory bowel disease you may be at higher risk to develop colon cancer.
How Are Polyps Treated?
A colonoscopy is the most effective way to identify and remove polyps. In most cases, colonic polyps are easily removed during a colonoscopy by performing a procedure known as polypectomy. In some cases, larger polyps cannot be removed with the colonoscope, and surgery must be scheduled.
If you have any type of colonic polyps, you will need to follow up with your doctor after removal. The frequency of regular follow up and repeat colonoscopy is determined based on the type and number of polyps you are found to have.
Schedule an appointment
If you need more information about colonic polyps, colon cancer, or to discuss your family history regarding screening, simply request an appointment with GI Associates.
When your stomach is growling so loudly that the person across the room can hear it, it’s tempting to grab a handful of chips or a cookie (or three) - especially since working from home has given most of us quick access to a pantry full of comfort foods! But if you have GERD, mindless snacking can have painful consequences.
Gastroesophageal reflux disease (GERD) is when the stomach acids in your stomach leak back into the esophagus. It’s often called acid-reflux, although GERD is more severe or consistent than occasional acid reflux. Typically, if reflux happens multiple times a week or is severe at least once per week, you may be experiencing GERD.
While a few lifestyle changes can help keep symptoms manageable, deciding on what types of foods to eat can be tricky. Eating large meals, eating fatty foods, or drinking certain drinks like alcohol or coffee can all trigger reflux.
However, being prepared for when the hunger pangs hit by adding these reflux-busting snacks to your grocery list can help you guard against reflux and help free you to enjoy your meals a little more:
- Non-citrus fruits
- Crackers with any type of nut butter
- Raw vegetables with dip or hummus
- Baked chips
- Half an avocado and some corn chips
- Baked chicken strips (or any small quantity of lean meat, besides red meat)
- Oatmeal or high-fiber cereal
- A baked potato, sweet potato, or yam
- Any type of grain
- Rice cakes
- Granola bars
- Half a bagel
- Lowfat dairy, such as low-fat cottage cheese with vegetables or crackers or fruit
- A hard-boiled egg
- A veggie or fruit (non-citrus) smoothie
Moderation is key
Even when you choose healthy snacks, too much of a good thing is, well, not good at all – especially when you have GERD. Limit your nibbles to small serving sizes, which will keep both your hunger and reflux under control. Experts recommend that you eat three small meals and two snacks daily.
When to see a doctor
If your signs and symptoms get worse, if you’re struggling with nausea or difficulty swallowing, or if you otherwise suspect that you may have GERD, meeting with a Board-certified gastroenterologist at GI Associates can help you manage GERD symptoms and create a diet plan that works best for you.
For more information, call (877) 442-7762 or fill out our online form today.
More and more health care providers are using technology to expedite patient care appointments. You may not have considered TeleHealth, but it may be the perfect way to continue prioritizing your health even while practicing social distancing.
Why choose a virtual visit with your medical provider?
TeleHealth allows you to discuss symptoms, medical issues, medications and more with a medical provider in real-time.
TeleHealth has been available for longer than you might have thought- beginning with telephone visits. Further advancements in technology have allowed patient portals and communication via the internet to become the norm in patient information and communications. Now, video conferencing helps improve communication even further.
TeleHealth is well suited for situations that aren't life-threatening or where you need advisement more than hands-on care. Through a virtual visit, your provider will assess your symptoms, review your medication regimen, recommend testing and treatment options and more. Patients with conditions such as reflux, Crohn's disease, and IBS will benefit from TeleHealth appointments.
It is important to know that you always call 911 or go to an emergency room for a life-threatening condition like a heart attack or stroke, cuts or lacerations, or broken bones that require x-rays, splints, or casts.
GI Associates offers TeleHealth
GI Associates has introduced TeleHealth as a protective measure for our most vulnerable patients while we navigate COVID-19. TeleHealth doesn’t mean that you’ll never visit a doctor’s office again, but it does make care more accessible.
Call our office at 877-442-7762 to discuss whether a virtual appointment with GI Associates is right for you!
In the United States, cancer is second only to heart disease in terms of annual deaths. Almost 600,000 people die from some form of cancer every year, and colorectal cancer is the second leading cause of cancer death for both men and women. More than 140,000 new cases are diagnosed every year of this largely preventable disease. March is National Colorectal Cancer Awareness Month. The main goal of the campaign is to raise awareness of the disease, but also to encourage people to get early screening for colorectal cancer. While it can be a deadly disease, catching it early can make an enormous difference in terms of both life expectancy and quality of life.
What Role Does the Colon Play in Digestion?
Although frequently asymptomatic, colorectal cancer can be related to a variety of gastrointestinal symptoms. It’s helpful to understand how the colon fits into the digestive process. When food enters the mouth and is chewed into a pulp, that mass (called a food bolus) makes its way down the esophagus and into the stomach. Digestive juices and muscle contractions, called peristalsis, act on the food bolus to reduce it to a semi-liquid material called chyme. The chyme then enters the small intestine where additional enzyme-rich juices further break it down into components that can be absorbed into the bloodstream and carried around the body to be used by cells.
After the small intestine, the chyme (composed mostly of waste materials and bits of undigested food at this point) enters the large intestine via the ileocecal valve. The cecum is the first portion of the colon followed by the ascending colon, transverse colon, descending colon, sigmoid colon, rectum, and anal canal.
The small intestine is primarily responsible for true “digestion” in the sense of utilizing the nutrients in food, and it is the colon that processes the remaining waste products by absorbing water and salts and forming stool. Though the colon doesn’t produce digestive enzymes, the gut flora present there can use the waste products in the stool to synthesize valuable vitamins. By the time the stool reaches the sigmoid colon, it is mostly solid and can be expelled through the anal canal.
What is Colorectal Cancer?
Colorectal cancer is an abnormal growth of mutated cells that can develop in either the colon or the rectum. Though the terms colon cancer and rectal cancer are used to describe cancers in those specific areas, colorectal cancer is a commonly used term to group the two conditions together since they both share similar attributes. Like any type of cancer, the abnormal growth of cells starts small and localized but can spread to other parts of the body and lead to major problems for multiple body systems.
Colorectal cancer typically begins in the inner lining of the colon or rectum with small, fleshy growths called polyps. Though typically benign at first, polyps can become cancerous over time if they aren’t removed. Some polyps, such as inflammatory or hyperplastic polyps, are considered to have low malignancy potential and are therefore unlikely to lead to cancer. Adenomatous polyps, on the other hand, are considered precancerous and thus have a much higher likelihood of leading to cancer. Polyps can usually be detected and, more often than not, removed during a colonoscopy.
Symptoms of colon cancer, if present, can vary and can be very similar to other digestive diseases, such as inflammatory bowel disease, irritable bowel syndrome, or hemorrhoids. Below are some of the more common symptoms reported:
- Fatigue or weakness
- Changes in bowel habits that persist for more than several days
- Unexplained weight loss
- Blood in the stool
- Bleeding from the rectum
- Abdominal pain
- Abdominal cramping
Symptoms cannot be relied on for screening or diagnosis, however, both because of their similarity to other diseases and because the symptoms are a late finding in colorectal cancer, meaning there has already been significant progression.
Causes of Colorectal Cancer
Although cancer is a complex process with a variety of causative factors, on a fundamental level, it occurs due to mutations in the DNA of the affected cells. The specific gene types that appear to be involved are called oncogenes and tumor suppressor genes; oncogenes are responsible for helping cells divide and grow, and tumor suppressor genes are responsible for preventing the kind of cellular overgrowth that happens in cancer.
One of the main tumor suppressor genes involved at the beginning of cancer is the adenomatous polyposis coli (APC) gene. When this gene becomes mutated, it can no longer function as a “brake” on cellular growth and therefore overgrowth happens. It is not completely understood why these kinds of mutations happen in the first place. Diseases like familial adenomatous polyposis (FAP), a condition characterized by the development of a large number of adenomatous polyps, suggest that it can sometimes be inherited from a parent. But research suggests that these mutations may also be acquired during the course of life from exposure to a variety of risk factors.
What are the Risk Factors for Colorectal Cancer?
Scientists have found links between certain behaviors and risk factors that make someone more likely to develop colorectal cancer, although it is still unknown how these factors precisely “cause” cancer. The American Cancer Society has identified a number of these risk factors, and they are generally divided into inherent factors (those that can’t be controlled) and lifestyle factors (those that can be controlled):
- Age 50 years or older
- Some diseases, such as inflammatory bowel disease or type 2 diabetes
- Personal or family history of colorectal cancer
- Racial and ethnic background, such as African Americans and Jews of Eastern European descent
- Inherited syndromes, such as FAP or Lynch syndrome
- Heavy drinking
- Smoking tobacco
- Eating a lot of red or processed meats
- Lacking sufficient regular exercise
Treatment Options for Colorectal Cancer
Doctors use a “staging” system to describe and organize the progression of cancer and the appropriate treatments for the different levels of progression. This system runs from very early (stage 0) to very advanced (stage IV):
- Status: The cancer is confined to polyps or small tumors in the mucosal lining of the colon
- Treatment: Endoscopy or surgery to remove the polyps or tumors is standard, but a partial colectomy may also be warranted
- Status: The cancer has grown past the mucosal lining and into the wall of the colon itself, but it hasn’t spread to the lymph nodes or other parts of the body
- Treatment: Surgery is the main treatment option to remove any cancer-containing parts of the colon
- Status: The cancer has grown through the wall of the colon, but still hasn’t reached the lymph nodes
- Treatment: Both surgery and chemotherapy are typically used at this stage, depending on the nature of the spread
- Status: The cancer has spread to the lymph nodes, but not to distant body parts
- Treatment: Surgery and chemotherapy are standard, but radiation therapy may also be employed
- Status: The cancer has spread beyond the colon to other parts of the body
- Treatment: Surgery may be utilized as needed (usually palliative, to improve quality of life), but chemotherapy is the primary treatment option
Colorectal Cancer Screening
It is before cancer develops or when the cancer is still in the early (or local) stage that doctors have the best chance of treating for long-term success. For this reason, those who are 45 years or older should start talking with a qualified gastroenterologist about getting screened. If you want more information about a colorectal cancer screening, Contact Us.
This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.