Our Gastroenterology Blog

Posts for category: Colon Cancer

When COVID-19 exploded onto the scene in early 2020, few if any could predict the enormous social, economic, and even political impacts that were to come. An interesting thing occurred, though, in the midst of the rising tide of the pandemic. While diagnosed cases of COVID-19 continued to rise around the country, some cancer diagnoses were on the decline, including those of colorectal cancer. On the surface, this would appear to be a monumental development and accomplishment in the fight against colorectal cancer! However, a closer look reveals the truth in the timing. The decrease in cancer diagnoses is directly related to the dramatic decrease in exams and screenings this past year, a trend we need to see reversed in 2021.

Why Was There a Decrease in Cancer Screenings? 


To say we were unprepared as a nation for a pandemic like COVID-19 is an understatement, and this became very apparent early on as health care facilities and hospitals in different areas around the country became overwhelmed with patients. Even as they neared or reached their patient capacity, information was still being acquired as to the contagious nature and potency of this disease. In a desire to minimize the spread and to conserve resources in the healthcare system, elective procedures, including certain cancer screening procedures, were postponed.

 

To their immense credit, the medical community of doctors, scientists, and researchers worked around the clock to understand how to treat COVID and how to reduce its spread. As more information became available regarding protective measures and patient safety, doctors began to schedule screenings again. This lapse of time though, will ultimately come at a cost, as cancer is a disease that doesn’t delay or stop due to worldwide pandemics or cultural changes. Unfortunately, it is inevitable that too many people will find out later than they should have that they have colorectal cancer. And as we know with cancer, every day counts when it comes to early detection and treatment. 

 

I Missed My Last Screening. When Should I Reschedule? 


Time matters when it comes to cancer, so you should reschedule your missed appointment. If you are concerned about COVID-19, we can assure you that we are taking every precaution possible when it comes to protecting your health and slowing the spread.  Contact us to schedule an appointment, whether you are a new patient or a current patient, or schedule your screening here. 

 

Is There a Vaccine and When Will I Have Access?


Yes! A COVID-19 Vaccine has recently been approved, with the CDC and FDA managing the distribution process.

 

In the near future, and as supplies ramp up, everyone will be able to have access to the vaccine. However, due to the initial limited supply of the vaccine, the state of Wisconsin (per supplies allocated at the federal level) will follow the recommendations developed by the federal Advisory Committee on Immunization Practices and the State Disaster Medical Advisory Committee.  As such, the vaccine will be offered in a series of phases, with the frontline healthcare workers and residents of long-term care facilities being the first to receive access. 


For more information on the development of this plan and distribution timelines, take a few moments and read the COVID-19 Distribution Plan for Wisconsin as well as the DHS executive summary, COVID-19 Vaccination - Planning in Action.

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:

  1. Are at a higher risk for advanced colorectal polyps and colorectal cancer themselves
  2. May require more frequent testing or screening
  3. 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.

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): 

 

Inherent Factors

  • 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

Lifestyle Factors

  • Heavy drinking 
  • Smoking tobacco
  • Eating a lot of red or processed meats
  • Obesity
  • 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): 

 

Stage 0

  • 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 

Stage I

  • 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 

Stage II

  • 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 

Stage III

  • 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

Stage IV

  • 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.

In honor of March being Colorectal Cancer Awareness Month, we are sharing the key risk factors for colon cancer. Colon cancer is sometimes called “the silent killer” because symptoms often don’t present themselves until later stages. That’s why it’s so important to get regular screenings after the age of 50—even if you have no other risk factors.

Colorectal cancer refers to cancer of the colon or rectum. The exact cause is not yet known, but the following risk factors may increase the chance that a person will develop this disease:

  • Age. The chances of developing colorectal cancer increase after age 50. In fact, more than 90% of people diagnosed with colorectal cancer are at least 50 years old.
  • Family history. Having close relatives (parents, siblings or children) who have been diagnosed with colorectal cancer increases your likelihood of having it. If you are at a higher risk, your physician may recommend screenings for you before the age of 50.
  • Personal history of colorectal polyps or colorectal cancer. A polyp is a growth that develops on the inner lining of the colon or rectum. Some polyps may become cancerous. If you’ve been diagnosed with colorectal cancer in the past, the disease may reoccur.
  • Personal history of inflammatory bowel disease. Other risk factors include eating diets high in fat and red meat, lack of exercise, smoking, and bowel disorders such as Crohn’s disease. Although some risk factors, such as age and family history, cannot be avoided, other factors are within your control.

Of course, the biggest risk anyone can take when it comes to colorectal cancer is not getting screened. Colon cancer is the second leading cause of cancer death in the U.S., but it has a 90% survival rate when caught early enough. Talk to your doctor about scheduling an appointment today.

Visit our Colon Cancer Screening and Colonoscopy pages to learn more.