My father had a colon cancer at age 52. How does this affect me? Should I undergo testing, and if so, what type?
Anyone with a history of inflammatory bowel disease, or a personal or family history of colorectal cancer or polyp, or cancer of the breast, ovary, or uterus, is at increased risk for having a colorectal cancer or polyp. My recommendation for someone with one or more of these risk factors is to undergo colonoscopy at an age ten years younger than the youngest family member who had one of these cancers. In your case, this would mean having a colonoscopy at age 42. Of course, any symptoms related to the gastrointestinal tract should be evaluated promptly regardless of your age.
I have no family history of cancer, nor any gastrointestinal symptoms. Do I need screening for colorectal cancer?
Yes! Colorectal cancer is the second most common cause of cancer death in the US. Men and women are at equal risk. Over 90% of colorectal cancers developing people with no family history of colorectal cancer, so screening is very important for early diagnosis and prevention. When diagnosed early, over 90% of colorectal cancer are curable.
Screening recommendations for someone without GI symptoms, and no personal or family history of colorectal cancer, or CA of breast, ovary, or uterus, is as follows:
At age 40- digital rectal examination, fecal occult blood testing, and sigmoidoscopy.
At age 50- complete colonic evaluation, consisting either of sigmoidoscopy and barium enema, or colonoscopy. This is repeated at ten-year intervals in the absence of new symptoms, or changes in personal or family history that would alter risk.
It is important to remember that fecal occult blood testing (FOBT) does not diagnose cancer or lack of cancer- only the presence or absence of blood in the stool. FOBT is never appropriate screening when used alone.
What are the symptoms of colorectal cancer?
The most common symptoms are rectal bleeding and change in bowel habits, such as constipation or diarrhea. These symptoms are also common in other disorders, so a thorough examination is important. Abdominal pain and weight loss often indicate advanced disease.
Colon polyps and early cancers often have no symptoms, which is why screening is so important. However, gastrointestinal symptoms that should always be evaluated by your physician include:
A change in bowel habits that persists for more than a week
Bleeding with bowel movements
Unexplained changes in weight, appetite, or the size of the abdomen
Abdominal pain or discomfort that is recurrent or persistent
These symptoms are most often caused by problems that are not cancer. However, evaluation by your physician is necessary to determine the cause.
My doctor just diagnosed a cancer in my colon. How will this be treated? Will I need a colostomy?
The colon is made up of the right colon, the transverse colon, the descending colon, and the sigmoid colon. (Diagram) Problems of the rectum are often discussed separately, since treatment may differ. Colorectal cancer requires surgery in nearly all cases for complete cure. Radiation and chemotherapy are sometimes used in addition to surgery, and may be used before or after surgery, depending on several factors.
Because of new innovations in the treatment of colorectal cancer, fewer than 5% of all people with colorectal cancer require a colostomy (the surgical construction of an artificial excretory opening from the colon).
Can colorectal cancer be prevented?
Scientists believe that nearly all colorectal cancer begin in benign polyps that form on the inner lining of the bowel. These have the potential to grow and become cancer. Removal of these polyps by colonoscopic techniques is an example of preventive medicine in action!
There is also some evidence that diet plays a role in cancer prevention. A high fiber, low fat diet is recommended. There is not yet sufficient information regarding vitamins, minerals, and various other nutritional supplements to recommend taking these in more than the recommended daily doses.