Colon Cancer Overview & Treatment

Colorectal cancer involves the proliferation of malignant or cancerous cells within the colon / large intestine or rectum. It represents 8% of both new cases and deaths associated with all forms of cancer. It is estimated that over 1 million people currently live with colorectal cancer in United States.

Several factors, including increased awareness and better screening, have helped the number of new cases as well as deaths due colorectal cancer decrease steadily over the past 20 to 30 years. However, lifetime risk of developing colorectal cancer is still high at over 4%.

Risk Factors for Colon Cancer

There are several known risks for colorectal cancer some of which are modifiable (in bold) and others not. The most common risks include:

• Age – over 90% of all colorectal cancers are diagnosed after age 50
• Race – African Americans have a higher incidence of colorectal cancer
• Smoking
• Excessive alcohol use
• Obesity
• A sedentary lifestyle
• Poor eating habits
• Family history – if a close family member had colorectal cancer, the patient’s risk is increased as well.
• Heredity (genetics)
• Ulcerative Colitis or Crohn’s Disease can, in some cases, lead to cancer

Patients can reduce their risk of developing colorectal cancer by improving their lifestyle and addressing the modifiable factors above.

Screening for Colon Cancer

Colon cancer screening rates have improved over the years and have led to diagnoses at ever earlier stages. As a result, the incidence and death rates associated with colon cancer have steadily diminished. Colon cancer screening is both accessible and accurate. Patients with some or all of the risk factors detailed above should speak to their primary care physician or specialist to determine an appropriate screening program. Most patient should begin screening at age 50. Speak with your doctor if someone in your family has been diagnosed with colorectal cancer as you may need to begin screening earlier.

Treatment Options

Options for treating colon cancer largely depend on the location, spread and aggressiveness of the malignancy. Typically, colon cancers are slow-growing, however there are also highly aggressive variants. Potential treatment by stage are discussed below:

• Stage 1: Cancer has not spread beyond the walls of the colon. In this case, colon resection surgery to remove part of the large intestine is necessary.
• Stage 2: Cancer has spread to nearby tissue but not to the lymph nodes. A colectomy will likely be the first course of treatment, possibly followed by a round of chemotherapy, known as adjuvant chemotherapy.
• Stage 3: Cancer has spread to nearby tissue and lymph nodes. A colectomy to remove the diseased section of the colon and affected lymph nodes will be followed by a round of chemotherapy, known as adjuvant chemotherapy.
• Stage 4: Cancer has spread to other organs – usually the liver, lungs and brain. Treatment choices become more complex at this point and depend on the characteristics of the cancer. Treatment may begin with surgery followed by chemotherapy if there are just a few, operable tumors in the body. A significant number of tumors or inoperable tumors may require chemo first (neoadjuvant therapy) to shrink them. This may be followed by surgery to remove operable tumors or relieve symptoms and then another round of chemo. At this stage immunotherapy and radiation may also be considered depending on the tumors’ reaction to chemo and surgery.

Clearly, with so many potential treatment options, visiting a qualified specialist is crucial to better long-term outcomes. We look forward to helping you through this difficult time starting with a consultation at our office.