Colon Cancer

Cancer of the colon or rectum (colorectal) develops in the digestive tract, also known as the gastrointestinal or GI tract. The colon, or large bowel, is a muscular tube about 5 feet long and is divided into 4 parts: Ascending, Transverse, Descending and the Sigmoid colon. The rectum connects the sigmoid colon to the anus and is six inches in length. Cancer can develop in any of sections in the colon and or rectum. Depending on the location, the symptoms differ as well as the tests to detect the cancer.

How Many People Are Affected By Colon Cancer?

Colorectal cancer is the third most common cancer diagnosed in both men and women, and the second leading cause of death in the United States. An estimated 145,300 new cases will be diagnosed in 2005, with 56,300 deaths from colon cancer.

Who Is At Risk For Colon Cancer?

Age increases risk - 50 years or older make up 90% of cases

Familial colorectal cancer syndromes:

  • Familial Adenomatous polyposis (also associated with Gardner’s syndrome): Makes up 1% of colon cancers all before age 40
  • Hereditary Nonpolyposis Colon Cancer (HNPCC): Makes up 3-4% of colon cancers. HNPCC is a genetic syndrome where women also have increased risk of endometrial cancer. Ask your doctor and seek genetic counseling (microsatellite instability testing) if the following Amsterdam criteria pertains to you:
  • At least 3 relatives with colorectal cancer, and at least one less than age 50 at presentation
  • Two successive generations involved, and at least two are first degree relatives

Ethnic background:

  • Jews of Eastern European descent (Ashkenazi Jews)
  • African Americans: highest death rate in U.S.
  • Personal History of colorectal cancer
  • Personal History of colorectal polyps: adenomatous (and hyperplastic if located in the ascending colon)
  • Chronic Inflammatory Bowel Disease: Crohn’s Disease or Ulcerative Colitis
  • High fat diet, animal sources. The ACS recommends 5 servings of fruits and vegetables a day

All The Following Increases The Risk Of Colorectal Cancer:

  • Sedentary lifestyle
  • Obesity
  • Diabetes
  • Smoking

What Are The Signs And Symptoms Of Colon Cancer?

Early colon cancer has no symptoms. Once the cancer is more advanced, signs and symptoms occur. Absence of symptoms is not a reason to delay colon cancer testing. Tell your doctor if you have any of the following symptoms:

  • Change in bowel habits: diarrhea or constipation, narrowing of stool diameter that lasts for more than a few days
  • Feeling like you have to have a bowel movement, that does not go away after you have the bowel movement
  • Bleeding from the rectum or blood in the stool
  • Cramping or gnawing stomach pain
  • Decreased appetite
  • Weakness and fatigue
  • Jaundice

How Can You Prevent Colon Cancer?

Early detection: Finding and removing the adenomatous polyp. Colonoscopy every 10 years starting at age 50, age 45 for African Americans.

Can You Survive Colon Cancer?

If colorectal cancer is found, early detection and treatment dramatically increases chances for survival. The relative 5 year survival rate for colorectal cancer in an early stage is 90%, compared to 67% if the cancer has spread to adjacent organs or lymph nodes. If the cancer has spread to the distant organs, such as liver and lungs 10% 5 year survival. only 39% of colon cancers are found at an early stage.

How Can You Lower Your Risk Of Developing Colorectal Cancer?

Follow the testing guidelines set by the American Cancer Society/ American College of Gastroenterology - See colon polyps/ colon cancer screening recommendations

Know your family history, maintain a healthy lifestyle:

  • No cigarette smoking. Exercise regularly, eat plenty of fruits, vegetables, whole grains, and maintain a healthy body weight. Daily multivitamin, with folic acid, vitamin D and calcium. Daily aspirin may reduce risk.

Will My Health Insurance Cover The Colon Cancer Screening?

Most health insurance plans cover some form of colon cancer screening. Not all cover the full range of options recommended by the American Cancer Society. Medicare does cover these screening tests. Contact your health insurance carrier for more information.

What Does Medicare Cover For Colon Cancer, People Age 50 And Older Who Have No Symptoms?

  • Yearly take-home fecal occult blood test
  • Flexible sigmoidoscopy every 4 years
  • Colonoscopy covered every 10 years, or 4 years after a flexible sigmoidoscopy
  • Double-contrast barium enema as an alternative to sigmoidoscopy or colonoscopy if requested in writing by the provider.

How Is Colon Cancer Treated?

There are 3 main types of treatment: Surgery, radiation therapy and chemotherapy. Treatment depends on the stage of the tumor.