Colorectal Cancer

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Colorectal Cancer
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What Is Colorectal Cancer?

• Colorectal cancer is the thirdmost common cancer
  in menand women.
• It begins in either the colon or rectum, which
  are both part of the digestive system (where food
  is processed).

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The American Cancer Societys Estimates

• In the United States during 2008
• 148,810 new cases of colorectal cancer will be
  diagnosed, including
• 108,070 cases of colon cancer
• 40,740 cases of cancer of the rectum
• 49,960 deaths will occur as the result of
  colorectal cancer

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Who Is At Risk?

• Two factors greatly influence the risk of
  developing colorectal cancer
• 1. Age
• More than 90 of colorectal cancers are
  diagnosed in people over age 50.
• 2. Racial or Ethnic Background
• Gender does not appear tobe a risk factor. Men
  andwomen are similarly affected.

• African Americans have the highest rates of
  colorectal cancer of all racial or ethnic groups
  in US. Ashkenazi Jews have a higher rate of
  colon cancer.

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Other Risk Factors

• Other factors that increase risk include
• If you have ever had colorectal polyps,
  previously been treated for colorectal cancer, or
  had inflammatory bowel disease
• Being physically inactive
• Eating a diet high in fat (especially from red
  meat and processed meats, such as hot dogs,
  bologna and luncheon meat)
• Obesity
• Smoking
• Heavy alcohol use
• Having a family history of colorectal cancers,
  certain other cancers, and benign colon polyps
  (fewer than 10 of colorectal cancers are caused
  by inherited gene mutations)

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Reducing Your Risk

• Early detection can help find and remove
  pre-cancerous polyps (tissue growths.)
• It also appears that the following behaviors may
  reduce risks
• Maintaining a healthy weight
• Getting regular physical activity
• Eating plenty of fruits, vegetables, and
  whole-grain foods
• Limiting high-fat foods, especially red meat and
  processed meats

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Symptoms

• Warning signs include
• Rectal bleeding
• Blood in the stool
• Change in bowel habits
• Cramping or abdominal pain (stomach area)
• These are also warning signs for other, less
  serious illnesses, so if they appear, they should
  be discussed with a doctor.

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Detection

• Colorectal cancers can almost always becured if
  detected early.
• People of average risk with no symptoms
  shouldbegin regular screeningat age 50.
• People at increasedrisk should be screened
  earlierand more often.

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Traditional Detection Methods

• Traditional methods for detecting colorectal
  cancer include
• Flexible sigmoidoscopy A doctor looks inside
  the rectum and the lower part of the colon
  (sigmoid colon) through a lighted tube.
• Colonoscopy A doctor exams the colon using a
  flexible, lighted instrument called a
  colonoscope.
• Double-contrast barium enema X-rays are taken
  after the patient is given a barium enema. Barium
  helps to outline the intestines on the x-rays.
• Fecal occult blood test (FOBT) or fecal
  immuno-chemical test (FIT) Tests for hidden
  blood in the stool

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Newly Recommended Detection Methods

• Two new methods of detecting colorectal cancer
  are recommended
• Virtual colonoscopy
• Stool DNA test with high sensitivity for
  cancer, timing uncertain

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The American Cancer Societys Screening
Recommendations

• Colorectal screening guidelines
  issued in March 2008 group screening test
  options into two categories for persons ages 50
  or older who have no symptoms and are average
  risk
• Tests that can detect precancerous polyps and
  cancer
• Tests that primarily detect cancer

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The American Cancer Societys Screening OPTIONS

• I. Tests that Detect Polyps and Cancer
• Colonoscopy every 10 years
• Flexible sigmoidoscopy every 5 years
• Double-contrast barium enema every 5 years
• Virtual colonoscopy (CT Colonography) every 5
  years
• II. Tests that Primarily Detect Cancer
• Guaiac-based fecal occult blood test (gFOBT),
  annually
• Fecal immunochemical test (FIT) with high
  sensitivity for cancer, annually
• Stool DNA test with high sensitivity for cancer,
  timing uncertain

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Treatment

• Treatment is most successful when cancer is
  detected early.
• Surgery is the only method used for localized
  cancers two or more treatment methods may be
  used for cancer that may have spread.
• Patients should thoroughly discuss treatment
  options with their doctors.

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Treatment Options

• Surgery is generally used, and it usually cures
  colorectal cancer that has not spread.
• Most patients whose cancer has spread receive
  chemotherapy or chemotherapy plus radiation
  before or after surgery.
• Regular follow-up examsand blood tests may be
  recommended.

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Survival Rates

• Five-year relative survival rate for localized
  disease is about 90.
• Localized cancer is cancer that, at the time of
  diagnosis, had not spread to additional sites
  within the body. Typically, the earlier a cancer
  is detected and diagnosed, the more successful
  the treatment, thus enhancing the survival rate.
• Five-year overall relative survival rate for
  colon cancer is 64.
• The five-year relative survival rates represent
  persons who are living five years after
  diagnosis, whether disease-free, in remission, or
  under treatment. They do not imply that five-year
  survivors have been permanently cured of cancer.

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How Will Cancer Affect Me And My Family?

• From the time of diagnosis, everyone is
  affectedin some way, even family and friends.
• The American Cancer Society works to enhance
  aspects of life often challenged by this disease
  through
• Reducing the physical toll of cancer
• Reducing barriers to allow those affected to
  continue with their day-to-day lives
• Reducing the social and financial impact of
  cancer
• Preserving the spiritual well-being of those
  affected

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Patient Concerns

• People with colorectal cancer are often concerned
  about bowel problems, especially in social
  situations, as well as the effects of
  chemotherapy and radiation.
• Other concerns include
• Fear of recurrence
• Chronic and/or acute pain
• Sexual problems
• Fatigue

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Additional Concerns

• Changes in physical appearance
• Depression
• Sleep difficulties
• Changes in what they are able to do after
  treatment
• Impact of cancer on finances and loved ones
• Guilt for delaying screening or treatment or for
  doing things that may have caused the cancer

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You Are Not Alone

• In recent years, the quality of life for
  those who are living with cancer has
  received increased attention.
• No one has to make the cancer journey alone.
  
• The American Cancer Society provides sources of
  information and support to cancer patients, their
  families, and friends. These include access to
  secure and private online chats and support
  groups.

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Hope for the Future

• Researchers are testing prevention methods,
  including whether fiber supplements, minerals,
  medicines, and vitamins can lower risk.
• Studies are expected to lead to new drugs and
  gene therapies to correct genetic problems and
  warn people most at risk.
• Scientists are also studying combinations of new
  chemotherapy drugs, new ways to combine proven
  drugs, and ways to combine chemotherapy with
  radiation therapy or immunotherapy.

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The Bottom Line

• Screening tests offer a powerful opportunity for
  the prevention, early detection, and successful
  treatment of colorectal cancers.
• You can reduce your risk by
• Getting screening for colon cancer starting at
  age 50
• Eating healthy foods, including fruits and
  vegetables
• Limiting intake of red meat and alcohol
• Getting 30-60 minutes of physical activity at
  least five days per week

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Contact The American Cancer Society

• Help from the American Cancer Society is
  available 24 hours a day, 7 days a week.
• To reach us
• Visit the American Cancer Society Internet Web
  site at www.cancer.org.
• Call toll free, 18002272345.

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Additional Resources

• National Cancer InstituteCancer Information
  Service Telephone 18004CANCER (toll
  free)Internet Web site www.cancer.gov
• American Gastroenterological AssociationTelephon
  e 3016542055Internet Web site www.gastro.org
• Colon Cancer AllianceTelephone 18774222030
  (toll free)Internet Web site www.ccalliance.org

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