Blum Center Program: Current Approaches for Colorectal Cancer Screening
In this presentation from February 3, 2022, Dr. Daniel Chung discusses specific risks for colon cancer that can help guide your choice of screening test.
The Tucker Gosnell Center for Gastrointestinal Cancers is one of the largest and most experienced centers in New England for the treatment of cancers of the colon and rectum.
Colorectal cancer may begin in either the colon (large intestine) or the rectum. Cancer is caused by malignant (cancerous) cells that grow and multiply without control. These growths, called polyps, may start noncancerous, but can turn into cancer over time. When cancer begins in the tissues of the colon, it is called colon cancer. When it forms in the tissues of the rectum, it is called rectal cancer. Because colon cancer and rectal cancer have many features in common, they are sometimes referred to together as colorectal cancer.
Making up 95% of colorectal cancer, adenocarcinoma is the most common form and often starts as polyps in the cells lining the large intestine. Doctors can screen for polyps during a colonoscopy and may remove them before they turn into cancer.
Each year, an estimated 150,000 new cases of colorectal cancer in U.S. adults is diagnosed. With about 50,000 deaths from colorectal cancer annually in the U.S., it is the second-leading cause of cancer death in both men and women. Colorectal cancer is the third-most diagnosed form of cancer for both men and women worldwide. The death rate for colorectal cancer has dropped annually, largely attributed to early screening practices finding and removing polyps before they turn cancerous.
When cells on the inner lining of the colon or rectum grow abnormally, they can produce polyps. While natural for cells to grow, divide and die to keep the body functioning properly, polyps may continue multiplying abnormally and develop cancerous cells. It may take multiple years for a polyp to become cancerous and not all polyps do so. Symptoms of colon cancer from polyps generally do not occur until they've become large or cancerous, so screening to remove polyps at an early stage, before signs of colon cancer appear, can help prevent the growth of cancerous polyps.
The risk of colorectal cancer increases with age, but a mix of other health conditions and lifestyle influences can impact colorectal cancer risk factors:
The majority of colorectal cancer cases are not tied to a family history of the cancer. Still, up to 30% of all colorectal cancer diagnoses come in families with a history of the cancer.
Colorectal cancer signs and colon cancer symptoms will present themselves differently in patients. Often those with colon cancer do not notice symptoms in the cancer's early stages and when they do show, the colorectal cancer signs vary based on the cancer's size and location within the colon or rectum.
Colon cancer symptoms may include:
Rectal cancer symptoms may include:
The symptoms of colorectal cancer may look similar to those associated with other medical conditions. Please consult your doctor if you notice any of the above symptoms.
Screening for colorectal cancer means testing for something abnormal before it gives you symptoms. This allows colon cancer or rectal cancer to be found earlier. The sooner colorectal cancer is found, even before colorectal cancer signs appear, the smaller—and more treatable—it is likely to be.
Tests commonly used to screen for colorectal cancer include:
The first step in diagnosing any disease is to complete a medical history and physical examination. If necessary, more tests and procedures are used to find and diagnose colorectal cancer. (As outlined above, several of these are also used for screening purposes.)
Following a diagnosis of colorectal cancer, further tests are done to determine the location or density of cancer cells. This process, known as staging, helps your doctor choose the best treatment for you. Imaging tests, surgery and X-rays are common approaches for staging colorectal cancer.
Stages of colorectal cancer range from Stage I (early-stage cancer) to Stage IV (cancer is advanced and has spread to other parts of the body, or metastatic colorectal cancer).
Your care team will work with you to develop a treatment plan that is right for you. This plan will depend on many factors, including type and stage of colorectal cancer, your general health, and your treatment preferences.
Treatment may involve one or more of these options:
Colorectal cancer prevention should center around both screenings and reducing risk factors within your control. Colorectal cancer screening is one of the most effective ways to catch polyps before they turn cancerous or when the cancerous cells are small and easier to treat. Lifestyle factors, such as eating healthy, staying at a healthy weight, eliminating alcohol and smoking and increasing exercise can all help to reduce the risk of colorectal cancer.
Adenocarcinoma of the colon makes up 95% of all colorectal cancer, the most common form. Adenocarcinoma starts in the cells lining the large intestine as a polyp. Other colorectal cancer types include colorectal carcinoma, carcinoid tumors, gastrointestinal stromal tumors, colorectal lymphoma along with hereditary nonpolyposis colorectal cancer and familial adenomatous polyposis.
Colorectal cancer can mean cancer of either the colon or the rectum, so colorectal cancer and colon cancer are effectively the same.
Early stages of colorectal cancer don't always produce symptoms. The early colon cancer signs and symptoms may include abdominal pain, rectal pain or bleeding, change in bowel habits, bloody, black or sticky bowel movements, weight loss for no apparent reason, nausea and vomiting or swelling of the abdomen.
Colorectal cancers are commonly treated and cured when the cancer remains in the colon or rectum. Surgery has proven successful in eliminating the cancerous cells, although recurrence is common for colorectal cancer.
It is not uncommon for pain from the cancer site within the colon or rectum to present as lower back pain. Typically, though, back pain accompanies other symptoms of colorectum cancer.
Learn more about colorectal cancer and meet Aparna Parikh, MD, medical director of the Center for Young Adult Colorectal Cancer at Mass General Cancer Center, who details why colorectal cancer is being increasingly diagnosed in younger patients around the world.
Mass General has the only proton therapy site in all of New England, with two proton therapy centers.
Our support programs can help patients and their families cope with the challenges of a cancer diagnosis.
In this presentation from February 3, 2022, Dr. Daniel Chung discusses specific risks for colon cancer that can help guide your choice of screening test.
A colonoscopy is the primary and most effective screening technique used to screen patients for colorectal cancer. Learn more in this video from Dr. Ted Hong, GI Radiation Oncologist at the Mass General Cancer Center.
Colorectal cancer is the third most common cancer diagnosed in both men and women in the United States. A portion of these colon cancers are due to genetic predisposition genes. The Blum Center shares more in a recent presentation.
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