MEDICAL SURFARI: PREVENTING COLORECTAL CANCER

Cancer occurs when cells grow, divide and continue to multiply unnecessarily and without order, ravaging normal tissues and organs. Growths of unnecessary cells are called tumors but not all tumors are malignant (cancerous); some are benign (non-cancerous). With any type of cancer, early detection and treatment greatly increases the chances of being cured, so your life depends upon your recognition of warning signs and symptoms.

Cancer is not just one disease but a group of diseases that may arise from virtually any tissue in the body. Most cancers are named after the tissue or body part where the cancer originates. Colon or rectal cancer (colorectal) begins in either the colon (large intestine) or rectum but if it spreads to the lungs or brain it is still considered colorectal cancer and not lung or brain cancer.

Each year approximately 125 to 150 thousand people will be diagnosed with colon cancer. Although the cause is not completely understood, environmental and hereditary factors are believed to lead to colon cancer. Even though the death rate from colorectal cancer has been going down for the past twenty years, there are still about 50 thousand people a year who die from this condition. The main risk factors for colorectal cancer are age older than 50 years, long-standing inflammatory bowel disease (ulcerative colitis and Crohn's disease), family history of colon cancer or intestinal polyps.

In many cases, this type of cancer can be detected early by paying close attention to your body's warning signs. Weakness and fatigue associated with decreased appetite and cramping or gnawing abdominal pain may be an early sign. Bleeding from the rectum or blood in the stool can be caused by something as simple as hemorrhoids or a small rectal tear but if it persists it may be a sign of colorectal cancer. Changes in bowel habits, diarrhea or constipation or narrowing of the stool that lasts more than a few days or a feeling that you need to have a bowel movement that does not seem to go away may be a warning sign. These signs or symptoms do not necessarily mean that you have cancer. For this reason, you must see your doctor for a proper history and examination as well as screening tests.

Screening tests include a rectal examination whereby your doctor checks your rectum with a gloved finger to feel for any abnormalities. Although this is a somewhat undignified examination, it is simple and effective for detecting rectal abnormalities and prostate abnormalities in men. Testing stool samples for blood is another simple screening test. Sigmoidoscopy or colonoscopy involves placing a slender, flexible scope into the rectum and colon to navigate and inspect for polyps (growths that may be benign or malignant). If your doctor sees anything unusual, a biopsy may be done to obtain a diagnosis. Another useful test is a barium enema which uses a chalky barium solution that can be seen on an x-ray to demonstrate polyps or a constriction.

The American Cancer Society recommends that men and women 50 years and older should have periodic screening tests every 5 to 10 years. They also recommend eating at least five servings of fruits and vegetables every day and six servings of other food from plant sources such as bread, cereals, grain products, rice, pasta or beans. Diets made up mostly of foods that are high in fat, especially from animal sources, may increase the risk of colorectal cancer.

If the diagnosis of colon or rectal cancer is made, complete removal of this abnormal tissue is the best therapy to achieve the optimal chance for cure if there is no evidence of metastasis (spread). Sometimes chemotherapy and/or radiation therapy may be recommended after surgical treatment.

Living with a serious disease such as cancer can be very physically and emotionally challenging requiring the support of those close to you. Take responsibility for your health care and schedule periodic screening tests to prevent, as possible, this situation for you and your family.

Worldwide Web Resources

CancerNet http://cancernet.nci.nih.gov/

CancerNet is a web site provided by the National Cancer Institute that can connect you to a wide range of accurate, credible cancer information reviewed regularly by oncology experts.

Dr. Scott Gibbs is a Cape Girardeau neurosurgeon and editor-in-chief of Mosby's Medical Surfari. You may e-mail questions to him at drgibbs@semissourian.com or write in care of the Southeast Missourian, P.O. Box 699, Cape Girardeau, Mo., 63702-0699.