If ever a disease needed a month devoted to it, it is colorectal cancer. It affects a region of the body that many people would rather not think about or discuss, even with a physician. Unfortunately, that is the main reason why colorectal cancer is so lethal in this country, where it is the second leading cause of cancer deaths. More than 50,000 Americans die from colorectal cancer each year.
Television correspondent Katie Couric’s husband, Jay Monahan, was one of them. Since he died from the disease at age 42, Couric has taken on the cause of bringing public awareness to colorectal cancer, launching a gastrointestinal cancer and wellness center at New York Presbyterian Hospital. She had her first colonoscopy televised on The Today Show in an attempt to demystify the procedure – and promote that screening really is the key to prevention. According to the Centers for Disease Control (CDC), if everyone 50 years old or older were screened regularly, up to 60 percent of colorectal cancer deaths could be prevented. About nine out of every 10 people whose colorectal cancer is diagnosed early are still alive five years post-diagnosis.
Colorectal cancer occurs in the colon (also called the large intestine) or the rectum. Almost all cases begin as polyps – growths occurring in that region. The majority of polyps are benign, but some will continue to grow and become cancerous. It’s not entirely clear why this happens, but we do know that in some cases there may be a genetic predisposition for the disease. Some cases may begin when cells become damaged with age.
Reducing Your Risk
Most cases of colorectal cancer – more than 90 percent – occur in people over 50. People who have inflammatory bowel disease may have a higher-than-normal risk. So do people with a family history of colorectal cancer. Diabetes, obesity, smoking and excessive alcohol use are also thought to increase risk.
You can help reduce your own risk for colorectal cancer by maintaining a healthy weight and getting regular exercise, and by eating five servings a day of fruits and vegetables. Quitting smoking and reducing alcohol consumption can also lower risk.
Some studies have also suggested that NSAIDs such as aspirin and ibuprofen can contribute to a lower colorectal cancer risk. Talk to your physician to find out the latest research on the subject. Taking these drugs regularly can lead to risks of heart problems and internal bleeding, so these must be weighed against the potential benefits.
Colorectal cancer may have symptoms, including unexplained weight loss, long-lasting stomach pains, recurring diarrhea or constipation, and narrow or bloody stools, but it’s important to remember that there may be no symptoms at all. That’s why screening is so important.
The U.S. Preventive Services Task Force has made recommendations for people starting at age 50 (except for individuals in a high-risk group; their physicians may recommend beginning screening earlier). These recommendations are:
- A stool test every year, to check for traces of blood in the stool.
- A flexible sigmoidoscopy every five years. During this test, the physician inserts a thin, flexible tube with a camera on the end into the patient’s rectum and examines the last two feet of the large intestine.
- A colonoscopy every 10 years. This test is similar to the sigmoidoscopy, but it is more rigorous. It allows the physician to examine the entire colon. The colonoscopy also allows the doctor to remove polyps during the procedure.
One of the latest developments in colorectal cancer screening is called a virtual colonoscopy, a procedure that uses CT scan technology to produce cross-sectional images of the colon, which together create a three-dimensional view of the intestine. This procedure is somewhat less invasive than a regular colonoscopy, but it does still involve inserting a small tube into the rectum so that air can be pumped into the colon, making it larger and easier to see. Not all physicians believe this test is as accurate as a traditional colonoscopy, though, and if growths are detected during the test, a second procedure is needed to remove them. But the virtual imaging does have the advantage of including more of the pelvic and abdominal area, and thus has some ability to check for abnormalities in those regions as well.
Deaths from colorectal cancer have been dropping in recent years, possibly because of increased awareness of the disease and more people getting screened – following Katie Couric’s test, there was a 20 percent increase in colonoscopies, according to research from the University of Michigan. Don’t wait for your doctor to bring it up. Ask what you can do to prevent colorectal cancer.