Colon cancer is the third most common cancer in men, after prostate and lung cancer and second most common in women, after breast cancer.
Colon cancer is considered a silent disease. Most of the time there are no symptoms. The symptoms that people may experience include a change in bowel habits, abdominal pain, blood in the stool, and weight loss. If individuals have these symptoms, the disease may already have advanced.
SCREENING FOR COLON CANCER
The most important action individuals can take to prevent colon cancer is to be screened regularly. However, one in three people between the ages of 50 and 75 have not been screened.
On average, individuals should start being screened at age 50. People who are at high risk, because of family history or because they have other health conditions that predispose them to develop colon cancer, should be screened at an earlier age. There has also been some evidence that African-Americans should start screening at 45 years of age.
If you have a family history of colon cancer — family members who had colon cancer before age 60 or more than two family members with colon cancer, or conditions which predispose you to the disease such as familial polyposis, ulcerative colitis, or Crohn’s disease, then you should be screened at an earlier age.
GOLD STANDARD FOR SCREENING
The gold standard for the diagnosis of colon cancer is colonoscopy. There are other tests available but they are not as reliable or effective as colonoscopy. To prevent colon cancer, individuals should have a colonoscopy on a regular basis. While colonoscopy is not a test most people look forward to undergoing, it is one of the few diagnostic procedures known to save lives.
Using colonoscopy, we look for polyps, which are small growths that can develop into cancer over time. If we can remove polyps before they have a chance to develop into colon cancer, we are preventing colon cancer.
We are often able to remove colon polyps during colonoscopy and no further surgery is required. Once a person develops colon cancer, they may require additional surgery. Ten to 20 percent of the time when we diagnosis a patient, they already have advanced cancer. At this point, they may need further treatment with surgery, chemotherapy or radiation.
In about 60 to 70 percent of patients, we find no polyps. In 30 to 40 percent, we do find polyps. Most of the time, the polyps are small and can be removed during the actual colonoscopy.
If we don’t find any polyps, we recommend a colonoscopy screening again in ten years. If we find polyps, then we want the patient to be screened again in three to five years.
If a patient has polyps, I generally recommend that they change their lifestyle habits by increasing their fiber intake and doing more physical activity. There are also some studies that have suggested aspirin can decrease the risk of developing colon polyps and colon cancer. However, individuals should consult their physician before starting an aspirin regimen.
POSSIBLE RISK FACTORS
Some conditions that predispose you to colon cancer include obesity, lack of physical activity, and a lack of fiber and vitamin D in your diet. In addition, smoking can increase the risk for developing colon cancer as well as excessive use of alcohol.
The survival rate for colon cancer depends on the stage of the disease. If it is caught at an earlier stage, there is almost a 90 to 100 percent survival rate. If the cancer has advanced to Stage III or IV, the survival rate goes down. But, if you combine all of the stages, 61 percent of patients with colon cancer have survived beyond five years with a combination of surgery, chemotherapy and radiation.