Colorectal Cancer

What is colorectal cancer?

Colorectal cancer, also referred to as colon or rectal cancer, starts in the colon or the rectum. The colon, rectum and anus are part of the large intestine, a long, tube-like organ that processes food and water and helps to pass waste material out of the body. Most colorectal cancers start when cells in the inner lining of the colon or rectum grow out of control. These abnormal growths are called polyps. Over time, some polyps can become cancerous. There are different types of polyps, however, and not all polyps become cancer. Colorectal cancer is the third most common form of the disease and the second leading cause of cancer death in the U.S. Overall, 1 in 23 men (4.3%) and 1 in 25 women (4%) are at risk of developing colorectal cancer in their lifetime. Thanks to screenings and lifestyle changes, the rate of people, especially older adults, being diagnosed with colorectal cancers has dropped in recent decades. However, rates have been increasing in younger people since the mid-1990s.
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What are the signs and symptoms of colorectal cancer?

There are often no signs or symptoms of colorectal polyps or cancer. As a tumor grows, it may bleed or block the intestine. Consequently, the most common warning signs include:

• Blood in the stool or in the toilet after a bowel movement
• Dark or black stools
• Bleeding from the rectum

Any of these symptoms should be reported to your primary health care provider right away.

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How is colorectal cancer diagnosed?

If something abnormal was found on any type of screening test or if a person is having symptoms, a diagnostic colonoscopy may be recommended. Any abnormal tissue can be removed and sent for biopsy.
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What causes colorectal cancer?

More than 50 percent of colorectal cancers have been linked to lifestyle-related factors:

• Being overweight or obese
• Lack of physical activity
• Eating red meat and foods that are high in fat, low in fiber and highly processed
• Not eating enough vegetables and fruits
• Smoking
• Drinking heavy amounts of alcohol

The risk of developing colorectal cancer increases with age. The majority of cases occur in adults ages 50 and older.

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Is colorectal cancer genetic?

Only a small percentage of colorectal cancers appear to be caused by inherited gene mutations. Most gene mutations that lead to colorectal cancer occur during a person’s lifetime.
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Is colorectal cancer curable?

When diagnosed at early stages, colorectal cancer is highly treatable (and with less extensive treatment) and often can be cured.
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How is colorectal cancer treated at FCS?

Each patient and each cancer are unique. At FCS, physicians develop a personalized treatment plan in partnership with patients, and based upon the type and stage of the cancer and whether it has spread to other parts of the body. Treatment for colorectal cancer at early stages often involves surgery. At later stages or if the cancer has spread to lymph nodes, treatment may include chemotherapy, radiation or a combination of both. At FCS, through our extensive clinical trials research program, we offer our patients access to the most advanced treatment options available. FCS is at the forefront of developing novel therapies that are proving effective and considered best-in-class treatment for many forms of cancer.
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What are common risk factors for colorectal cancer?

• If you have Crohn’s disease, ulcerative colitis or other inflammatory bowel disease or a family history of colorectal polyps or cancer, you may be at high risk. Radiation to the abdomen or pelvic area to treat prior cancers can also increase risk.
• A lack of regular physical activity, being overweight or obese, eating a diet high in fat and lacking fruits and vegetables, as well as tobacco use and alcohol consumption, can also contribute.
• A healthy lifestyle can greatly reduce the risk for colorectal and other forms of cancer.

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Is there a screening test for colorectal cancer?

Several screening tests are used to detect polyps, genetic changes or other abnormalities in the colon and rectum. Some tests can actually prevent cancer because they allow polyps to be removed at an early stage, before turning into cancer. The most common tests include:

• Colonoscopy – looks inside the colon and rectum with the use of a thin, long tube with a light and small video camera on the end to check for irritated tissues or polyps. During the procedure polyps or tissue samples can be removed and checked under a microscope for cancer.
• Fecal occult blood test – checks for blood in the stool that can only be seen with a microscope.
• Sigmoidoscopy – less invasive than a colonoscopy, a thin, tube-like instrument is used to look inside the lower colon for polyps, abnormal areas or cancer. Polyps or tissue samples can be removed and checked under a microscope for signs of cancer.
• Virtual colonoscopy – a series of x-ray images are taken to show polyps or other abnormalities on the inside surface of the colon.
• DNA stool test – checks DNA for genetic changes that may signal cancer.

Generally, it is recommended that regular screenings for colorectal cancer begin at age 45. Talk with your doctor to gain a full understanding of the benefits and any risks, and determine which test is recommended for you and how often you should be screened.

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