Wednesday, March 23, 2016

About Colorectal Cancer: Advances in its detection and care

March is Colorectal Cancer 
Awareness Month.
Help us spread the word on how a
 simple procedure can save lives!

"March is Colorectal Cancer Awareness Month, a time to raise awareness about the disease and to encourage action toward prevention.

Colorectal cancer is the third most common cancer in the United States and the second leading cause of death from cancer. Colorectal cancer affects people in all racial and ethnic groups and is most often found in people age 50 and older, but can also be found in younger people. 

The colon is another name for the large intestine is approximately 4-5 feet long. The rectum is the final section of the large intestine that connects the colon to the anus and is about a foot long. "Accordingly, colon cancer develops in the colon and rectal cancer arises in the rectum," says Dr. Daniel Feingold, a board-certified general and colorectal surgeon at New York-Presbyterian/Hudson Valley Hospital in Cortlandt Manor. "Commonly the two cancers are lumped together and are called 'colorectal cancer' but it is helpful to distinguish the two diseases as they have different treatments and different responses to therapy. Generally speaking, it takes many months if not years for colorectal cancer to spread to other organs."

At a glance: colorectal cancer and risk factors

-The risk of colorectal cancer is greatest for adults at least 50 years old, with the incidence increasing every 10 years of life thereafter.
-Risk factors for developing colorectal cancer include having a first degree relative with colorectal cancer (mother, father, sibling), having inflammatory bowel disease, having had pre-cancerous polyps in the past. 
-Routine colonoscopy screenings, which help to examine the intestines and detect irregularities consistent with cancer, are recommended every 10 years for people beginning at age 50 and until age 75.

Common symptoms include bleeding with bowel movements, weight loss, abdominal pain and changes in bowel habits. Colorectal cancer is often referred to as a 'preventable malignancy' since most patients develop a pre-cancerous polyp first, but the polyp can be found during a colonoscopy and removed before it grows and turns into cancer.

The importance of screening

Advances in colorectal cancer detection and care mean patients can greatly reduce the likelihood they will ever develop the condition by having regularly scheduled screenings, the most common of which is the colonoscopy, most often performed by a gastroenterologist or a colorectal surgeon. 

In order to undergo a colonoscopy, the patient needs to cleanse the colon the day before the procedure using laxatives and ingesting fluids to prevent dehydration. The procedure is usually done in an outpatient setting with IV sedation so patients don't feel discomfort. Once sedation takes effect, a thin, flexible tube with a video camera at the end is carefully passed up through the anus and is advanced about five feet to the very beginning of the colon where it connects to the small intestine. Samples may be taken during the procedure. 

Says Dr. Feingold, "If the colonoscopy finds a polyp, the doctor will remove the polyp and plan another colonoscopy to see if new polyps have grown in a few years. If patients have symptoms like bleeding or abdominal pain or changes in bowel habits, the doctor will likely recommend a colonoscopy well before age 50 in order to check the colon. Most patients with colorectal cancer are able to undergo surgery to remove the part of the intestine that has the cancer. The success rate of this, in terms of cure, depends on the stage of the cancer."

Using a team approach that includes a colorectal surgeon, a medical oncologist, and for rectal cancer patients a radiation oncologist, has helped to improve patient outcomes according to Dr. Feingold. 

Advances in detection and care

Research is ongoing in the prevention and treatment of colorectal cancer, and there is a focus on developing new, even more effective screening tests. In addition to traditional surgery to treat colorectal cancer, less invasive surgical techniques include the use of laparoscopic surgery (several small incisions in the abdomen instead of one large one) and robotic surgery (where the surgeon uses a robotic arm to preform the procedure). Studies are also being performed that involve the use of targeted drug therapies (which affect specific parts of cancer cells that make them different from normal cells), and immunotherapy (using the body's own immune system to fight the cancer).

"The hope is that with continued study of colorectal cancer, we can find its cause with the hope of using that knowledge to prevent it altogether," says Dr. Feingold."

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