Colon Cancer
Colon cancer is also called colorectal cancer. In the United States, colorectal cancer is the fourth-most common cancer in men, after skin, prostate and lung cancer. It is also the fourth-most common cancer in women, after skin, lung and breast cancer.
Symptoms
Common symptoms of colorectal cancer include:
- A change in bowel habits
- Diarrhea, constipation or feeling that the bowel does not empty completely
- Blood (either bright red or very dark) in the stool
- Stools that are narrower than usual
- General abdominal discomfort (frequent gas pains, bloating, fullness, and/or cramps)
- Unexplained weight loss
- Constant tiredness
- Nausea and vomiting
Most often, these symptoms are not due to cancer. Other health problems can cause the same symptoms. Anyone with these symptoms should see a doctor so that any problem can be diagnosed and treated as early as possible.
Screening
Colon cancer diagnosis involves the use of screening tools. Screening for cancer before a person has symptoms can help the doctor find polyps or cancer early. Finding and removing polyps may prevent colorectal cancer. Also, treatment for colorectal cancer is more likely to be effective when the disease is found early.
To find polyps or early colorectal cancer:
- People in their 50s and older should be screened.
- People who are at higher-than-average risk of colorectal cancer should talk with their doctor about whether to have screening tests before age 50, what tests to have, the benefits and risks of each test, and how often to schedule appointments.
The following screening tests are used to detect polyps, cancer or other abnormalities in the colon and rectum. The doctor can explain more about each test:
- Fecal occult blood test: Sometimes cancers or polyps bleed, and the FOBT can detect tiny amounts of blood in the stool. If this test detects blood, other tests are needed to find the source of the blood. Benign conditions (such as hemorrhoids) also can cause blood in the stool.
- Sigmoidoscopy: The doctor checks inside the rectum and lower (sigmoid) colon with a lighted tube called a sigmoidoscope. If polyps are found, the doctor removes them.
- Colonoscopy: The doctor examines inside the rectum and entire colon using a long, lighted tube. The doctor removes polyps that may be found.
- Double-contrast barium enema: A DCBE is a series of X-rays of the colon and rectum. The patient is given an enema with a barium solution, and air is pumped into the rectum. The barium and air outline the colon and rectum on the X-rays. Polyps may show up on the X-ray.
- Digital rectal exam: A rectal exam is often part of a routine physical examination. The doctor or nurse inserts a lubricated, gloved finger into the rectum to feel for abnormal areas in the lower part of the rectum.
Diagnosis
If tests show an abnormal area (such as a polyp), a biopsy to check for cancer cells may be necessary. Often, the abnormal tissue can be removed during a colonoscopy or sigmoidoscopy. A pathologist checks the tissue for cancer cells using a microscope.
Treatments
Treatment depends on a number of factors, including the type of cancer; the size, location and extent of the tumor; and the general health of the patient. Many different treatments and combinations of treatments may be used to control colon cancer, and/or to improve quality of life by reducing symptoms.
Surgery
Surgery is an operation to remove the cancer. The type of surgery a doctor performs depends on the location of the tumor. Some tumors can be removed with a colonoscope. Others may require an incision in the abdomen. If a section of the colon or rectum is removed, the surgeon can usually reconnect the healthy parts. However, sometimes reconnection is not possible. In this case, the surgeon creates a new path for waste to leave the body.
Chemotherapy
Chemotherapy uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. The way the chemotherapy is given depends on the type and stage of the cancer being treated. The Medical Oncology/Hematology Division at Sinai directs the chemotherapy program at LifeBridge Health.
Radiation therapy
Radiation therapy uses high-energy X-rays or other types of radiation to kill cancer cells. The Department of Radiation Oncology at Sinai Hospital provides the most advanced radiotherapy for many cancers.