Colorectal Cancer

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Colorectal Cancer
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What Is Colorectal Cancer?

• Colorectal cancer is the thirdmost common cancer
  in menand women.
• It begins in either the colon or rectum, which
  are both part of the digestive system (where food
  is processed).

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The American Cancer Societys Estimates

• In the United States during 2008
• 148,810 new cases of colorectal cancer will be
  diagnosed, including
• 108,070 cases of colon cancer
• 40,740 cases of cancer of the rectum
• 49,960 deaths will occur as the result of
  colorectal cancer

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Who Is At Risk?

• Two factors greatly influence the risk of
  developing colorectal cancer
• 1. Age
• Over 90 of colorectal cancers are diagnosed in
  people over age 50.
• 2. Racial or Ethnic Background
• Gender does not appear tobe a risk factor. Men
  andwomen are similarly affected.

• African Americans have the highest rates of
  colorectal cancer of all racial or ethnic groups
  in US. Ashkenazi Jews have a higher rate of
  colon cancer.

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Other Risk Factors

• Other factors that increase risk include
• A personal history of colorectal polyps,
  previously treated colorectal cancer, or
  inflammatory bowel disease
• Being physically inactive
• Eating a diet high in fat (especially from red
  meat)
• Obesity
• Smoking
• Alcohol use
• Eating a diet low in fruits and vegetables
• Having a family history of colorectal cancers,
  certain other cancers, and benign colon polyps
  (Fewer than 10 of colorectal cancers are caused
  by inherited gene mutations.)

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Reducing Your Risk

• Early detection can help find and remove
  pre-cancerous polyps (tissue growths).
• It also appears that the following behaviors may
  reduce risks
• Regular physical activity
• Eating plenty of fruits, vegetables, and
  whole-grain foods
• Limiting high-fat foods, especially red meat and
  processed meats

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Symptoms

• Warning signs include
• Rectal bleeding
• Blood in the stool
• Change in bowel habits
• Cramping pain in the lower abdomen
• These are also warning signs for other, less
  serious illnesses, so if they appear, they should
  be discussed with a doctor.

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Detection

• Colorectal cancers can almost always becured if
  detected early.
• People of average risk with no symptoms
  shouldbegin regular screeningat age 50.
• People at increasedrisk should be screened
  earlierand more often.

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Traditional Detection Methods

• Traditional methods for detecting colorectal
  cancer include
• Flexible sigmoidoscopy A doctor looks inside
  the rectum and the lower part of the colon
  (sigmoid colon) through a lighted tube.
• Colonoscopy A doctor exams the colon using a
  flexible, lighted instrument called a
  colonoscope.
• Double-contrast barium enema X-rays are taken
  after the patient is given a barium enema. Barium
  helps to outline the intestines on the x-rays.
• Fecal occult blood test (FOBT) or fecal
  immuno-chemical test (FIT) Tests for hidden
  blood in the stool.

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Newly Recommended Detection Methods

• Two new methods of detecting colorectal cancer
  are recommended
• Fecal immunochemical test (FIT) with high
  sensitivity for cancer, annually
• Stool DNA test with high sensitivity for
  cancer, timing uncertain

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The American Cancer Societys Screening
Recommendations

• Colorectal screening guidelines
  issued in March 2008 group screening test
  options into two categories for persons ages 50
  who have no symptoms and are average risk
• Tests that detect precancerous polyps and cancer
• Tests that primarily detect cancer

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The American Cancer Societys Screening OPTIONS

• I. Tests that Detect Polyps and Cancer
• Colonoscopy every 10 years
• Flexible sigmoidoscopy every 5 years
• Double-contrast barium enema every 5 years
• Virtual colonoscopy (CT Colonography) every 5
  years
• II. Tests that Primarily Detect Cancer
• Guaiac-based fecal occult blood test (gFOBT),
  annually
• Fecal immunochemical test (FIT) with high
  sensitivity for cancer, annually
• Stool DNA test with high sensitivity for
  cancer, timing uncertain

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Treatment

• Treatment is most successful when cancer is
  detected early.
• Often two or more treatment methods are used.
• Patients should thoroughly discuss treatment
  options with their doctors.

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Treatment Options

• Surgery is generally used, and it usually cures
  colorectal cancer that has not spread.
• Most patients whose cancer has spread receive
  chemotherapy or chemotherapy plus radiation
  before or after surgery.
• Regular follow-up examsand blood tests may be
  recommended.

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Survival Rates

• 5-year relative survival rate for localized
  disease is 90
• Localized cancer is cancer that, at the time of
  diagnosis, had not spread to additional sites
  within the body. Typically, the earlier a cancer
  is detected and diagnosed, the more successful
  the treatment, thus enhancing the survival rate.
• 5-year overall relative survival rate is 64
• The 5-year relative survival rates represent
  persons who are living 5 years after diagnosis,
  whether disease-free, in remission, or under
  treatment. They do not imply that 5-year
  survivors have been permanently cured of cancer.

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How Will Cancer Affect Me And My Family?

• From the time of diagnosis, everyone is
  affectedin some way, even family and friends.
• The American Cancer Society works to enhance
  aspects of life often challenged by this disease
  through
• Reducing the physical toll of cancer.
• Reducing barriers to allow those affected to
  continue with their day-to-day lives.
• Reducing the social and financial impact of
  cancer.
• Preserving the spiritual well-being of those
  affected.

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Patient Concerns

• People with colorectal cancer are often concerned
  with bowel dysfunction and the associated social
  stigma, as well as the effects of chemotherapy
  and radiation.
• Other concerns include
• Fear of recurrence
• Chronic and/or acute pain
• Sexual problems
• Fatigue

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Additional Concerns

• Changes in physical appearance
• Depression
• Sleep difficulties
• Changes in what they are able to do after
  treatment
• Impact of cancer on finances and loved ones
• Guilt for delaying screening or treatment or for
  doing things that may have caused the cancer

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You Are Not Alone

• In recent years, the quality of life for
  those who are living with cancer has
  received increased attention.
• No one has to make the cancer journey alone.
  
• The American Cancer Society provides sources of
  information and support to cancer patients, their
  families, and friends. These include access to
  secure and private online chats, message boards,
  and support groups.

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Hope For The Future

• Researchers are testing prevention methods,
  including whether fiber supplements, minerals,
  medicines, and vitamins can lower risk.
• Studies are expected to lead to new drugs and
  gene therapies to correct genetic problems and
  warn people most at risk.
• Scientists are also studying combinations of new
  chemotherapy drugs, new ways to combine proven
  drugs, and ways to combine chemotherapy with
  radiation therapy or immunotherapy.

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The Bottom Line

• Screening tests offer a powerful opportunity for
  the prevention, early detection, and successful
  treatment of colorectal cancers.
• People can reduce their risk by following
  screening guidelines eating a healthy, low-fat
  diet and increasing their level of physical
  activity.

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Contact The American Cancer Society

• American Cancer Society programs and services are
  available 24 hours a day, 7 days a week.
• To reach us
• Visit the American Cancer Society Internet site
  at www.cancer.org.
• Call toll-free, 1800ACS2345.

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Additional Resources

• National Cancer InstituteCancer Information
  Service Telephone 18004CANCER (toll
  free)Internet www.cancer.gov
• American Gastroenterological AssociationTelephon
  e 3016542055Internet www.gastro.org
• Colon Cancer AllianceTelephone 18774222030
  (toll free)Internet www.ccalliance.org
• United Ostomy AssociationTelephone
  18008260826 (toll free) or 7146608624Inter
  net www.uoa.org

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