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Colon Cancer: The Silent Killer

Colorectal cancer, sometimes referred to as colon rectal cancer or colon cancer, is a "silent killer." In this article on colorectal cancer, we provide you with information about colorectal cancer to help you understand this deadly form of cancer.

Most of us probably know someone who has passed on way too early in their lives. Some may not have had a choice, while others might have been able to do something to prevent dying so young. It is especially disturbing when any person is taken by something that could have been detected early and possibly prevented altogether. If this is the circumstance, loved ones are often left with the question of "What if?" Those two words can tear people and families apart. They're left wondering if they might have been able to do something to help save their loved one. This is especially true of the silent killer known as colorectal cancer. This "life robber " is especially dangerous because it does not discriminate between men or women, doctors or lawyers, firefighters or homemakers, rich or poor. It is an equal opportunity disease and killer, and one which we can, and must, defeat.

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He Had It All

We all probably know someone like Ed. He was a person who seemed to have it all — a wonderful family, a thriving business, a nice home, very loyal friends and relatives who truly loved and respected him. When Ed walked into a room, it lit up from his love for people, energy for life and his bubbly personality. Yep, Ed had it all, including the deadly silent killer, colon cancer. This disease snuck up on him and took his life at the young age of 54. Sadly, Ed's untimely death may have been prevented if he had just taken the time to get a colorectal screening when he turned 50 — a key age to begin this preventive health check.

Is Colon Health a Big Problem?

Sure, talking about bowels, colons and rectums can be awkward, but guess what? They are part of life. Ignoring this subject can lead to an early death — a death that could possibly have been prevented. Years back, both prostate and breast health were topics the general population were hesitant to talk about. Now, there is great public awareness on these topics and, as a result, lives are being saved. It's time the topic of colon and rectal health was brought to the forefront of public awareness. The reason? Excluding skin cancer, the American Cancer Society (ACS) states that colorectal cancer is the third most common cancer diagnosed in men and women in the United States, as well as the second leading cause of cancer death in our country. In fact, the ACS estimates that about 147,500 new cases of colon cancer will be diagnosed in 2003, and sadly, this disease will take the lives of more than 57,100 in this very same year. These numbers make it a true public health problem, even though a large percentage of colorectal cancer could have been, and can be, prevented. But there is some good news here: The death rate from this type of cancer has been declining for the past 20 years, perhaps because of increased public awareness, earlier colorectal cancer screenings and better treatment.

See the next page to learn more about risks and symptoms of colon cancer.

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Unfortunately, colorectal cancer can happen to anyone. There are certain risk factors, however, which are known to increase the chances of it happening.

  • Age: Colorectal cancer is more likely to occur as a person gets older, but it can strike the younger set in some cases.
  • Ulcerative Colitis: This condition causes the lining of the colon to become inflamed. Those who suffer from ulcerative colitis are at an increased risk for developing colorectal cancer.
  • Diet: People who maintain a diet containing a lot of fats and calories seem to be at a greater risk for colorectal cancer.
  • Polyps: These are noncancerous growths on the inner lining of the colon and rectum. Even though they are very common in people over age 50, certain types of polyps can develop into a dangerous cancer.
  • History: Women with a history of ovarian, uterine or breast cancer have a slightly increased risk of developing colorectal cancer. Also, those with a parent or sibling with colorectal cancer have a higher risk.
  • Diabetes: Not a commonly advertised fact, people with diabetes have a 30 to 40 percent increased risk of developing colon cancer.

Time Is On Your Side

Tumors of the rectum and colon often begin as small growths about the size of a mushroom, which we call polyps. Most polyps are noncancerous (benign), but a small percentage can turn cancerous (malignant). The good news is that the turnaround from a benign to a malignant growth often takes at least five years. This offers a window of opportunity to detect and remove these polyps before they affect your health. The statistics show that if cancerous cells are detected in the colon before they spread, the removal of the affected polyps can produce a cancer cure in more than 90 percent of cases. But the bad news is that only one in four Americans undergo the recommended colorectal screenings at the appropriate intervals, so many of these polyps go undetected, making cancer more probable.

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The Symptoms of Colorectal Cancer

Because colorectal cancer can strike without any warning signs, it is very important to get regular checkups. Without these screenings, by the time this cancer is found it may be too late. There are certain symptoms, however, which may signify that cancer is lurking inside. Please don't get alarmed if you are suffering from any of the symptoms I am about to mention. These can be the result of other, noncancerous, medical conditions. But no matter what, it is very important to check with your health care professional, even if just for reassurance.

  • Change in bowel habits. Most of us know our regular patterns, but if there is a noticeable change, perhaps more constipation, diarrhea or even leakage, it may be cause for concern.
  • Blood on or in your stool. I know, not fun to have to look, but this simple check may save your life. Please know that blood may indicate cancer, but that there are also many other noncancerous reasons for it to be present. In either case, it's best to get it checked.
  • Unusual gas or abdominal pain.
  • Unexplained weight loss.
  • Fatigue that isn't like your "usual" tired feeling.
  • Unexplained low blood count, or anemia.
  • Unexplained vomiting.

I know it is often scary to go to the doctor, especially with these symptoms, but we need to work together to identify what is causing your change in health. Hopefully, it is something noncancerous and easy to treat. But if it is a colorectal cancer, early detection gives us a terrific chance of helping you beat it.

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If you are in good health and do not have a family history of colorectal cancer, the American Gastroenterological Association recommends annual stool screenings using a fecal occult blood test (FOBT) beginning at age 50. This test involves putting a small amount of stool on a specially treated card, which is then sent to a lab to check for traces of blood not detectable by the naked eye. This test has been credited with reducing deaths from colorectal cancer by one-third.

Next, it is vitally important to get a digital rectal examination, plus one or more of the following recommended tests: a sigmoidoscopy, double-contrast barium enema or a colonoscopy.

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  • A sigmoidoscopy is an examination of the lower third of the colon (where 60 percent of the cancers occur) using a flexible lighted instrument. This should be done once every five years.
  • A double-contrast barium enema (recommended once every five years beginning at age 50) may be used for elderly patients or patients with heart disease. If abnormal, a colonoscopy is needed.
  • Colonoscopy is one of our best weapons against colorectal cancer because it can both detect and prevent the disease. This test also involves using a flexible lighted instrument, but the advantage is that it examines a more extensive area of your colon, and should be done once every 10 years.

The type of test(s) you should get will be determined by your overall health, as well as by an in-depth discussion with your physician.

An important exception to the age 50 recommendation is if you or your family have a history of colorectal cancer or polyps, or if you or a loved one has a history of ulcerative colitis or Crohn's disease. If the answer is yes, then preventive health screenings will begin at age 40, or perhaps even earlier.

Over the past several years, I have known two wonderful physicians who didn't take the time to get checked for colorectal cancer. I can still picture both of them in their hospital beds. They were so vibrant just a year earlier attending to others in those very same beds. Unfortunately, both were diagnosed late in their disease and were lost from this life in their mid-50s. This didn't have to happen, because colorectal cancer has an enemy — early screening and treatment. We have it in our power to make the first move, and the time is now. For further information about this nasty disease, please call the American Cancer Society at 1-800-ACS-2345.

Copyright 2003, Dr. Rob Danoff

Robert Danoff, D.O., M.S., is a family physician. He is program director of Family Practice Residency Frankford Hospitals, Jefferson Health System, Philadelphia, Pa. He also is a medical correspondent for The Comcast Network, CN8, contributing writer to the New York Times and writes a weekly medical column for the Bucks Courier Times, Bucks County Pa.

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