Cancer of the Colon and Rectum (Colorectal Cancer)
Definition of colon cancer: Cancer that forms in the tissues of the colon (the longest part of the large intestine). Most colon cancers are adenocarcinomas (cancers that begin in cells that make and release mucus and other fluids).
Definition of rectal cancer: Cancer that forms in the tissues of the rectum which is the last several inches of the large intestine closest to the anus. The anus is he opening at the lower end of the bowel through which feces are released.
Colorectal Cancer in the U.S. and Mississippi
It is estimated that 146,970 men and women (75,590 men and 71,380 women) will be diagnosed with cancer of the colon and rectum in 2009. 49,920 men and women are estimated to die of cancer of the colon and rectum in 2009 (Source: National Cancer Institutes)
When looking at incidence rates by race, black men have the highest incidence rate for men at 69.3 per 100,000 and black women have the highest incidence rate for women at 53.5 per 100,000.
Click here to view more information on Colon and Rectal Cancer from the National Cancer Institutes
In 2008 an estimated 1,470 new cases were diagnosed and 590 men and women were expected to die of colorectal cancer in Mississippi. Colorectal cancer has the fourth highest incidence rate in Mississippi after lung, prostate, and breast cancer but the second highest number of deaths. Incidence and mortality rates have been declining since 1998. Research indicates this decline may be partly related to increased screenings and polyp removal that prevents the progression of polyps to invasive cancers.
Click here to view the Mississippi Comprehensive Cancer Control Plan 2006 - 2011
Colorectal Cancer at Forrest General Hospital
In the Forrest General Hospital Cancer Registry database, colorectal cancer has the fourth highest incidence with 92 new cases reported in 2007.
Colorectal cancer is often one of the most preventable cancers since it frequently develops from polyps that can be detected and removed before they become cancerous. To help prevent cancer of the colon or rectum:
- Get regular screening tests
- Exercise regularly, and maintain a healthy weight
- Eat a diet rich in fruits, vegetables and whole grains
- Don't smoke, and don't drink alcohol excessively
Risk Factors for Colorectal Cancer
Research has shown that people with certain risk factors are more likely than others to develop colorectal cancer. A risk factor is something that may increase the chance of developing a disease.
- Men and women age 50 and older: More than 90% of people with this cancer are diagnosed after age 50.
- People with a personal or family history of colorectal cancer or benign (not cancerous) colorectal polyps
- People with a personal or family history of inflammatory bowel disease, ulcerative colitis or Crohn's disease
- People with a family history of inherited colorectal cancer
- People who use tobacco
- People who are obese or sedentary
To use the National Cancer Institute's Colorectal Cancer Risk Assessment Tool to calculate your individual risk of colorectal cancer, click here.
Symptoms of Colorectal Cancer
In the early stages of colorectal cancer, there may not be any symptoms. Symptoms may begin to appear as the cancer progresses. Pain is usually not an early sign of cancer. The presence of a symptom does not mean you have colorectal cancer but you should consult a physician if you notice the following:
- Rectal bleeding or finding blood in or on the stool (bright red)
- Changes in bowel habits such as having diarrhea or constipation
- Stools that are narrower than usual (may be described as pencil-shaped)
- Frequent or general stomach discomfort (bloating, fullness or cramps)
- Diarrhea, constipation or feeling that the bowel does not empty completely
- Frequent gas pains
- Weight loss for no apparent reason
- Constant tiredness
- Having nausea and/or vomiting
Men and women at average risk should begin regular screening at age 50. If you are at greater risk, you may need to begin regular colorectal cancer screening at an earlier age. Discuss your individual screening needs with your physician. There are many options for screening:
- Have a Fecal Occult Blood Test (FOBT) annually. A FOBT is a test to check for blood in the stool which may be done at home or in the physician's office. Small samples of stool are placed on special cards and sent to a doctor or laboratory for testing. Sometimes cancers or polyps bleed making blood in the stool a possible sign of colorectal cancer. The FOBT can detect tiny amounts of blood in the stool. If blood is detected, other tests are needed to find the source of the blood. Benign conditions (such as hemorrhoids) also can cause blood in the stool.
- Have a sigmoidoscopy every five years, a colonoscopy or double contrast barium enema every five to 10 years. During a sigmoidoscopy or colonoscopy, the physician looks inside your bowel with a lighted tube. If polyps are found, the physician removes them with a procedure called a polypectomy.
- Have a digital rectal exam every five to 10 years at the time of each screening sigmoidoscopy, colonoscopy or barium enema.
- Double-Contrast barium enema. During a barium enema, the person is given an enema with a barium solution, and then air is pumped into your rectum. Several x-ray pictures are taken of your colon and rectum. The barium and air help your colon and rectum show up on the pictures.
- Virtual colonoscopy is a newer method of early detection that is under study. A virtual colonoscopy is a method to examine the inside of the colon by taking a series of x-rays. A computer is used to make 2-dimensional (2-D) and 3-D pictures of the colon from these x-rays.
Treatment of Colorectal Cancer
There are three types of cancer treatment: surgery, chemotherapy, and radiation therapy. Each of these treatments may be used alone or in combination. Surgery is the most common treatment for all stages of colon and rectal cancer. Even if the surgeon removes all the visible cancer during the operation, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy.
Colorectal cancer is usually diagnosed primarily by a gastroenterologist who is a doctor who specializes in diseases of the gastrointestinal system. Once cancer is diagnosed, you may be referred to a surgeon to plan any surgical treatment if needed. Interventional Radiologists may also be involved in some cases. After surgery you may see a Medical Oncologist or a Radiation Oncologist or both for chemotherapy and radiation therapy treatments.
If you do not have a physician, you may locate one by calling FGH OnCall at 1-800-844-4445 or click here to search for a physician who is on staff at Forrest General Hospital.
Other Sources of Information on Colorectal Cancer
Centers for Disease Control and Prevention (CDC) - Colorectal (Colon) Cancer
American Cancer Society - Learn About Colon and Rectum Cancer
American Gastroenterological Association - Patient Center
Colorectal Cancer Coalition
Colon Cancer Alliance
KOSMIX - Colon Cancer Guide