Did you know that Colorectal Cancer is the 2nd leading cancer killer in North America? Despite this, early diagnosis can prevent deaths from this cancer which "no one talks about". This means that you should seek medical advice for symptoms rather than ignoring them. Those at High Risk for getting this cancer will also benefit from screening examinations.

High Risk for Colorectal Cancer
Patient with past history of colorectal polyps or cancer
Family history of colorectal polyps or cancer
Familial polyposis
Ulcerative colitis
Patient with past history of breast cancer - it is controversial if this increases risk of getting colorectal cancer

Early symptoms of Colorectal Cancer include painless rectal bleeding and a change in bowel habit. Abdominal pain and weight loss occur later. Unfortunately some of these cancers are silent and the patient will not complain of anything. Often the bleeding is not visible but is "occult" and only detected by Hemoccult testing of the stool.

A polyp is an abnormal growth of cells that line the colon and rectum. With time (5-10 years) some of the cells in a polyp can grow out of control and a cancer then develops. Removing colon polyps will prevent Colorectal Cancer. Most polyps found in the colon are benign and many never become cancer. Unfortunately you cannot predict which polyp will grow into a cancer so it's best to remove all polyps in the colon.

If your doctor finds a polyp in your colon or rectum, you should have your entire colon checked with colonoscopy as there is a good chance (30%) you may have polyps elsewhere in the colon. Most polyps can be removed without surgery with the help of colonoscopy. After your first colonoscopy, your colon will have to be rechecked in a year and then at least every 3-5 years as new polyps may grow back in the future. Rarely if the polyp is too large to remove with the colonscope, surgery may be necessary.

If you have a cancer in the colon or rectum, the entire colon should be examined with colonoscopy or barium enema X-ray. Most of the time, surgery is the treatment for Colorectal Cancer. In preparation for surgery, you will have tests to ensure that there is no spread (metastasis) of the cancer. To prevent infection that can complicate the surgery, you will be given antibiotics and laxatives/enemas to cleanse the colon. Fortunately, infection occurs rarely. Frequently, even if the cancer is near the rectum, it can be removed without a colostomy. A colostomy cannot be avoided if the cancer is very close to the end of the rectum. In that situation, in order to be cured, the rectum and sphincter (muscles of control) are removed with the cancer. The remaining colon is brought out through the abdomen as an opening (colostomy) to pass stool. The need for a colostomy will depend on the location of the tumor, your build (i.e. obese), and the skill of your surgeon.

Prognosis, or how well you will do after the surgery, will depend on the stage of the cancer (how far has it spread?), the type of tumor (analysis by pathologist), and the surgery you received. Certain tumors may require additional treatment with chemotherapy or radiation to improve the prognosis. However, if the cancer was found early, surgery may be the only treatment necessary. After surgery, your doctor may want to monitor your progress closely for the first few years to look for any tumor recurrence.

Colorectal Cancer is a common disease. One way to improve our ability to treat this cancer is to detect it earlier. You should have a screening checkup if you have a close family member with this cancer or polyps or if you are known to have polyps of the colon. Someone in this "high risk" category has 2-3 times greater chance of getting this cancer than the normal person. Symptoms such as rectal bleeding or change in bowel habit should not be ignored. Despite the present infatuation for gimmicks and new technology in treatment, I would put greater emphasis on the experience and skill of the physicians and surgeons treating this disease.

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