To aim the campaign, we’ve gathered together some key points about this type of cancer that you may find helpful.
Here are a few stats about Colorectal Cancer (or Bowel Cancer in the UK)
- It’s the third most common cancer diagnosed in the United States and the 4th most common in the UK
- Your risk increases the older you get. The incidence is highest in people aged 85 to 89
- African Americans have the highest colorectal cancer incidence and mortality rates of all racial groups in the US - for reasons that are not fully understood
- Overall, the lifetime risk of developing colorectal cancer in the US is slightly higher for men than women: about 1 in 23 for men and 1 in 25 for women
- Every year the disease kills about 53,200 people in the US and 16,200 in the UK
- It’s estimated that 54% of bowel cancer cases in the UK are preventable
- 32% of people in the US are not up to date with their screening
- With an early diagnosis, 92% of people will survive their disease for five years or more, compared with 1 in 10 (10%) people when the disease is diagnosed at the latest stage.
Because the survival rate is so much higher following an early diagnosis, it is very important that you take up the offer of screening - if your healthcare system offers it. If not, and you feel you fall into a high-risk category, you may want to ask your doctor.
Causes of Colorectal Cancer
Although there is still more research required to determine the exact causes, studies have shown that the frequency of bowel cancer is greater in countries that eat a diet high in fat and low in fiber. It has also been suggested that high alcohol intake, particularly of beer, may be linked to this cancer.
- Given that 54% of colorectal cancer is preventable, these are the things you can control:
- Being overweight
- Lack of exercise
- Diet that's high in red meats (such as beef, pork, lamb, or liver)
- Processed meats (like hot dogs and some luncheon meats)
- Cooking meats at very high temperatures (frying, broiling, or grilling) creates chemicals that might raise your cancer risk
- Heavy use of alcohol
However, there are also things that you can’t change
- Old age – as you get older the risk increases
- You suffer from an inflammatory bowel disease such as ulcerative colitis or Crohn’s disease
- A family history of colorectal cancer or adenomatous polyps
- Inherited syndromes such as Lynch syndrome, Familial adenomatous polyposis (FAP)
- You have type 2 diabetes
If you fall into the latter group, ask your doctor about early screening.
Symptoms of colorectal cancer
It’s not easy to spot because many of the symptoms can be caused by conditions other than colorectal cancer, such as infection, hemorrhoids, or irritable bowel syndrome. But if you have any of these problems, it’s important to see your doctor right away so the cause can be found and treated:
- A change in bowel habits - this will generally be the first thing you notice, such as diarrhea and constipation.
- A feeling that you haven’t managed to completely empty your bowels.
- Bleeding from your rectum – watch out for darker stools
- Cramping or pain in your abdominal
- Generally listless or tired
- Sudden weight loss not attributed to your diet
If your symptoms have lasted six or more weeks, you need to see a specialist.
How can colorectal cancer be diagnosed?
Luckily you can be screened for colorectal cancer. As with all cancers the earlier you catch it, the better the outcome.
In the US screening starts at 45 years of age, in the UK, if you are generally in good health, you'll have to wait until you're 60 (on the NHS). But every country is different so check with your doctor.
Some people may be at higher risk based on their family health history and other risk factors so might need to start testing earlier.
A screening test is used to look for a disease when a person doesn’t have symptoms. Colorectal cancer almost always develops from precancerous polyps (abnormal growths) in the colon or rectum. Screening tests can find precancerous polyps so that they can be removed before they turn into cancer.
Generally, screening will require a stool sample and a colonoscopy, which is a visual examination of the colon and rectum for any abnormal areas. This is done either with a scope (a tube-like instrument with a light and tiny video camera on the end) put into the rectum or with special imaging (x-ray) tests.
If the screening requires further investigation or you have already started to develop symptoms, you may undergo one or more of the following procedures:
- Physical examination: your doctor will feel your abdomen for masses or enlarged organs, and also examine the rest of your body. You may also have a digital rectal exam (DRE). During this test, the doctor inserts a lubricated, gloved finger into your rectum to feel for any abnormal areas.
- Sigmoidoscopy & colonoscopy: during these investigations, the doctor passes a scope (a tube with a small camera on the end) into your bowel. A sigmoidoscopy looks at the lower part of your large bowel, while the colonoscopy looks further up the colon.
- Barium enema: this is an X-ray examination using barium which brightens the X-ray picture. The barium is given as an enema and will outline the lower part of your bowel.
- Biopsy: the doctor may need to remove a small piece of tissue with a special instrument passed through the scope. Less often, part of the colon may need to be surgically removed to make the diagnosis.
- Other tests: you may also have other tests, which can include blood tests, abdominal ultrasound, CT scan or MRI scan
If you’re diagnosed with colorectal cancer, treatment will usually be an operation to remove the cancer and/or to relieve your symptoms. You may also have chemotherapy or radiotherapy as well as an operation.
- Surgery: some early signs of colon cancers, generally found through screening, polyps can remove be removed during a colonoscopy.
If the cancer is more developed an operation may be performed to remove the cancer and part of the bowel on either side of this. Depending on the extent of the operation the two ends of the bowel may be stitched together,
If the tumor is sited low in your rectum, there may not be enough bowel left to join together. In this case, you may have to have a colostomy formed. A colostomy, or stoma, is an artificial opening created when the healthy part of your bowel is brought out onto the surface of your abdomen. You will need to wear a bag to collect your stools.
In some situations, you may need to have a temporary colostomy formed to rest your bowel while healing takes place. This is usually only for a few weeks and will be discussed with you by your doctor.
- Radiation Therapy: this form of therapy uses high-energy rays (such as x-rays) or particles to destroy cancer cells. It's more often used to treat people with rectal cancer than for people with colon cancer. For some colon and rectal cancers, treating with chemotherapy at the same time can make radiation therapy work even better. Using these 2 treatments together is called chemoradiation or chemoradiotherapy.
- Chemotherapy: this is a drug treatment that may be recommended for you. Chemotherapy means treatment with anti-cancer drugs, which are given to destroy or control cancer cells by damaging them so that they can't divide and grow.
- Targeted Therapy Drugs: these work differently from standard chemotherapy (chemo) drugs. They sometimes work when standard chemo drugs don’t, and they often have different (and less severe) side effects. They can be used either along with chemo or by themselves if chemo is no longer working.
- Immunotherapy: this is the use of medicines to help a person’s own immune system better recognize and destroy cancer cells. Immunotherapy can be used to treat some people with advanced colorectal cancer.
Many people do not know the symptoms of this cancer and, furthermore, do not know that screening exists – so please do your bit and spread the word.
Sources: The American Cancer Society, Cancer Research UK, Royal Marsden Hospital, Centers forDisease Control and Prevention (US)
If you or anyone you know has been affected by colorectal cancer, you can find support and advice from people fighting cancer right now, on the Facebook Chemotherapy Support Group.
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