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March Is National Colorectal Awareness Month

Originally Posted: February 26, 2010

Dr. Eyad M. Ali, FACG, FASGE

March Is National Colorectal Awareness Month. (colonclub.com)

Southampton - March is National Colorectal Awareness month, and it's a good time to learn more about colorectal cancer, how it can be prevented and how it's treated.

Colorectal cancer, which includes cancer of the colon and rectum, is the second leading cause of cancer related deaths in the United States after lung cancer. According to the American Cancer Society, there are almost a 150,000 new cases of colorectal cancer that were diagnosed and approximately 50,000 people died from the disease last year.

Despite these staggering statistics, and unlike some cancers, colorectal cancer is highly preventable and can be detected early through proper screening.

Although a potentially serious disease, if left undetected and untreated, colorectal cancer can often be prevented through a healthy diet, regular exercise, and routine screenings. Of course, the key is to catch it early if the disease is present. This stresses the importance of regular screenings. The risk of developing colorectal cancer increases with advance in age, with roughly 90 percent of cases occurring in people aged 50 or older.

Men and women, age 50 and over, should be screened at least every five to 10 years because of the increased risk for developing colorectal cancer. Some people are at a higher risk and should be screened at an age younger than 50, including those with a personal or family history of inflammatory bowel disease, colorectal cancer or polyps.

If everyone aged 50 or older were screened regularly, as many as 60 percent of deaths from this cancer could be avoided. Colorectal cancer screening costs are covered by Medicare and most commercial health insurance plans, usually starting at age 50 for the most common tests.

As we know, colorectal cancer screenings saves lives, however, many people who are at risk for the disease are not being screened according to national guidelines. In most cases, colorectal cancer develops from pre-cancerous polyps (abnormal growths) in the colon or rectum. During screening tests precancerous polyps can be found and removed before they turn into cancer. Screening tests can also find colorectal cancer early when treatment works best.

Some studies show that increased physical activity and maintaining a healthy weight may decrease the risk for colorectal cancer. Evidence is less clear about other ways to prevent this. Currently there is no consensus on the role of diet and preventing colorectal cancer.

Medical experts recommend a diet low in animal fats and high in fruits, vegetables and whole grain products to reduce the risk of other chronic diseases, such as heart disease and diabetes.

In addition, researchers are examining the role of certain medications and supplements including aspirin, calcium, vitamin D, and selenium in preventing colorectal cancer. While these supplements may reduce the risk of colorectal cancer, the most effective way to reduce your risk is by having regular colorectal cancer screenings beginning at age 50.

Colonoscopies are a type of procedure that is performed by your doctor in the hospital or office setting. Colonoscopies remain the gold standard for colorectal cancer screenings and are a very safe and effective procedure when performed by a physician with specialized training in gastrointestinal disorders.

The colonoscopy is the test most gastroenterologists recommend as the single best screening exam for colorectal cancer. It's the only method that combines both screening and prevention.

For those unfamiliar with the colonoscopy, this procedure involves the examination of the colon by using a long flexible lighted tube, called a colonoscope, through which the doctor can view the entire colon and rectum for polyps or cancer. The colonoscope has a camera at the end, which can project images on a screen.

If a polyp is found, it can be removed by a wire loop that is passed through the colonoscope and hooked around the base of the polyp. The doctor then sends an electric current through the loop which severs the polyp from the colon wall and pulls it out of the colon. The polyp is then sent to the lab and tested to determine whether it is cancerous.

This procedure requires patients to be sedated and it takes approximately 30 minutes. Some pressure may be felt from the instrument's movements during the exam and there may be some cramping afterwards. The colonoscopy can be performed safely in an Ambulatory Surgical Center, an outpatient office, or a hospital setting. Patients do not have to be hospitalized for this examination.

For the test preparation, your doctor will prescribe the diet, often clear liquids, for the day prior to your examination, and laxatives or enemas will be required.
Colorectal cancer begins as a polyp, which is a tissue growth that starts on the lining of the colon or rectum. Identifying and removing a polyp early in its development may prevent it from becoming cancerous.

Colorectal cancer often has no symptoms until the disease has progressed beyond its earliest stages. Some potential signs and symptoms of colorectal cancer to watch for, and to ask your physician about, include a change in bowel habits, such as constipation, diarrhea, or a narrowing of the stool that lasts for more than a few days. Another symptom is the feeling of needing to have a bowel movement that doesn't go away after doing so. Rectal bleeding, dark stools, or blood in the stool, cramping, stomach pain, weakness and tiredness are also potential symptoms of colorectal cancer.

There are several things you can do to lower your risk of developing colorectal cancer. Get regular colorectal cancer screenings beginning at age 50. Eat a low fat, high fiber diet. If you use alcohol, drink only in moderation. If you use tobacco, quit smoking. If you don't use tobacco, then don't start. Alcohol and tobacco in combination are linked to colorectal cancer and many other cancers. Exercise for at least 20 minutes three to four days each week. Moderate exercise such as walking, jogging or climbing steps may help.

Can colorectal cancer be cured? There are very few symptoms associated with colorectal cancer so regular screenings are essential. A screening is beneficial for two main reasons. The first is colorectal cancer is extremely preventable with polyps that lead to the cancer are detected and removed. It is also very curable if detected in its early stages. If detected colorectal requires surgery in nearly all cases for a complete cure, sometimes in conjunction with radiation and chemotherapy. Between 80 percent to 90 percent of patients are restored to normal health with the cancer detected and treated in the early stages. However, the cure rate drops to 50 percent or less when diagnosed in the later stages.

The United States Preventative Services Task Force recommends screening for colorectal cancer for all people until they reach 75 years old and for some people when they are older than 75. If you are in this age group ask your doctor if you should be screened. Other tests are being evaluated and recommended by the United States Preventative Services Task Force for use in colorectal cancer screening in the future, including CT Colonography also known as a virtual colonoscopy, and stool DNA testing. However, these procedures are still experimental and colonoscopy is still the gold standard.

In honor of March being National Colorectal Awareness month, get screened, and encourage your family and friends to save their lives and get screened as well. Call your gastroenterologist and schedule an appointment today.

 • Eyad M. Ali, MD, FACG, FASGE, Twin Forks Gastroenterology and Hepatology, PC, 34 East Montauk Highway, Suite 1, Hampton Bays, 631-723-0600, twinforksgi@optonline.net

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