Colorectal cancer is a disease in which cancer cells develop in the colon or rectum.  It is estimated by the American Cancer Society that approximately 132,700 cases of colorectal cancer will be diagnosed in the United States, and nearly 49,700 men and women will die of the disease this year.

Risk Factors

There are several factors which may increase a person’s chances of getting colon or rectal cancer, including:

• Age – chances of being diagnosed with colorectal cancer increase as a person gets older
• Family history – having close relatives with colorectal cancer increases a person’s risk of developing the disease
• Diet – diets high in fat and low in calcium, folate and fiber may increase the risk
• Ethnicity – Jews of Eastern European descent have a higher rate of colon cancer
• Genetic alterations – certain syndromes that involve family members having hundreds of polyps in their colon or rectum may make someone more likely to get colorectal cancer
• History of colorectal polyps – common in people over the age of 50, some growths on the inner wall of the colon or rectum can become cancerous
• Smoking – may increase risk of developing polyps and colorectal cancer
• Alcohol – heavy use of alcohol has been linked to the disease
• History of bowel disease – a disease called ulcerative colitis (Crohn’s colitis) increases the risk of colon cancer
• Lack of exercise – people who are not active have a higher risk of colorectal cancer
• Overweight – being very overweight increases a person’s risk

Signs and Symptoms

Men and women who experience any of the following signs or symptoms should consult their healthcare provider:

• change in bowel habits
• diarrhea, constipation or feeling that the bowel does not empty completely
• blood in the stool
• stools that are narrower than usual
• abdominal discomfort such as cramps, gas pain or bloating
• unexplained weight loss
• fatigue
• nausea and vomiting

Screening

The American Cancer Society recommends both men and women begin screening at age 50 with one of five options (listed below).  People at higher-than-average risk should discuss screening at an earlier age with their physicians.

• Fecal occult blood tests (FOBT) or fecal immunochemical tests (FIT) – stool blood tests, which can detect small amounts of blood in the stool, should be administered yearly.
• Flexible sigmoidoscopy - every five years a physician should check inside the rectum and lower colon for polyps with a lighted tube.
• Double Contrast Barium Enema - every five years patients should have an enema with a barium solution and air pumped into rectum. Then x-rays are taken of the colon and rectum to detect polyps.
• Colonoscopy - every 10 years a physician should examine the inside rectum and colon using a long, lighted tube called a colonoscope.  The colonoscope is longer than a sigmoidoscope, which is used during a sigmoidoscopy, and allows physicians to view the entire colon.

Staging

If cancer is found, an oncologist will need to determine the progression of cancer.  This classification, called staging, allows the healthcare provider to properly identify a treatment plan and to determine the prognosis.  All cancers are staged on a Roman numeral scale, I-IV (1-4), where the higher stage represents a more advanced cancer.

Treatment

Treatment options are different for colorectal cancer and rectum cancer, but may include surgery, radiation therapy or chemotherapy.  Each treatment option may be used alone or in combination. 

• Surgery is the removal of malignant polyps, either through the anus with a colonoscope, or through an incision in the abdomen to remover the tumor and part of the colon or rectum.  Surgery is the most common treatment for all stages of rectal cancer.
• Radiation Therapy is the use of high-energy rays to kill cancer cells in the treated area.  It is usually administered from a machine outside the body.
• Chemotherapy is the use of drugs to kill cancer cells.  The drugs are administered orally or infused directly into the bloodstream.  The drugs travel throughout the body reaching cancer cells that may have spread beyond the colon or rectum to other parts of the body.