Dr Schneider employs a comprehensive approach to the treatment of colon cancer and rectal cancer, with integrated use of surgery, radiation when applicable and chemotherapy.
What is Colorectal Cancer Screening?
Checking for Colorectal cancer (Colon cancer) or for abnormal cells that may become cancer in people who have no symptoms is called screening.
Screening can help doctors find and treat several types of cancer early before they cause symptoms.
Early detection is important because when abnormal tissue or colon cancer is found early, it may be easier to treat.
By the time symptoms appear, cancer may have begun to spread and be harder to treat.
It is important to remember that when your doctor suggests a screening test, it does not always mean he or she thinks you may have colon cancer.
Screening tests are done when you have no cancer symptoms. When a person has symptoms, diagnostic tests are used to find out the cause of the symptoms.
Sidenote: If you have a strong family history of colorectal polyps or cancer, you have a higher risk of getting colorectal cancer yourself.
Cancer in first-degree relatives such as parents, brothers, and sisters is most concerning.
Having two or more relatives with colorectal cancer is more concerning than having only one relative with it, which is why we recommend you be screened more regularly if this is the case with you.
Is Screening for Colon Cancer Effective?
From the time the first abnormal cells start to grow into polyps, it usually takes about 10 to 15 years for them to develop into colorectal cancer.
With regular screening, most polyps can be found and removed before they have the chance to turn into cancer.
Regular colorectal cancer screening is one of the most powerful weapons for preventing and finding traces of colorectal cancer.
If you’re interested in the latest Colorectal cancer findings, click here.
When Should You be Screened for Colon Cancer?
People at risk of colorectal cancer should start regular screening before the age of 45.
Those who do not have a family history of colon cancer should get screened at age 45 onwards.
There are some exceptions to this below:
- If you are experiencing symptoms, talk to your doctor immediately.
- If you have a family history of colorectal cancer or polyps, we recommend getting screened 10 years before the age of the youngest case in your immediate family (mother, father, sister, brother)
- If you have ulcerative colitis, inflammatory bowel disease or Crohn’s disease we recommend also getting screened.
Symptoms of Colorectal Cancer
Many people with colon cancer experience no symptoms in the early stages of the disease.
When symptoms appear, they’ll likely vary, depending on cancer’s size and location in your large intestine.
Consult with a Gastroenterologist if you have these symptoms:
- A persistent change in your bowel habits, including diarrhoea or constipation or a change in the consistency of your stool.
- Blood in your stool.
- Persistent abdominal discomforts, such as cramps, gas or pain.
- Bleeding from the rectum.
- Feeling like the bowel is not empty after a bowel movement.
- Weakness or fatigue.
- Unexplained weight loss and loss of appetite.
- A lump in the abdomen or rectum.
Test Options for Colorectal Cancer Screening
Several test options are available for colorectal cancer screening:
1. Stool-based tests:
- Highly sensitive faecal immunochemical test (FIT) every year.
- Faecal occult blood test (FOBT). This test finds blood in the faeces, or stool, which can be a sign of polyps or cancer. There are two types FOBT: guaiac and immunochemical.
- Multi-targeted stool DNA test (MT-sDNA) every 3 years.
2. Visual (structural) exams of the colon and rectum:
- During this procedure, the doctor inserts a flexible, lighted tube called a colonoscope into the rectum. The doctor can check the entire colon for polyps or cancer.
- CT colonography (virtual colonoscopy) every 5 years.
- The doctor uses a flexible, lighted tube called a sigmoidoscope to check the lower colon for polyps and cancer. The doctor cannot check the upper part of the colon with this test.
Can Colon Cancer be Prevented?
Keeping your body healthy can lower your chances of getting colon cancer. Here are some steps you can take to decrease your risk.
- Stop Using Tobacco – Talk to your doctor about ways to quit that may work for you.
- Maintain a Healthy Diet – Fruits, vegetables and whole grains contain vitamins, minerals, fibre and antioxidants, which may play a role in cancer prevention.
- Skip Alcohol – If you drink alcohol, drink only in moderation.
- Exercise Regularly – Maintaining a healthy weight and getting regular exercise such as walking, gardening, or going to the gym will reduce your risk.
- Don’t Forget Vitamins – Take calcium or folic acid supplements.
- Know Your Family History – Talk with your Gastroenterologist if you are concerned about your personal or family history of cancer and decide when to start regular cancer screening.
- Get Screened – Be sure to get regular check-ups and talk to your health care provider about cancer screening.
Stages of Colorectal Cancer
Staging describes or classifies cancer based on how much cancer there is in the body and where it is when first diagnosed. This is often called the extent of cancer.
The stage is the most important prognostic factor for colorectal cancer. The lower the stage at diagnosis, the better the outcome.
For colorectal cancer, there are 5 stages – stage 0 followed by stages 1 to 4. More information can be found here.
The cancer cells are only in the inner lining of the colon or rectum (mucosa) and have not grown past the muscle layer of the mucosa.
The tumour has grown into the layer of connective tissue that surrounds the mucosa (submucosa) or into the thick outer muscle layer of the colon or rectum (muscularis propria).
Many stage II colon cancers have grown through the wall of the colon, and maybe into nearby tissue, but they have not spread to the lymph nodes.
Stage III colon cancers have spread to nearby lymph nodes, but they have not yet spread to other parts of the body.
The cancer has spread to other parts of the body (called distant metastasis), such as to the liver or lungs. Even though stage 4 cancer is not considered curable, there are many treatment options available.
Surgery is the primary treatment for most colorectal cancers. Depending on the stage and location of the tumour, you may have one of the following types of surgery:
Removing Polyps During a Colonoscopy (Polypectomy)
If your cancer is small and in the early stage, and has not spread to other body parts, your doctor may be able to remove it completely during a colonoscopy.
Minimally Invasive Surgery (laparoscopic surgery)
Polyps that can’t be removed during a colonoscopy may be removed using laparoscopic surgery.
In this procedure, your surgeon operates through several small incisions in your abdominal wall, inserting instruments with attached cameras that display your colon on a video monitor.
Chemotherapy is a common treatment for colorectal cancer. It is often used after surgery for stage 2 and 3 colon cancer.
Chemotherapy can be used as the main treatment for stage 4 or recurrent cancer in the colon or rectum that can’t be removed by surgery.
Chemoradiation combines chemotherapy with radiation therapy. Chemotherapy is given during the same period as radiation therapy.
Radiation therapy is mainly used for cancer in the rectum. It is usually used before surgery and may be given as part of chemoradiation.
Targeted therapy is used to treat stage 4 colorectal cancer that has spread to distant organs like the liver or lungs.
Follow-up after treatment is an important part of cancer care. You will need to have regular follow-up visits, especially in the first 5 years after treatment has finished.
These visits allow your gastroenterologist to monitor your progress and recovery from treatment.
DISCLAIMER: PLEASE READ CAREFULLY
The information on this website is to provide general guidance. In no way does any of the information provided reflect definitive medical advice and self-diagnoses should not be made based on information obtained online. It is important to consult a Gastroenterologist or medical doctor regarding ANY and ALL symptoms or signs including, but not limited to: abdominal pain, haemorrhoids or anal / rectal bleeding as it may a sign of a serious illness or condition. A thorough consultation and examination should ALWAYS be performed for an accurate diagnosis and treatment plan. Be sure to call a physician or call our office today and schedule a consultation.
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© Dr. H Schneider, Registered Gastroenterologist, GI Doc Johannesburg
Our website information is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a doctor about your specific condition. Only a trained physician can determine an accurate diagnosis and proper treatment.