National Colorectal Cancer Awareness Month 2020

March is National Colorectal Cancer Awareness Month, officially declared in February 2000 by President Clinton as a time to spotlight a pervasive form of cancer whose incidence rate is increasing. Since then, it has grown to be a rallying point for the colon cancer community where thousands of patients, survivors, caregivers, and advocates throughout the country join together to spread colorectal cancer awareness by wearing blue, holding fundraisers and educational events, talking to family and friends about screening, and so much more. 

 

 

What is Colorectal Cancer?

Colorectal cancer occurs in the colon or rectum. The term colorectal cancer is used to describe colon cancer, rectum cancer, or both. The colon is part of the large intestine or large bowel. The rectum is the passageway that connects the colon to the anus. 

Colorectal cancer, when discovered early, is highly treatable. Even if it spreads into nearby lymph nodes, surgical treatment followed by chemotherapy is highly effective. In the most difficult cases - when the cancer has spread to the liver, lungs, or other sites - treatment can help make surgery an option for many, as well as prolonging and adding to one's quality of life. Research is consistently being done to learn more and provide hope for people, no matter what stage their cancer is in.

 

Most colorectal cancers develop first as polyps, which are abnormal growths inside the colon or rectum that may later ulcerate, or become cancerous if not removed. 

Colorectal cancer is actually the 3rd most common cancer in the United States, and the 2nd leading cause of cancer death. It affects men and women of all racial and ethnic groups, and is most often found in people 50 years or older. However, there has been an increase in colorectal cancer diagnosis in those younger than 50. 

This disease claims the lives of more than 50,000 people every year. The goal of the Colorectal Cancer Alliance is to help educate people on how to prevent the disease and lower that high statistic.

 

Colorectal Cancer Statistics & Risk Factors

This year, the American Cancer Society estimates that 95,520 people will be diagnosed with colon cancer, 39,910 will be diagnosed with rectal cancer, and 50,260 people will die from this disease. On average, the lifetime risk of developing colon cancer is about 1 in 23 for men and women combined - or 4.5%. Of course, this does vary widely according to individual risk factors. Approximately 71% of cases arise in the colon, and approximately 29% in the rectum.

Age

The median age at diagnosis for colon cancer is 68 in men and 72 in women, whereas for rectal cancer, it is 63 years old for both men and women. As a result of rising colon and rectal cancer incidence rates in younger age groups coincident with declining rates in older age groups, the proportion of cases diagnosed in people younger than 50 years old increased from 6% in 1990 to 11% in 2013. 72% of these cases occur in people who are in their 40s.

Your family history, ethnicity and even race can put you at a higher risk for colorectal cancer. For example, colon cancer and rectal cancer incidence and mortality rates are highest in African Americans. 

People with a parent, sibling, or child who have or has colorectal cancer are between two and three times the risk of developing the cancer than those without a family history.

Survival Rates

The colorectal cancer survival rate has been increasing, due to increased awareness and screening. By finding polyps and cancer in the earlier stages, it is easiest to treat. Improved treatment options have also contributed to a rise in survival rates as well.

The 5 year survival rate for colorectal cancer found at the local stage is 90% At the regional stage, the survival rate is 71%, and at the distant stage, the survival rate is 14%. There are currently more than 1 million colorectal cancer survivors alive in the United States today.

 

Staging

According to the American Cancer Society, 39% of colon and rectal cancer patients are diagnosed with localized stage disease. 35% of colon and rectal cancer patients are diagnosed with regional stage disease. And, 21% of colon and rectal cancer patients are diagnosed with distant stage disease. 

Stage 0: This is the earliest stage possible. Cancer hasn't moved from where it started; it's still restricted to the innermost lining of the colon. Stage 0 is also called Carcinoma in Situ. Surgery is required, but chemo, radiation or interventional radiology are not. 

Stage I: Cancer has begun to spread, but it is still in the inner lining. Stage 1 is also called Dukes A colon cancer. Surgery is required, but chemo, radiation or interventional radiology are not. 

Stage II: Many of these cancers have grown through the wall of the colon and may extend into nearby tissue. They have not yet spread to the lymph nodes. Stage II is also called Dukes B colon cancer. Surgery, chemotherapy, and radiation (for rectal cancer) are required, where interventional radiology is not.

Stage III: Cancer has spread to lymph nodes, but has not been carried to distant parts of the body. Stage III is also called Dukes C colon cancer. Surgery, chemo, and radiation (for rectal cancer) are required, and interventional radiology is not.

Stage IV: Cancer has been carried through the lymphatic system to distant parts of the body, most commonly the lungs and the liver. This is known as metastasis. Stage IV is also called Duked D colon cancer. Surgery, chemo, radiation, and interventional radiology are all required.

 

Symptoms

Colorectal cancer first develops with few, if any symptoms. Be proactive and talk to your doctor about getting screened regularly. If symptoms are present, they may include the following:

A change in bowel habits: including diarrhea, constipation, a change in the consistency of your stool or finding your stools are narrower than usual. 

Persistent abdominal discomfort: such as cramps, gas, or pain and/or feeling full, bloated, or that your bowel doesn't empty completely. 

Rectal bleeding: finding blood - either bright red or very dark in your stool. 

Weakness or fatigue: can also accompany losing weight for no known reason, nausea, or vomiting. 

Colorectal cancer symptoms can also be associated with many other health conditions. Only a medical professional can determine the cause of your symptoms. Early signs of cancer often do not include pain. It is important not to wait before seeing a doctor. Early detection can save your life. 

Remember, the most common symptom is no symptom - which is why colorectal cancer is often called a silent killer. If you're age 50 or older and at average risk, get screened! If you're 50 or younger, but with a family history - get screened! Tomorrow can't wait. 

 

Treatment Options for Colorectal Cancer

Treatment for colorectal cancer depends on the location of the tumor and the stage of the diagnosis. Treatment may involve:

• Surgery
• Chemotherapy
• Immuno-oncology
• Biological Therapy
• Liver Directed Therapy
• Radiation Therapy

 

Screening & Prevention

Screening is the number one way you can reduce your risk of colon cancer and rectal cancer. Despite its high incidence, colorectal cancer is unique in that it is one of the most preventable and, if found early, most treatable forms of cancer. Screening is fairly simple, as there is an option for everyone. If you're over 50, high risk or symptomatic, don't put it off! Talk to your doctor about getting screened!

There are several forms of screening methods, including:

Colonoscopy: Where the inside of the rectum and entire colon are examined using a long, lighted tube called a colonoscope. 

Stool DNA: Instead of looking just for blood in the stool, these tests look for certain DNA mutations caused from cancerous tumors or precancerous polyps. 

Virtual Colonoscopy: Where X-rays and computers are used to take 2 or 3D images of your colon and rectum. 

Remember:

ALL MEN AND WOMEN should be screened for colon cancer beginning at age 50, if not earlier. 

FAMILY HISTORY OF COLORECTAL CANCER: People with personal or family history of colorectal cancer, inflammatory bowel disease, or experiencing symptoms are considered high risk. The majority of colorectal cancer patients do not have a family history or genetic connection to the disease. This is when the cancer occurs by chance, and is called sporadic cancer.

However, in some families, cancer occurs more than we want or expect. About 1 in 4 patients have a family history of colorectal cancer that could suggest a genetic and/or hereditary factor. A family history of colorectal cancer, where an immediate family member or multiple family members with colorectal cancer or polyps, puts you at an increased risk for the disease.  

SHOWING SIGNS & SYMPTOMS: If you're exhibiting signs & symptoms, regardless of age or family history, you should be screened. 

While screening is the most important step you can take to prevent colorectal cancer, it's not the only one. You may be able to lower your colorectal cancer risk with some simple lifestyle changes. Be proactive about keeping yourself healthy. 

For instance, focus on eating well. Consistent evidence shows diets that are high in vegetables, fruits, and other plant foods may reduce the risk for many diseases, including colorectal cancer. In addition, foods containing plenty of dietary fiber and nutrients, and plants foods with phytochemicals, all protect cells in the body from damage that can lead to cancer. Plant foods can also help maintain a healthy weight, which is important in reducing the risk of colorectal cancer. 

Diets high in red and processed meats have also been linked to colorectal cancer. Red meats, including beef, pork or lamb, should be limited to 18 ounces (cooked) per week or less. Processed meats, including hot dogs, ham, bacon, and sausages, should be avoided if possible. Processed meats increase the risk of cancer, even with low consumption. 

Getting the right amount of exercise can also help to reduce the risk of colorectal cancer by 30 to 40%. 30 to 60 minutes of moderate to vigorous physical activity per day is needed to protect against colorectal cancer. Exercise also helps you to maintain a healthy body weight, which reduces your risk for colorectal cancer. In fact, studies show that people who are overweight or obese are more likely to develop colon polyps. 

Lastly, avoid alcohol and cigarettes. Although modest amounts of some alcohols have been linked to protecting against coronary heart disease, alcohol is known to increase cancer risk. According to the National Cancer Institute, people who regularly drink 3.5 drinks per day have 1.5 times the risk of developing colorectal cancer as nondrinkers or occasional drinkers. If you do choose to drink, limit your consumption. 

Long term cigarette smoking is also associated with increased risk of colorectal cancer. The longer a person smokes, the greater the risk. 

 

Conclusion

If you or a loved one gets diagnosed with colorectal cancer, have hope. While it can be frightening, know that there are so many treatment opportunities and possibilities out there to help rid you of that vicious disease. When talking to friends or family, encourage them to get screened, as it is the most important way to detect polyps and cancer. 

Be sure to consult with your doctor or a qualified health care professional before taking any medication, supplements, or beginning health regimens.