As we age, one type of cancer that we become most at risk for developing is colon cancer. Statistics show that over 90 percent of colon cancer cases occur in those over 50, and about 60 percent occur in those over 70.
Although most colon cancer cases are in adults ages 50 and older, roughly 12% of individuals younger than 50 will be diagnosed with colon cancer, which is the equivalent of about 49 new cases per day.
Colon cancer doesn’t always present symptoms. In fact, there are no warning signs in about half of colon cancer cases. This can make it difficult for seniors to identify colon cancer without a screening.
With this in mind, everyone, especially seniors, needs to know about colon cancer, the warning signs to watch for, preventative steps you can take, and the surgery it may require should you be diagnosed with colon cancer.
WHO IS AT RISK FOR COLON CANCER?
In the United States, colon cancer is the third most commonly diagnosed cancer in men and women combined and the second leading cause of cancer death in men and women combined.
As mentioned, those over 50 are at the highest risk for colon cancer. Incidence rates for colon cancer are also slightly higher in men than women. Approximately 1 in 23 men and 1 in 25 women will be diagnosed with colon cancer in their lifetime. However, lifetime risk is similar in men and women despite higher incidence rates in men because women have a longer life expectancy.
In addition to sex and age, race/ethnicity also greatly influences risk. Recent statistics show that African Americans have the highest incidence and mortality rates of colorectal cancer of any ethnic group in the United States, followed closely by American Indians and Alaska Natives, and lowest in Asians/ Pacific Islanders.
Colorectal cancer occurrence also varies from state to state. In the 1970s and 1980s, the burden was highest across the Northeast and lowest in the South. Today it is highest in parts of the South, Midwest, and Appalachia and lowest in the West and Northeast. Tennessee is rated on the higher end for both occurrences of colon cancer cases and mortality.
RISK FACTORS FOR COLON CANCER
The first factor to consider is your lifestyle. More than half of all colorectal cancer cases in the United States are attributable to lifestyle factors, including an unhealthy diet high in red meats, processed and deep-fried foods, insufficient physical activity, high alcohol consumption, and smoking.
Coming in second is a family history of colon cancer. Up to 30% of colon cancer patients have someone in their family that has been diagnosed with the disease, making this one of the most important and actionable risk factors. People with a parent, sibling, or child diagnosed with colon cancer have 2 to 4 times the risk of developing the disease compared to people without this family history, with a higher risk for diagnosis before age 50 and/or multiple affected relatives. However, a history of colorectal cancer among more distant relatives also increases risk, as does a family history of benign (noncancerous) tumors.
Your own medical history could also put you at higher risk of colon cancer. Patients with a higher-than-average occurrence of issues like inflammatory bowel syndrome or Crohn’s could also be at higher risk for cancer.
Finally, colon cancer is more prevalent among those with Type II diabetes. If you are at risk for colon cancer, your doctor may recommend you talk with a nutritionist about diet changes to prevent worsening diabetes.
HOW TO REDUCE YOUR RISK OF COLON CANCER
You can help reduce your risk of colon cancer by kicking bad habits like smoking and drinking, eating a healthy high-fiber diet, getting regular exercise, and maintaining a weight deemed healthy by your doctor.
Colon cancer screenings are also crucial, as colon cancer is preventable with early detection. Additionally, the most important predictor of colon cancer survival is the stage at diagnosis.
The 5-year survival rate is 90% for the 39% of patients diagnosed with localized-stage disease but declines to 71% and 14% for those diagnosed with regional and distant stages. The relative survival rate for colon cancer is 64% at 5 years following diagnosis and 58% at 10 years.
In years past, screening for colon cancer was suggested to begin at age 50. But the age to initiate CRC screening was recently lowered from 50 to 45 years because incidence rates are increasing in younger populations. Screening before age 45 is recommended for those at an increased risk of colon cancer because of family history or certain medical conditions.
Many people do not want to undergo invasive screenings, but as you can see, they are vital for detecting colon cancer early and increasing your chances of survival. When seniors understand the risk factors for colon cancer and are screened regularly, it can be easier to identify colon cancer early on when treatment works best.
WHAT ARE THE SYMPTOMS OF COLON CANCER?
Many people with colon cancer experience no symptoms in the early stages of the disease, which is one reason it is often diagnosed in later stages if you aren’t having regular colorectal screenings.
When symptoms do appear, they typically vary depending on the cancer’s size and location, and can mimic an upset stomach. Many seniors will experience the same mild discomfort they would expect to feel when having a bowel movement or experiencing constipation.
Colon cancer has several symptoms you may spot. If you notice any of these common colon cancer symptoms, contact your doctor as soon as possible.
- Sudden changes in bowel movement activity (e.g., diarrhea each day, sudden bouts of constipation that doesn’t go away with changes to your diet, a change in your need to defecate.)
- A persistent change in the consistency of your stool.
- Rectal bleeding or bloody stools.
- Unexplained fatigue, loss of appetite, or weight loss.
- Fever or night sweats.
- Pain in your side, back, or stomach area.
- Persistent abdominal discomfort, such as cramps, gas, or stomach pain.
- A feeling that your bowel doesn’t empty completely.
If colon cancer is left untreated and spreads through the body, it can affect other organs like the liver and lungs.
DIAGNOSING COLON CANCER
Your doctor will be able to make an official colon cancer diagnosis with a colonoscopy, sigmoidoscopy, and/or CT scan.
A sigmoidoscopy and colonoscopy are similar in that they both use small cameras to look at the colon and rectum for any irregularities or signs of early-stage colon cancer. However, they do have some differences.
- Sigmoidoscopy – A sigmoidoscopy isn’t widely used for colorectal cancer screening in the U.S. If your doctor recommends it is less invasive as it only looks at the lower part of your colon. The bowel prep is less complicated, and sedation is usually not needed. If your doctor finds polyps during your sigmoidoscopy, you will probably need a colonoscopy.
- Colonoscopy – A colonoscopy is the gold standard for cancer screening in the U.S. It is suggested that those at average risk for colon cancer have a colonoscopy done every 10 years starting at the age of 45. Your doctor may advise you to have them more frequently if you are considered high risk or if abnormalities such as polyps are discovered.
The procedure uses a longer tube and looks at the entire colon. The colon must be completely clean for this procedure; therefore, bowel prep is more invasive. Solid foods must be avoided the day before the test, and only clear liquids must be consumed. A solution that makes you go to the bathroom is also taken to ensure there is no waste in your colon. Sedation is usually needed, meaning someone must drive you home after you wake up.
Other Colon Cancer Diagnostic Tools
If your doctor has recommended colon cancer screening, you might be able to choose from other colon cancer screening tests, such as:
- Virtual Colonoscopy (CT Scans): A noninvasive procedure that uses a series of x-rays called computed tomography to create a series of pictures of the colon.
- DNA Stool Tests: Checks DNA in stool cells for genetic changes that may be a sign of colorectal cancer.
- Fecal Occult Blood Tests: A test to check stool for blood that can only be seen with a microscope.
Early detection of colon cancer through screening could save your life by identifying the disease before symptoms become too severe. It’s especially critical that you receive regular screenings if you have any of the risk factors discussed above or if colon cancer runs in your family.
WHAT DO DOCTORS CONSIDER BEFORE TREATMENT?
Many treatments are available to help control colon cancer, including surgery, radiation therapy and drug treatments, such as chemotherapy, targeted therapy and immunotherapy.
Often, colon cancer treatment requires a multidisciplinary approach, meaning your doctor might suggest more than one treatment. It really depends on the stage of your cancer and your current health and fitness.
Seniors are a vulnerable group, so doctors must thoroughly assess a patient’s health and fitness before considering treatment options, especially surgery, which is often suggested as a treatment option because it can help prevent colon cancer from spreading throughout the body and causing more serious illness or death.
To determine if you are healthy enough for surgery and the best treatment approach, your doctor will ask you a series of questions and perform several exams and tests.
Some other things your doctor will consider include:
- Stage of cancer
- Cancer size and location
- Type of cancer (colon vs. rectal)
COLON CANCER SURGERY TYPES
Doctors will use three main types of colon cancer surgeries based on the specific diagnosis: colectomy, colon resection, and proctocolectomy.
A colectomy is a surgery that removes part of your colon entirely. This might be the best option if you have colon cancer in one specific area or even throughout most of your colon.
Additionally, doctors may use colon gland sparing during this type of surgery to ensure that healthy colon glands are not removed. This is a colon cancer surgery that your doctor might use to limit the amount of colon affected by this type of procedure.
A colon resection only removes part or all of your colon depending upon where in your colon you have been diagnosed with cancer. During this procedure, doctors will remove as much colon cancer as they can without harming the healthy colon glands.
A proctocolectomy is a surgery that removes your colon and rectum entirely, meaning you will no longer be able to defecate in the seat of your pants. This type of colon cancer surgery might take place if doctors have found tumors throughout both parts of the colon.
HOW DOES COLON CANCER SURGERY WORK?
Surgery is often the most effective method of treating colon cancer in the first two stages. Depending on the colon cancer surgery best for your unique case, the doctor may remove the cancer, any surrounding tissue, or even part of the colon itself. If you go through surgery, you might not need chemotherapy or radiation.
The Surgical Clinic knows you may be nervous about surgery, but that does not mean you don’t have options. Thanks to advancements in colon cancer surgery techniques, many patients are more comfortable after surgery than ever before.
We can often use something called a laparoscopic method that allows a surgeon to access the inside of the abdomen and pelvis without having to make large incisions in the skin. Rather than doing a colectomy as an open surgery through a single long incision, a surgeon can do the procedure through several smaller incisions using special tools for a minimally invasive approach.
When the laparoscopic method is used, patients may even get out of a long hospital stay after the surgery. Additionally, this type of surgery is great for seniors because it can reduce the risks associated with blood loss during surgery and may lead to increased recovery of the digestive system.
The Surgical Clinic has over 40 surgeons with multiple specialties throughout Middle Tennessee. Find your location and then call us today to discuss your surgical options and to learn more about the treatments for colon cancer treatment.
Meet Some of Our Surgeons
Marc E. Rosen, MD, FACOS
St. Thomas West Clinic
Summit Clinic, Mt. Juliet Clinic