Jiri Bem, MD
Sekou Rawlins, MD
BY AMBER SMITH
Colorectal cancer kills some 50,000 men and women in America every year. The death rate could decrease by 90 percent, says Jiri Bem, MD, medical director of Upstate’s colorectal oncology program.
“If everybody would be compliant with recommendations in terms of screening and surveillance, the number would drop to 5,000, which is clearly a striking difference,” he says.
Cancers of the colon and rectum are largely preventable. The majority of these cancers begin in polyps that can be removed — if they’re found before they’ve developed into cancer and spread. Most cancers found at screening are curable.
Screening recommendations
Bem recommends people at average risk of colorectal cancer start screening at age 50 and continue at least through age 79. Those at higher risk may need to begin screening earlier, and several gastroenterology societies say African-Americans should start at age 45.
People at increased risk of colorectal cancer include those with a personal history of colorectal cancer or certain type of polyps, a family history of colorectal “cancer, a personal history of inflammatory bowel disease (such as ulcerative colitis or Crohn’s disease), a confirmed or suspected hereditary cancer syndrome or a personal history of radiation to the abdomen or pelvis to treat a previous cancer. (Hear Bem speak about colorectal cancer and its prevention in this podcast/radio interview.)
Types of screening tests
Stool tests can be used to detect blood or to examine genetic changes that may occur in colon cancer cells.
Two options provide a look at the structure of the inside of the colon and rectum for abnormal areas that might be cancer or polyps. In a colonoscopy, the doctor inserts a flexible camera into the rectum to inspect the interior walls of the intestine. A virtual colonoscopy is an imaging scan. For both tests, the patient must empty his or her colon by consuming only liquids and a bowel preparation solution prior to the test.
Signs and symptoms
“Many people who are diagnosed with colon cancer don’t have any symptoms, which is why the screening strategies are so important,” says Upstate gastroenterologist Sekou Rawlins, MD. “A lot of people felt perfectly normal, and then they had their cancer found.” (Hear Rawlins discuss colorectal cancer screening and colon health in this podcast/radio interview.)
Contact your doctor if you notice
— A change in bowel habits, such as diarrhea, constipation or narrowing of the stool that lasts for more than a few days.
— A feeling that you need to have a bowel movement that’s not relieved by having one.
— Rectal bleeding with bright red blood.
— Blood in the stool, which may make the stool look dark.
— Cramping or belly pain.
— Weakness or fatigue.
— Unintended weight loss.
Prevention
These steps may help reduce your risk, but there’s no sure way to prevent colorectal cancer.
- Maintain a healthy weight.
- Participate in regular moderate physical activity.
- Eat a diet high in vegetables, fruits and whole grains, and limit your intake of red meats and processed meats.
- Avoid excessive alcohol use.
- If you smoke, quit.
Do you need an appointment?
For help scheduling a colonoscopy, contact the Upstate Cancer Center at 800-464-4673 or Upstate Gastroenterology at 315-464-1600.
This article appears in the summer 2018 issue of Cancer Care magazine.