Francesco Grasso, MD, colorectal surgeon, exams a monitor during a colonoscopy. Surgery may be part of your colorectal cancer treatment plan, depending on your unique condition.
Colorectal cancer occurs in the last two parts of the digestive system: the colon (large intestine) or rectum (connects the colon and the anus). Most colorectal cancers (sometimes referred to as colon cancer) begin as small abnormal growths of tissue called polyps that form in these areas of the digestive system. A polyp is not cancer, but it can change over time into cancer.
The cancer can start in different areas of the colon and rectum, and may cause different side effects.
- Diarrhea, constipation, or the feeling that the bowel has not emptied
- Unusually narrow stools
- A bloody stool
- Bloating, cramping, fullness, and/or frequent gas pains
- Unexplained weight loss
- Continuous fatigue
If you experience these symptoms for more than two weeks, see your doctor. These symptoms can also be caused by other conditions, so it's important to consult with your MedStar Health doctor to determine whether they are connected to colorectal cancer or some other condition.
Individuals with colorectal polyps or cancer may have no symptoms at all, especially at first. By the time most symptoms appear, the cancer is already growing, making it harder to treat. It is important to get screened, pay attention to your body and be on the lookout for anything that is not normal.
Research has shown that people with certain risk factors are more likely than others to develop colorectal cancer Knowing your risks will help you and your doctor make the best health choices for you.
- Age—Most colorectal cancers are found in people over 50.
- Race or background—African-American or Jewish with an Eastern European backgrounds are at a higher risk.
- Medical history—People with ulcerative colitis, Crohn’s disease, Type 2 diabetes, or previous cancers have higher risk of developing colorectal cancer.
- Family medical history—Close family members with colorectal cancer, as well as some conditions passed down through families, raise the risk.
- Lifestyle—The links between diet, weight and exercise and colorectal cancer risk are some of the strongest for any type of cancer. Some evidence suggests that colorectal cancer may be associated with a diet that is high in fat and calories and low in foods with fiber, such as whole grains, fruits, and vegetables.
If you do have any of these risk factors, talk to your doctor. Your doctor may be able to suggest ways to reduce your risk, especially lifestyle factors that you can change.
Prevention and Screening
Some people inherit colorectal cancer, but, in most people, no identifiable cause exists. Eating a healthy diet with plenty of fiber, not smoking, and getting exercise may help prevent colorectal cancer but, without a known cause, prevention is challenging. This is why screenings are important.
Beginning at age 50, men and women who are at average risk for developing colorectal cancer should be screened. Health care providers may suggest one or more of the tests listed below for colorectal cancer screening.
- Colonoscopy: A lighted instrument called a colonoscope is used to inspect the rectum and entire colon. Colonoscopy can find precancerous or cancerous growths throughout the colon, including the upper part of the colon, where they would be missed by sigmoidoscopy.
- Double Contrast Barium Enema: X-rays of the colon and rectum are taken after the patient is given an enema with a barium solution and air is introduced into the colon. The barium and air help to outline the colon and rectum on the X-rays.
- Fecal Occult Blood Test: This test checks for hidden blood in the stool. Studies have proven that this test, when performed every 1 to 2 years in people age 50 to 80, reduces the number of deaths due to colorectal cancer.
- Sigmoidoscopy: A lighted instrument called a sigmoidoscope is used to examine the rectum and lower colon. Sigmoidoscopy can find pre-cancerous or cancerous growths in the rectum and lower colon. Studies suggest that regular screening with sigmoidoscopy after age 50 can reduce the number of deaths from colorectal cancer.
- Stool DNA Test: This test checks for colorectal cancer of all stages and in all locations in the colon.
If you or someone you know has a colorectal problem or if you need a screening test, call the MedStar Health Cancer Network for an appointment at 877-715-HOPE. Our expertise can make a big difference in getting the right diagnosis and the right treatment, right away.
If you are a Baltimore County resident, do not have health insurance that covers the cost of the screening, diagnosis, or treatment services, and have a low income, you may qualify for free colorectal cancer screening services. Call 410-887-3456 to see if you qualify.
If you are 50 or older, live in Baltimore City and have a low income, you may qualify for one of a limited number of free screening colonoscopies. Call 410-554-6590 to see if you qualify.
Our goal at MedStar Health is to complete the diagnostic phase promptly so that you can begin treatment as soon as possible. We use the most advanced diagnostic technology to diagnose and stage your cancer because we know that the more accurate your diagnosis, the more precise your treatment regimen will be.
Oncologists believe many cases of colorectal cancer can be cured, as long as they are diagnosed early. Unfortunately, most patients don't schedule regular preventive examinations and only seek medical attention when they have symptoms. As a result, colorectal cancer is usually diagnosed after it has left the bowel lining and progressed beyond the site of origin.
At MedStar Health, we advise our patients to get tested at a younger age and more frequently if they have certain risk factors such as a strong family history of colorectal cancer or polyps; a relative with a genetic colorectal cancer syndrome; or a personal history of colorectal cancer, adenomatous polyps, or inflammatory bowel disease.
Once you receive your diagnosis, your MedStar Health care team will proceed quickly to the treatment phase. Your doctor will discuss your treatment options with you, which depend on the stage of your cancer, whether it has metastasized (spread), and your general health. At MedStar Health, your colon/GI cancer team will carefully explain each treatment option, give you advice, and thoroughly support you throughout your treatment process.
Surgery is often the cornerstone of any cancer treatment plan. The goal of surgery is to remove the entire tumor, or as much of it as possible. You may have other treatments following the surgery to destroy any remaining cancer cells and prevent it from returning. Sometimes, you receive treatment such as chemotherapy or radiation before your surgery, so the tumor is easier to remove.
- Local excision is used when the cancer is found at an early stage. Your surgeon accesses the tumor through the rectum and removes it.
- Resection is used when the tumor is bigger. Your doctor removes the tumor and as much of the colon as necessary and reattaches the healthy part of the colon.
- Resection with colostomy happens if your doctor is unable to reattach the colon. In order for your body to get rid of waste, your doctor will create an opening, called a stoma. A bag is attached to the stoma to collect the waste. This procedure is called a colostomy.
MedStar Health also offers robotic surgery for colorectal cancer, which is a more precise treatment that minimizes the pain and risk associated with surgery while increasing the likelihood of a fast recovery and excellent clinical outcomes.
Awards and Recognitions
- Commission on Cancer of the American College of Surgeons, Three-Year Approval with Commendation
- Commission on Cancer of the American College of Surgeons, Three-Year Accreditation with Commendation (as part of MedStar's Baltimore Region Cancer Network)