Colorectal Cancer: The Second Leading Cancer Killer

Colorectal cancer may not be an easy topic to talk about, but it’s an important one to know. It’s often called the “silent killer” because it may have few symptoms, yet it is the second leading cancer killer, behind lung cancer. That’s why understanding what colorectal cancer is, what its symptoms are, and how to prevent it, is essential. Since March is Colorectal Cancer Awareness Month, now is the ideal time to start the conversation.

What is colorectal cancer?

The colon and rectum make up the large intestine, also called the large bowel. Undigested food enters the colon from the small intestine, and travels through the four sections of the colon: the ascending colon, traverse colon, descending colon and sigmoid colon, which joins the rectum, which is the last 12 centimeters of the intestine. 

Colorectal cancer describes a malignancy that is found within the inner lining of the colon or in the rectum. The malignancy may start as growths called polyps. Not all polyps are cancerous, but some will change into cancer over time. Polyps may take 10-15 years to develop.

Colon cancers are found in the colon; rectal cancers are found in the rectum, and colorectal cancer is a broader term that includes any malignancy in the area. Because treatment and prognosis are based on the location, it is necessary to differentiate between the areas. 

What are the signs or symptoms?

Colorectal cancer may have few or mild symptoms, which is why routine colonoscopy screening is so important. Some people may have mild abdominal pain, changes in the stool, such as bleeding. They may also have weight loss or fatigue—vague manifestations that don’t indicate a serious problem. In advanced cases, a person may have severe pain from a cancer-related perforation or obstruction, indicating a progression of the disease.

Certainly not all abdominal pain or bleeding in the stools indicate cancer—but too often, people put themselves at risk by assuming the problem is a fissure (small tear in the anus) or hemorrhoid (swelling in the rectum), without confirming with their physician. The doctor might do an endoscopy or other tests to rule out cancer. 

What is the treatment for colorectal cancer?

Adenocarcinomas account for 96% of colorectal cancers, and treatment depends on the location of the cancer and its stage. For colon cancer that has not spread to other areas of the body, it is often treated surgically. Rectal cancer may require chemotherapy and radiation prior to surgery. 

Who is at risk?

While colorectal cancer is more common in older men, anyone can get the disease. Because the chances increase with age, current recommendations are for people 50 and older to have a colonoscopy screening, and have follow up screenings as recommended. However, anyone who has any symptoms or has higher risk factors, including family history or inflammatory bowel syndrome, may require earlier or more frequent screenings.

Do I really need a screening colonoscopy? 

The colonoscopy is one of the best ways to prevent colorectal cancer. The procedure can detect small polyps, assess them through a biopsy, and remove them so they don’t become cancerous. Colonoscopies are extremely safe and effective at detecting cancers. Some people are concerned about completing the bowel prep, but a lot of progress has been made with the formulas, and they’re generally well tolerated. 

In addition to a screening colonoscopy, other actions to take to reduce the risk of colorectal—or any type of cancer include:

• Maintaining a healthy weight
• Being physically active
• Eating a diet low in red meats or processed foods
• Not smoking

But unlike other cancers, colorectal cancer can be prevented through a screening colonoscopy. Unfortunately, not enough people take this simple test. Make this March the month you pledge to get screened to protect yourself against colorectal cancer.