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Colon
Cancer
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Colorectal
cancer is the second most common cancer in the United States, striking
140,000 people annually and causing 60,000 deaths.
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WHO
IS AT RISK?
Though colorectal cancer may occur at any age, more
than 90% of the patients are over age 40, at which point the risk
doubles every ten years. In addition to age, other high risk factors
include a FAMILY history of colorectal cancer and polyps and a PERSONAL
history of ulcerative colitis, colon polyps or cancer of other organs,
especially of the breast or uterus. The majority of patients who
develop colon cancer, however, have no high risk factors.
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How
Do Colon Cancers Form?
It is widely thought that the majority of colon cancers begin as
noncancerous polyps. These growths form on the bowel wall, increase
in size, and eventually become invasive cancers. By removing noncancerous
polyps it is thought that colon cancers can be prevented.
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CAN
COLON CANCER BE PREVENTED?
There are steps that reduce the risk of contracting the disease. One
way is having benign polyps removed by an outpatient procedure called
colonoscopy.
In some cases polyps can not be removed by colonoscopy for technical
reasons. In these situations, that portion of the colon my need to
be removed surgically. In most cases this can by done using a minimally
invasive procedure called laparoscopic
colectomy.
Though not definitely proven, there is some evidence that diet may
play a significant role in preventing colorectal cancer. As far as
we know, a high fiber, low fat diet is the only dietary measure that
might help prevent colorectal cancer. Advice
from the American Cancer Society on diet and exercise.
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WHAT
ARE THE SYMPTOMS?
Unfortunately, the most common symptom of colon polyps and colon
cancer is no symptoms at all! When patients have symptoms, the most
common symptoms are rectal bleeding and changes in bowel habits,
such as constipation or diarrhea. (These symptoms are also common
in other diseases so it is important you receive a thorough examination
should you experience them.) Abdominal pain and weight loss are
usually late symptoms indicating possible extensive disease.
The lack of symptoms in most patients with polyps and early cancers
makes screening tests pivotal to diagnosing this cancer in a curable
stage.
(Click
for link to American Cancer Society colon cancer screening recommendations)
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HOW
IS COLORECTAL CANCER TREATED?
Colorectal cancer requires surgery in nearly all cases for complete
cure. Radiation and chemotherapy are sometimes used in addition
to surgery. Between 80-90% are restored to normal health if the
cancer is detected and treated in the earliest stages. The cure
rate drops to 50% or less when diagnosed in the later stages. Thanks
to modern technology, less than 5% of all colorectal cancer patients
require a colostomy, the surgical construction of an artificial
excretory opening from the colon. Tranditionally colon cancer surgery
has been done using an open technique - open
colectomy. Over the past several years an increasing number
of colon cancers have been removed using a minimally invasive technique
called laparoscopic colectomy. In
the past, there was suspicion that the cure rate for laparoscopic
colectomy was not as high as with traditional open techniques. An
increasing number of recent studies
have shown that in the well selected patient, the cure rate for
the laparoscopic approach is as good as with the more invasive open
techniques.
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Additional
Information
American
Cancer Society
University
of South Carolina
American
College of Gastroenterology
New York Times article reviewing laparoscopic
colon surgery study
New England Journal of Medicine article
showing equal cure rate for laparoscopic colectomy
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