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Published on March 08, 2019

Colorectal Cancer: Signs and Symptoms, How It's Diagnosed and the Latest Treatments

Colorectal CancerIn this Fox 8 House Call series, Cone Health experts discuss colorectal cancer, including:

Colorectal Cancer: Who’s at Risk, Signs and Symptoms

Colorectal cancer is one of the leading causes of cancer-related deaths in the United States. Approximately 150,000 people in the U.S. are diagnosed each year, and 50,000 people die from the disease. However, early diagnosis often leads to a complete cure. Almost all colorectal cancer starts in glands in the lining of the colon and rectum.

Those who are over the age of 50 and have a family history of colorectal cancer are at highest risk. Other factors include obesity, diabetes and smoking.

Colorectal cancer can often be asymptomatic. However, the following symptoms are indicative of the disease:

  • Abdominal pain and tenderness in the lower abdomen
  • Blood in the stool
  • Diarrhea, constipation or other change in bowel habits
  • Weight loss with no known reason

With proper screening, colorectal cancer can be detected before symptoms develop, when it is most curable. Signs include:

  • Anemia.
  • A stool test with traces of blood.
  • A CAT scan – patients will sometimes get these for other reasons and signs of colorectal cancer appear.

William Outlaw, MD, is a gastroenterologist in Greensboro and a member of the Cone Health Medical and Dental Staff. Outlaw received his Doctor of Medicine from the University of Florida College of Medicine in 2001. He completed his residency in internal medicine, as well as his fellowship in gastroenterology and advanced endoscopy at Wake Forest University Baptist Medical Center.

Colorectal Cancer: How It’s Diagnosed

According to the Centers for Disease Control and Prevention (CDC), colorectal cancer is the second leading cause of cancer-related deaths in the U.S. People with early stage colorectal cancer rarely experience symptoms, but possible signs may involve:

  • Blood seen in the stool (rectal bleeding).
  • Abdominal pain.
  • Change in bowel habits - diarrhea, constipation or change in the shape of the stool.
  • Sudden weight loss.
  • Decrease in appetite.

It’s important to listen to your body – if something doesn’t seem right, see your primary care provider who may refer you to a specialist.

A colonoscopy is the best way to diagnose colorectal cancer. A preventative colonoscopy can help catch symptoms before they develop, and a diagnostic colonoscopy helps doctors follow up on patients with symptoms. Screening is recommended for adults over the age of 50 with no family history of colon cancer. If you do have a family history, screenings may start at the age of 40 or earlier, depending on when your family member was diagnosed. There are a few different screening methods available, including:

  • Colonoscopy – The gold standard of screening tools that can detect and remove growths during the procedure.
  • Stool tests (Cologuard is the most common) – Recommended for low-risk patients who have no family history, symptoms or history of polyps. If you test positive, then you will need a colonoscopy. If you test negative, you’ll need to follow up in 3 years.

When you get a colonoscopy, you’ll need to maintain a liquid diet 24 hours prior to the procedure. You’ll be asked to drink a bowel cleanser the evening before and morning of. During the procedure, you’re under anesthesia for 30 to 40 minutes and in recovery for 20 minutes. You can go home afterward and eat the same day.

If your doctor finds polyps, which are small growths that turn into cancer over time, they will remove them. If a mass or tumor is found, your doctor will take a biopsy to test for cancer.

Kavitha Veena Nandigam, MD, is a gastroenterologist at LeBauer Gastroenterology and a member of Cone Health Medical Group. She received her doctorate of medicine from Jawaharlal Institute of Post Graduate Medical Education & Research. She is board certified in internal medicine and gastroenterology, and is a member of the American Gastroenterology Association, the American Society for Gastrointestinal Endoscopy, the American College of Gastroenterology, and the North Carolina State Medical Society.

Colorectal Cancer: the Latest Treatments

Colorectal cancer is cancer of the colon and rectum. It can be caught early with screening, which has increased survival rates. Everyone should be screened starting at age 50, but if you have a family history of colon cancer, or if you have specific disease conditions, you should start at least 10 years earlier. All colon cancer starts as polyps, which is why it’s important to get screened in order to catch the cancer early. Colorectal cancer screening is separate from a colonoscopy and can be done by your primary care provider.

All colorectal cancers are not created equally. On a stage to stage basis, rectal cancer is more aggressive. Cancer specialists now look at the right and left side of the colon as different entities. Prognosis and treatments can differ for colorectal cancer depending on if the cancer originates on the right or left side. Cancer on the right side of the colon tends to be more difficult to treat.

Intravenous, oral and targeted therapy forms of chemotherapy treatments remain the primary treatment for colorectal cancer. Once it’s determined which side of the colon the cancer is affecting, further treatments are tailored specifically to the patient. Doctors can now identify particular genetic mutations in each patient’s cancer and custom design treatment for the patient, which has led to more desirable outcomes. Survival is improving because doctors now have a better understanding of the genetic makeup of each patient’s cancer.

Peter Ennever, MD, is an oncology and hematology specialist at Cone Health Cancer Center at MedCenter High Point and a member of Cone Health Medical Group. Ennever earned his doctorate of medicine at George Washington University. He completed his residency at University of Pittsburgh Health Science Center and completed a fellowship in hematology and medical oncology at Yale-New Haven Hospital. He is a member of several organizations, including the American College of Physicians, American Society of Clinical Oncology, American Society of Hematology and North Carolina Medical Society.

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