Showing posts with label Colon cancer. Show all posts
Showing posts with label Colon cancer. Show all posts

Monday, March 12, 2012

Colorectal Cancer Awareness Month shines light on need for early screening

Colorectal cancer
Classification and external resources

Diagram of the lower gastrointestinal tract
ICD-10C18-C20/C21
ICD-9153.0-154.1
ICD-O:M8140/3 (95% of cases)
OMIM114500
DiseasesDB2975
MedlinePlus000262
eMedicinemed/413 med/1994ped/3037
Colorectal cancer, commonly known as bowel cancer, is a cancer from uncontrolled cell growth in the colon, rectum, or appendix. Symptoms typically include rectal bleeding and anemia which are sometimes associated with weight loss and changes in bowel habits.
Most colorectal cancer occurs due to lifestyle and increasing age with only a minority of cases associated with underlying genetic disorders. It typically starts in the lining of the bowel and if left untreated, can grow into the muscle layers underneath, and then through the bowel wall. Screening is effective at decreasing the chance of dying from colorectal cancer and is recommended starting at the age of 50 and continuing until a person is 75 years old. Localized bowel cancer is usually diagnosed through sigmoidoscopy or colonoscopy.
Cancers that are confined within the wall of the colon are often curable with surgery while cancer that has spread widely around the body is usually not curable and management then focuses on extending the person's life via chemotherapy and improving quality of life. Colorectal cancer is the fourth most commonly diagnosed cancer in the world, but it is more common in developed countries.[1] Around 60% of cases were diagnosed in the developed world.[1] It is estimated that worldwide, in 2008, 1.23 million new cases of colorectal cancer were clinically diagnosed, and that it killed 608,000 people.[1]

When John Hobart first found out he had colon cancer, he was supposed to be asleep.

“I was on the table [after my colonoscopy], and they had just put me in a recovery room,” Hobart said.  “I was supposed to be out still, but I could overhear a doctor talking about my cancer and how they were going to tell me.”

Hobart said he was “dumbfounded. It really doesn’t register at first.”

A nurse later confirmed what Hobart already knew – the doctors had found a large cancerous tumor in Hobart’s lower colon.  While the diagnosis was definitely not what Hobart wanted to hear, part of him wasn’t surprised.  Coming from a family that rarely went to the doctor, Hobart had waited until the last second to get screened.

“I had a feeling that it probably was going to be cancer because my mother died of cancer,” Hobart said.  “Nobody in my family ever went to the doctor, which was such a mistake.  You literally had to be on the ground to go to the doctor.  But thank goodness I went – a couple more months, and I’d have been dead.”

March is National Colorectal Cancer Awareness Month, and Hobart is sharing his story in hopes that people will realize the importance of getting screened.  Currently, colon cancer is the second leading cause of cancer-related deaths, with approximately 150,000 new cases diagnosed in the United States each year.

After getting over the shock of his diagnosis and understanding his chances, Hobart set out to find the right oncologist to help treat his cancer.  He came across Dr. Brett Ruffo, a board-certified colorectal surgeon at Peconic Bay Medical Center in Riverhead, N.Y.  Ruffo easily related to Hobart, having lost his own father from colon cancer because he had waited too long.

“He was a stubborn Italian and was told never to go to the doctor,” Ruffo said.  “By the time he went it was too late.  He had a very miserable course – a terrible metastatic disease that spread to his liver, lung, and brain actually.”

Thursday, February 23, 2012

Colon cancer study backs blood stool screening test

Although colon cancer screening is recommended by many organizations, less clear is which method is best to detect tumors and precancerous lesions.
A study in the New England Journal of Medicine suggests that a relatively inexpensive and non-invasive test may be just as effective as a colonoscopy.
Meanwhile, a 23-year study, also published in the journal, has confirmed that removing precancerous polyps, known as adenomas, during a colonoscopy can reduce the risk of death from colorectal cancer by half.
Based on the results, "an appealing concept would be to use colonoscopy as a triage screening test, offering it once for everybody at 60 years of age" and using it to classify people into high- and low-risk categories, Dr. Michael Bretthauer of Oslo University Hospital and Dr. Mette Kalager of Telemark Hospital, both in Norway, wrote in an editorial in the journal.
Low-risk people would not need further screening while those with adenomas would be evaluated regularly.
One in 20 Americans will develop colorectal cancer. About 140,000 cases are diagnosed in the United States each year, resulting in about 49,000 deaths, according to the National Cancer Institute. It is the third most common cancer worldwide.
The U.S. Preventive Services Task Force, a government-backed agency, recommends screening for people age 50 to 75 years by one of three methods: a colonoscopy every 10 years; annual stool testing; or a less-thorough look into the colon (known as flexible sigmoidoscopy) every five years in conjunction with stool testing every two to three years.
People often find the tests unpleasant. For example, in the new study that compared stool testing with colonoscopy, only 34 percent went along with stool testing. The participation rate was even lower when colonoscopy was offered, even though doctors can use it to cut away those suspicious precancerous adenomas.
In theory, adenoma removal saves lives by preventing a tumor. Ann Zauber of the Memorial Sloan-Kettering Cancer Center in New York, chief author of the long-term evaluation of polyp removal, and her colleagues said their work demonstrates that.
"This study is showing both a reduction in colon cancer incidence and colon cancer deaths by removing the adenomas, and it's a long-term effect" she said in a telephone interview. "This is reassuring for people to come in for screening."
The conclusion is based on people who were sent for a colonoscopy between 1980 and 1990. The Zauber team compared their death rate to the estimated death rate from the Surveillance Epidemiology and End Results (SEER) program.
Over a period as long as 23 years, the rate from colorectal cancer among the 2,602 people who originally had adenomas removed was 53 percent lower than estimated from the SEER data. In all, 12 died from cancer in the removal group, while 25 had normally been expected to die of colorectal disease.
The lower rate includes the fact that 81 percent of the patients who had polyps removed continued to have periodic colonoscopies to check for growths.