Colorectal Cancer

alt

Colorectal Cancer

In the digestive system, the colon is the organ responsible for storing the body's waste. The rectum is the canal connecting the colon and anus. Collectively, these two organs are known as the large intestine. Cancers of the large intestine can be referred to as colon cancer, rectal cancer or colorectal cancer depending on the location of the cancer.

The incidence of colorectal cancer depends on the existence of tumors, which are growths that begin on the lining or wall of the large intestine. Not all tumors are cancerous. Non-cancerous, or benign tumors are called polyps. These type of tumors are not life-threatening, and can be treated with a procedure called a colonoscopy. However, if left untreated for a period of time, polyps can transform into cancerous or malignant tumor cells. Malignant tumors are very serious and life-threatening--especially if the cancer has spread to other organs of the body. Colorectal cancer commonly spreads to the liver and the lungs. In such cases, a cancer patients chances for survival are very unlikely.

Fortunately, there are procedures available that can help physicians detect cancer early, in addition to several treatments that can help cancer patients return to a normal lifestyle. Also, being aware of risk factors and symptoms can help you stay one step ahead of colorectal cancer, catching it while treatment can still be highly effective.

Risk Factors

There are several risk factors for colorectal cancer:

	Diet: eating foods that are high in fat and low in fiber increases your risk of developing colorectal cancer. It is believed that some of the elements present during the breakdown of fat can be carcinogenic (cancer-causing). In contrast, diets that are rich in fiber including grains and vegetables can help guard against colon cancer.
	Family history: individuals with first-degree relatives (parents, children, siblings) who have had colorectal cancer are more likely to develop this type of cancer themselves.
	Personal history: patients who have survived this type of cancer are at risk for a recurrence. Research shows that women who have had ovarian, uterine or breast cancer are also at greater risk of developing colorectal cancer.
	Polyps: patients with a history of polyps in the colon are at greater risk of developing cancer in this area. Removing benign polyps can reduce a person's chance of developing colorectal cancer.
	Age: individuals above the age of 50 are at greater risk of developing colon cancer.
	Ulcerative Colitis: a disease characterized by inflammation of the colon wall increases a person's chance of developing colorectal cancer.

In contrast to these factors, there are also steps an individual can take to reduce their risk of developing colon cancer. In addition to removing benign polyps and following a high-fiber/low fat diet, individuals can also monitor any genetic change that may lead to colorectal counselor. You may choose to see a genetic counselor to be screened for genetic changes of this kind. Speak with your physician to see of you are a good candidate. Also, studies show that reducing your consumption of aspirin and alcohol as well as the cessation of smoking and an increase in physical activity can reduce your chances of developing colorectal cancer.

Early Detection

If you are at risk for colon cancer or are over the age of 40, early detection methods will be key in your fight against cancer. These tests should be done regardless of whether there are symptoms present. Speak with your physician to find out when you should begin any of the following procedures:

	Fecal Occult Blood Test (FOTB): this test analyzes stool samples for the presence of blood. Blood in the stool may be a sign of cancer; however, it may also be a symptom of other conditions as well
	Sigmoidoscopy: this procedure can also be used to remove tissue samples that can be analyzed for cancer. It is recommended that high risk patients and individuals over 40 have this procedure done as a precaution every 3-5 years. Discuss your time frame with your physician.
	Colonoscopy: this procedure can also be used to remove tissue samples for further analysis.
	Double Contrast Barium Enema (DCBE): this procedure can be used to determine the presence of polyps and tumors in the colon.
	Digital Rectal Exam: the physician will stick a gloved, lubricated finger into your rectum to feel for abnormalities in the lining.
	Carcinoembryonic Antigen (CEA) Test: this substance is found in abundance when there is cancer present.

Symptoms

Symptoms of colorectal cancer are variable and non-specific. In some cases, it may take years for symptoms to develop depending on where the original tumor is located. Therefore, you should discuss any abnormalities with your physician in addition to discussing early detection methods. The following are symptoms associated with colorectal cancer:

	change in bowel habits
	diarrhea or constipation
	feeling that your bowel does not empty completely
	narrow stool
	blood in stool
	abdominal discomfort: cramps, painful gas, bloating
	weight loss for unknown reason
	fatigue
	vomiting

Diagnosis

Many of the techniques used for diagnosing colorectal cancer are similar to those used in early detection. Sigmoidoscopy, Colonoscopy and barium enemas may all be used in combination in order to diagnose this type of cancer. Biopsy, which involves the removal of a tissue sample from the colon or rectum can also be performed during a colonoscopy or sigmoidoscopy. Another procedure used to diagnose colorectal cancer is the polypectomy, which is the removal of polyps during a colonoscopy of sigmoidoscopy.

Once cancer has been diagnosed, it is important for your physician to determine the stage to which the cancer has progressed. Determining the stage of cancer is necessary in order to recommend proper treatment. The following is a general outline of the stages associated with colorectal cancer:

	Stage 0: cancer is only found in the innermost lining of the colon.
	Stage 1: cancer involves more of the inner wall but has not spread to any tissue outside the colon.
	Stage 2: cancer has spread to tissue outside the colon but not the lymph nodes.
	Stage 3: cancer has spread to nearby lymph nodes but not to other organs in the body.
	Stage 4: cancer has spread to other parts of the body. Colorectal cancer commonly spreads to the liver and lungs.
	Recurrent: cancer has returned to the colon or rectum after treatment.

Treatment

Once the stage of cancer has been determined, a physician can recommend treatment. The following are forms of treatment used to fight colorectal cancer. A physician may use these types of treatment in combination depending on the size, location and stage of cancer present.

Surgery: this is the most common form of treatment for colorectal cancer. During surgery, the cancerous portion of the colon and rectum is removed in addition to some healthy surrounding tissue and nearby lymph nodes in order to determine if the cancer has spread. The colon is then reconnected. In some cases, patients undergo an additional surgical procedure called a colostomy. In a colostomy, a surgical opening is created through the abdomen to allow for the removal of waste. A bag is attached to the surgical opening where waste can be collected. Most patients. Sometimes a temporary colostomy is necessary to give time for the patient's colon to heal. In approximately 15% of cases, when the colon cannot be reattached a permanent colostomy is necessary.

Depending on the outcome of the staging process, a physician may also recommend additional treatment either before, after or in place of surgery. These types of treatment include:

	Chemotherapy: destroys cancer cells by using special drugs-either one or a combination. These drugs may be given via injection or by mouth. Chemotherapy is a systemic treatment which means the drugs will flow through your blood to all parts of your body. For patients undergoing chemotherapy, the side effects depend on the types of drugs used and the dosages given. However, in general, chemotherapy mostly affects the cells in the body which divide rapidly; therefore, chemotherapy patients may experience a wide variety of effects. These include: infection, loss of hair, poor appetite, nauseam vomiting and mouth sores. Patients may bruise and bleed easily and have less energy.
	Radiation Therapy: bombards cancer-infected areas with high energy rays to stop cancer cells from growing. This treatment can be given externally using a machine or internally by placing radioactive material in or around the affected area. This treatment may also be used before surgery to decrease the size of the tumor. Patients undergoing radiation therapy often feel tired; however, patients are encouraged to remain active. Other side effects include: loss of hair and skin irritation. A "bronzing" of the skin may also occur in the treated area. It is important to keep the treated area out of the sun and to refrain from using creams or lotions without the consent of your physician. Try to avoid wearing clothing that rubs against the affected areas. Some patients may also experience diarrhea and discomfort while urinating.
	Biological Therapy: designed to improve the way your immune system fights cancer. This type of treatment is administered through a vein or by mouth.

Follow-up

Colorectal cancer patients are still at a higher risk for cancer recurrence; therefore, it is necessary to continue examinations proceeding surgery or any other cancer treatment. Cancer recurrence can occur in or around the previously affected areas or in other organs such as the liver and lungs. For proper follow-up a physician may perform one or more of the following procedures:

	physical examinations
	blood test for liver enzymes: elevated enzymes may indicate that cancer has spread to the liver.
	CAT Scan of abdomen and pelvis: can be used to find tumors in the colon, liver or other organs.
	chest x-rays: can be used to find tumors located in the lungs.
	blood CEA levels: rising CEA levels can indicate cancer recurrence.
	colonoscopy

Patients who have suffered from colon cancer are also at risk for developing cancer in other areas of the body like the prostate, breast and ovary; therefore, these areas should be checked as well.

BrooklynGI.com with offices in New York City Brooklyn Queens and Manhattan. Treating patients from New York, New Jersey and Connecticut. is dedicated to helping patients and physicians receive accurate and up-to-date information on the Gastrointestinal tract (GI Tract) The organs that compose the GI tract include, Esophagus, Stomach, Small Intestine, Large Intestine (Colon), Pancreas and the Liver and Gall Bladder (Hepato-Biliary Tree) Dr. Scott Tenner
Physicians include Dr. Scott Tenner Dr. Robin Baradarian Dr. Susan Ramdhaney Dr. Nison Badalov
Private Practice at 2211 Emmons Ave. Other locations include Maimonides Medical Center 1025 48th Street, Beth Israel Medical Center at KD3201 Kings Highway, Kingsbrook Jewish Medical Ctr at 585 Schenectady Ave, Brookdale Hospital at One Brookdale Plaza, and Kings Highway Hospital at 2525 Kings Highway
We treat a variety of gastrointestinal GI diseases and conditions including Achalasia
Barrett's Esophagus Chronic Hepatitis Cirrhosis of the liver Celiac disease Collagenous Colitis Colorectal cancer Colorectal polyps Constipation Crohn's disease Diverticulosis And Diverticulitis Fatty liver (Steatohepatitis) Gallstones Gas Gastritis Gastric Cancer GERD Helicobacter pylori infection Hemochromatosis Hemorrhoids Hepatitis (Viral Hepatitis A, B, C etc) Hiatus Hernia Irritable Bowel Syndrome Lactose Intolerance Liver failure and transplantation Lymphocytic Colitis Microscopic Colitis Esophageal Cancer Pancreatitis Peptic Ulcer Primary biliary cirrhosis Reflux esophagitis Ulcerative colitis
A premier site for the diagnosis, treatment and management Gastrointestinal diseases, Drs. Tenner and Baradarian provide a variety of Patient Services.
Drs. Tenner and Baradarian are Board Certified Gastroenterologists performing a variety of tests and procedures at their private offices and at Maimonides Medical Center.
We perform many tests & procedure, including: Barium Enema Barium Esophagram Capsule Endoscopy Colonoscopy Colon Cancer Screening EGD (Esophagogastroduodenoscopy) Endoscopic Ultrasound ERCP (Endoscopic Retrograde Cholangiopancreatography) Esophageal Dilation Esophageal pH Fundoplication Hemorrhoid Banding Hemorrhoidectomy Lactose Tolerance Test Liver Biopsy PEG (Percutaneous Endoscopic Gastrostomy) Sigmoidoscopy Stool Acidity Test Upper GI Series
BrooklynGI.com with offices in New York City Brooklyn Queens and Manhattan. Treating patients from New York, New Jersey and Connecticut. is dedicated to helping patients and physicians receive accurate and up-to-date information on the Gastrointestinal tract (GI Tract) The organs that compose the GI tract include, Esophagus, Stomach, Small Intestine, Large Intestine (Colon), Pancreas and the Liver and Gall Bladder (Hepato-Biliary Tree) Dr. Scott Tenner. Physicians include Dr. Scott Tenner Dr. Robin Baradarian Dr. Susan Ramdhaney Dr. Nison Badalov.
Gastrointestinal GI diseases and conditions including Achalasia Private Practice at 2211 Emmons Ave. Other locations include Maimonides Medical Center 1025 48th Street, Beth Israel Medical Center at KD3201 Kings Highway, Kingsbrook Jewish Medical Ctr at 585 Schenectady Ave, Brookdale Hospital at One Brookdale Plaza, and Kings Highway Hospital at 2525 Kings Highway
Barrett's Esophagus Chronic Hepatitis Cirrhosis of the liver Celiac disease Collagenous Colitis Colorectal cancer Colorectal polyps Constipation Crohn's disease Diverticulosis And Diverticulitis Fatty liver (Steatohepatitis) Gallstones Gas Gastritis Gastric Cancer GERD Helicobacter pylori infection Hemochromatosis Hemorrhoids Hepatitis (Viral Hepatitis A, B, C etc) Hiatus Hernia Irritable Bowel Syndrome Lactose Intolerance Liver failure and transplantation Lymphocytic Colitis Microscopic Colitis Esophageal Cancer Pancreatitis Peptic Ulcer Primary biliary cirrhosis Reflux esophagitis Ulcerative colitis
A premier site for the diagnosis, treatment and management Gastrointestinal diseases, Drs. Tenner and Baradarian provide a variety of Patient Services.
Drs. Tenner and Baradarian are Board Certified Gastroenterologists performing a variety of tests and procedures at their private offices and at Maimonides Medical Center.
We perform many tests & procedure, including: Barium Enema Barium Esophagram Capsule Endoscopy Colonoscopy Colon Cancer Screening EGD (Esophagogastroduodenoscopy) Endoscopic Ultrasound ERCP (Endoscopic Retrograde Cholangiopancreatography) Esophageal Dilation Esophageal pH Fundoplication Hemorrhoid Banding Hemorrhoidectomy Lactose Tolerance Test Liver Biopsy PEG (Percutaneous Endoscopic Gastrostomy) Sigmoidoscopy Stool Acidity Test Upper GI Series