Cancer screening saves lives, but not everyone takes advantage of it. This is particularly true for colorectal cancer. It is one of the most preventable and treatable diseases when proper screening protocols are followed, yet it remains the second-leading cause of cancer death for men and women in the United States.
March is Colorectal Cancer Awareness Month, and health organizations are using the opportunity to bring greater awareness to colorectal cancer and the importance of regular screening. Today, there are more than 1 million survivors of colorectal cancer in the United States, and with more effective screening tests and advanced treatment options now available, even more lives can be saved.
Here, surgeon Kurt Melstrom, M.D., clinical professor of surgery at City of Hope, explains the main causes of colorectal cancer, the importance of screening and the growing list of treatments for the disease.
What causes colorectal cancer, and who is most at risk?
Like all cancers, colon cancer is primarily caused by mutations in our DNA. The number one risk factor for colon cancer is age, with more than 90 percent of colon cancers occurring in patients older than 50. Excessive red meat intake, smoking, alcohol use and obesity also contribute to colon cancer to a lesser extent. There are several very rare genetic disorders that will lead to colon cancer in most of the patients carrying that disorder.
What are the biggest developments in treating colorectal cancers?
Over the last 20 years, there have been great advancements in the surgical and medical care of colon and rectal cancer. The addition of newer chemotherapies for colon cancer has doubled survival times in patients with the most aggressive forms of colon cancer. Surgically, the addition of minimally invasive surgery has greatly enhanced postoperative recovery. We are now able to perform the same operation using laparoscopic or robotic techniques with a shorter hospital stay, less pain and smaller incisions.
What can people do to limit their risk of colorectal cancers?
The number one way to limit colon cancer is to get a colonoscopy. If a colon cancer is caught early, it is a curable disease. Screening starts at age 50, unless there is a family history or symptoms, and is followed by repeat colonoscopies every five to 10 years. A healthy diet high in fiber and low in fat and red meat is always recommended, not only to prevent cancer but heart disease, as well.
What advice do you have for patients recently diagnosed with this cancer?
My first recommendation is not to worry. We have made great advancements in the field, and the majority of colon cancers are curable. The next step is to see a colorectal surgeon as soon as possible. He or she will complete the staging work-up and either schedule a surgery or get the patient in to see a radiation or medical oncologist based on the stage and type of disease.
Why did you choose to enter this field? What inspires you to do the work you do?
My primary drive for going into medicine was the opportunity to treat and cure patients affected by disease. I have always had a drive to help out people, and I felt this field was the best way for me to advance treatments and give back to our society. Once I had finished medical school, I realized that I enjoyed operating too much to do anything else. There is great satisfaction in identifying a tumor, removing it and restoring the body to normal functioning. My inspiration comes from the individual challenge that each patient brings and finding the best way to treat them maximally.
For more information about colorectal cancer, listen to Melstrom discuss treatment, the importance of early screening and how to reduce risk in this RadioMD podcast episode.
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