For National Colorectal Cancer Awareness Month, Misagh Karimi, M.D., a medical oncologist at City of Hope | Newport Beach, tells you what you need to know about this disease.
Why should people know more about colorectal cancer?
It is the third most common cancer in America. Colorectal cancer is traditionally considered a disease that affects older adults, but in recent years we’ve noticed a trend that concerns us. While cases are decreasing among people 65 and older, they’ve actually been increasing, by about 2% each year among adults 50 and younger. It’s believed the decline in cases for older people can be attributed to increased cancer screenings, but we don’t know yet why more young people are getting colorectal cancer.
What are some common myths about colon cancer?
Many people think this is a disease that afflicts older men. However, not only does colorectal cancer affect younger people, it’s only slightly more common in men than women. Another misconception I hear is that people don’t think they need to be screened because they don’t have symptoms, but signs of colorectal cancer tend to appear when the cancer is in its later stages. Finally, people consider colorectal cancer to be a deadly disease, but thanks to screening and new therapies, the prognosis is very good when the cancer is caught early.
What are the symptoms?
As colorectal cancer progresses, you may have bloody stool, weight loss or persistent stomach pain. Because these symptoms appear later, screening is essential for early detection that improves the odds of successful treatment.
When should people get screened?
Colorectal cancer screening was recommended for people age 50 and older. However, those guidelines are changing with the increase in cases among younger people. The American Cancer Society and the American Society of Colon & Rectal Surgeons have lowered their recommended screening age to 45, and the U.S. Preventive Services Task Force is doing the same. High-risk individuals should talk with their doctor about early screening.
What are the types of screening tests?
There are several, and your physician can help select the best one for you:
- Stool tests, such as the guaiac-based fecal occult blood test or fecal immunochemical test. A sample of your stool is checked for blood in these tests, which should be done annually. A third test, FIT-DNA, checks the stool for cancer cells and should be performed every one to three years.
- Flexible sigmoidoscopy. A thin tube illuminates the rectum and lower part of the colon to detect polyps. This test is done every five years; with an annual FIT-DNA, you only need it every 10 years.
- Colonoscopy. Like a flexible sigmoidoscopy, but the entire colon is examined. It takes place every 10 years.
- CT colonography/virtual colonoscopy. A doctor reviews computer-generated images of the colon in this screening, which is done every five years.
For many people, fear is a barrier to getting screened — they worry that the test will be painful or embarrassing. Typically, these tests aren’t painful, and any embarrassment is outweighed by the benefits of colorectal cancer screening.
What are the treatment options?
Polyps may be removed during colonoscopy. If cancer cells are still in the colon, that section can be removed with surgery, which is often minimally invasive. If the cancer has spread beyond the colon, you may also need chemotherapy or radiation therapy.
In recent years, we’ve seen the advancement of colorectal cancer treatment with targeted therapies and immunotherapy drugs. And there are exciting innovations developing at City of Hope. Our scientists are researching a cancer-killing virus that could help the immune system fight colon cancer, as well as a botanical agent that may help treat chemo-resistant colorectal cancer.
Can you prevent colorectal cancer?
I encourage everyone to get a colorectal cancer screening as their physician may advise, which is an excellent preventive measure. It’s also wise to eat a nutritious, whole-food diet and exercise regularly because being overweight or obese can increase your cancer risk. Finally, I advise people to quit smoking and limit their alcohol consumption if they’re concerned about colorectal cancer.
Discover safe and expert colorectal cancer care at City of Hope | Newport Beach. Schedule an appointment to speak with one of our highly specialized cancer physicians. Call 949-763-2204 or visit CityofHope.org/OC/NewportBeach.