Getting Ahead of Colon Cancer

Annually, colon cancer claims more than 50,000 American lives, making it the second leading cause of cancer deaths in our country.  March has been designated as National Colorectal Cancer Awareness Month, and it offers us an opportunity to educate the community about how to protect themselves. 

Colorectal cancer can afflict anyone, and research has shown that the risk of death from colon cancer decreases dramatically when it is caught early. Lives can be saved by highlighting risk factors and increasing awareness about routine screening. 

I asked Niraj Jani, MD, Chief of Gastroenterology and Director of GBMC’s Kroh Center for Digestive Diseases, to discuss colon cancer, how to reduce risk, and how to detect colon cancer.

How is colon cancer diagnosed and why is screening for colorectal cancer important? 
There are multiple ways to detect colon cancer, including stool-based tests, imaging such as CT scan, MRI or colonoscopy.  Early detection is key to cure and increased survival. The gold standard test is colonoscopy, which allows for the detection of early lesions, such as polyps, which are the precursor to colon cancer. If a polyp is detected during colonoscopy, it can be either biopsied or entirely removed, thereby eliminating the chance it could develop into cancer.

How important is it for people to get screened now, since they might have put it off due to the COVID-19 pandemic? 
It is especially important to get screened starting at age 45 for routine screening or earlier if you have symptoms or a family history of colon cancer. Delay of screening procedures due to COVID has led to delay in diagnosis and detection and, unfortunately, finding more advanced disease. Symptoms of colon cancer are vague and often don't occur until disease has advanced. These may include blood in the stool, change in bowel habits, abdominal pain, and/or fatigue.

How does someone know which colon cancer screening is right for them?
A colonoscopy still remains the gold standard for colon cancer screening.  For a patient who may be high risk or have multiple other health problems, other less invasive alternatives to colonoscopy exist. One example is Cologuard, a stool-based DNA test. It is a very sensitive test, but it has a high false-positive rate of 13 percent. In select patients with difficult anatomy, prior surgeries, or radiation, virtual colonoscopy through a CT scan is also a good option.

If someone’s recent colonoscopy showed a few polyps, should they be worried?
If a prior colonoscopy detected polyps, surveillance colonoscopy should be done earlier than the normal 10-year interval. The screening interval depends on the pathology and number of polyps. If you had polyps before, that does not always mean another polyp will be detected on subsequent colonoscopies.

How is colon cancer treated?
If you’ve been diagnosed with colon cancer, your treatment team may include medical oncologists, surgeons, and radiation oncologists. They will all work together to develop the best treatment plan for your condition.

Colon cancer treatment depends on how early the cancer is caught. Sometimes, polyps can be removed during a colonoscopy and no additional treatment is necessary. Alternatively, surgery and/or chemotherapy may be needed.

How can you prevent colon cancer?
Tools that may prevent colon cancer include a diet that is low in saturated fat, eating high fiber plant-based diets and getting routine screening. 

For those individuals who are at high risk for colon cancer, some medications have been found to lower the chance of precancerous polyps or colon cancer. Some research has shown a reduced risk of polyps and colon cancer from the regular use of aspirin or aspirin-like drugs. However, dosage and the length of time needed to reduce the risk of colon cancer is still in question. Consuming aspirin daily has some risks, including gastrointestinal bleeding and ulcers. 

Again, there isn't enough evidence to recommend these medications to people who have an average risk of colon cancer. If you have an increased risk of colon cancer, discuss with your doctor your risk factors and if preventive medications are safe for you.

As with so many diseases, the best defense against colorectal cancer is early detection. The COVID-19 pandemic disrupted our lives, including, for many, evidence-based screenings, like colon cancer screening, that are vital to guarding against disease. 

As Dr. Jani mentioned, colon cancer is one of the few cancers that can be prevented through timely screening and removal of pre-cancerous polyps. I urge people to take the precautions to stay vigilant against cancer — don’t delay your recommended screenings, doctor’s visits, and treatments. I want to thank Dr. Jani for his participation this week. Please remember to schedule your colonoscopy when you are due. Thank you!

Seeing Blue!
You may have noticed the blue wall lighting coming down the concourse from the Lily Garage into the hospital and a shade of blue shining on our main sign on Charles Street. This was done in conjunction with the American Cancer Society (ACS), Colon Cancer Coalition and Fight Colon Cancer, in recognition of Colorectal Cancer Awareness Month to support patients, raise awareness, increase screening rates, and save lives. 

I want to thank Brian Fitzpatrick, our Energy and Facilities Manager, and his crew for turning our lights blue. Again, I hope it encourages people to get screened when they are due!

Thank You!!
This week has been designated as Human Resources in Healthcare Week and Pulmonary Rehabilitation Week. 

Our human resource professionals work hard to develop policies to recruit and retain great people for our team. Our pulmonary rehab staff  help our patients, who suffer from lung disease, acquire increased endurance, strength, and a better quality of life and to take on and complete daily tasks that can be strenuous to someone living with shortness of breath.

Please take the time to thank our human resources team and our pulmonary rehab staff for all that they do to move us closer to our vision!