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Colorectal Cancer (Part II)

By Indran B. Indrakrishnan, M.D. Email By Indran B. Indrakrishnan, M.D.
January 2005
Colorectal Cancer (Part II)

The colon and the rectum are parts of the digestive system and together they form a long muscular tube known as large intestine. The first 5 feet of the large intestine is colon and the last 10 inches is the rectum. Cancer of the colon and the rectum are referred to as colorectal cancer.

Colorectal cancer grows from benign growths called polyps. A polyp is a mushroom-like growth in the lining of the colon or rectum. Polyp usually develops in the people of 50 years or over. However, it can also develop in younger people if there are associated risk factors, which will be discussed below. The polyps grow larger and eventually become cancer over a period of several months to years.

What are the risk factors?

The exact causes of colorectal cancer are not known, but the clinical studies have shown that there are risk factors which increase the people's chances for developing this deadly cancer.

*Age

As people get older they are more likely to develop colorectal cancer and approximately 90% of this cancer occurs in the people over the age of 50. However, it can also develop in people as young as in their teens, particularly if there is a strong family history of colorectal cancer.

*Diet

Diet rich in animal fat and low in fiber & vegetables appear to be associated with increased risk of developing colorectal cancer.

*Life Style

People who are over weight with sedentary life style and reduced physical activity are at an increased risk for colorectal cancer. In addition, it has been shown that smoking and heavy alcohol intake may also increase the risk.

*Polyps

As mentioned above, presence or past history of colon polyps increase the risk of colon cancer. These polyps can be detected and removed by colonoscopy.

*Personal History of Female Cancers or Prostate Cancer

Research has shown people with a history of ovarian, uterine, cervical, breast and prostate cancers are at an increased risk of developing colorectal cancer.

*Family Medical History

First-degree relatives (parents, siblings and children) of the colorectal cancer patients have an increased risk for colorectal cancer. The risk is higher if the patient is diagnosed with cancer at a relatively young age. Approximately, 10% of colon cancers occur as a result of inherited genetic syndrome. Some of the common syndromes include Familial Colon Cancer (FCC), Hereditary Non-Polyposis Colon Cancer (HNPCC) and Familial Adenomatous Polyposis (FAP). Individuals with the family history of these diseases are at increased risk of developing colorectal cancer and should be followed closely by specialist. Recently genetic tests have been developed to identify the people with high risk for these syndromes.

*Inflammatory Bowel Disease

People who suffer from long standing ulcerative colitis and crohn's colitis have an increased risk of colorectal cancer.

Please note that presence of these risk factors does not imply that the person will certainly develop colorectal cancer, but it merely increases the chances. You may want to discuss these risk factors with your physician.

Symptoms of Colorectal Cancer

The important message here is that early stages of colorectal cancer may not give any symptoms and patients may feel absolutely fine for several months until the cancer invades deeply and spreads to the adjacent organs. Some of the symptoms/ signs include the following:

* Rectal bleeding

* Change in the bowel habits with either constipation or diarrhea

* Unexplained stomach pain

* Persistent decrease in the size or caliber of the stool

* Frequent feeling of distension or bloating of the stomach

* Weight loss

* Tiredness & weakness due to loss of blood

Fortunately, there are wide variety of excellent diagnostic tests and various treatment options available to beat this deadly cancer and we will discuss these topics in the next issue.

--By Indran B. Indrakrishnan, M.D.

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