The James Experts on Colorectal Cancer: Prevention, Detection Are Key
March is National Colorectal Cancer Awareness Month, and to avoid becoming one of the more than 134,000 new colorectal cancer patients in 2016 (as projected by the American Cancer Society), prevention knowledge is key.
“The most important thing we can talk about and teach people is prevention, prevention is so vital,” said Christina Wu, MD, a medical oncologist at The Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute.
Dr. Wu specializes in targeted therapies for colorectal cancer – a cancer that starts in either the colon or rectum. She believes education and awareness would lead to more people getting colonoscopies, the procedure that detects per-cancerous polyps in the colon and rectum. These pre-cancerous polyps are then removed through a simple procedure before they can become cancerous, metastasize and travel to and grow in other parts of the body.
More screenings save lives by reducing the number of new colorectal cancer cases. Colorectal cancer is the fourth most common cancer type and represents 8 percent of all new cancer cases in the United States, according to the National Cancer Institute (NCI).
“The national guidelines say to have a colonoscopy at 50,” Dr. Wu said. “But if, for example, you are diagnosed with colon cancer at 45, all your first-degree relatives should have a colonoscopy 10 years prior to when they turn 45.”
Anyone with a first-degree relative – your parent, sibling or child – diagnosed with colorectal cancer is “two to three times more likely to get it,” said Heather Hampel, MS, LGC, associate director of the Division of Human Genetics at the OSUCCC – James.
Hampel is also the lead of the OSUCCC – James’ Ohio Colorectal Cancer Prevention Initiative (OCCPI). This statewide program has tested more than 2,000 colorectal cancer patients from 50 Ohio hospitals to determine if they have Lynch Syndrome, a mutation of one of four genes that leads to colorectal cancer, as well as uterine, ovarian and gastric cancer.
The relatives of these colorectal patients with Lynch Syndrome are in turn tested to determine if they have the genetic mutation. To date, about 50 of these relatives have been diagnosed with Lynch Syndrome – and will undergo a colonoscopy every year or two starting at the age of 20 to 25 to detect the pre-cancerous polyps that will inevitably form.
“If you find people with Lynch Syndrome before they develop cancer, you can take the proper precautions and save lives,” Hampel said.
Unfortunately, there are a few hurdles to more widespread screenings, which is why the percentage of people up-to-date on colonoscopies is low.
“Many people think the symptoms are minor and will go away,” Dr. Wu said. “They think they have hemorrhoids and they overlook it.”
Symptoms of colorectal cancer include: blood in the stool; a change in bowel habits, such as more or less bowel movements; diarrhea, constipation or a feeling that the bowel has not emptied completely; frequent gas pains, bloating, fullness or cramps; and weight loss for no apparent reason.
“Anemia is another symptom and is indicative of blood loss,” Dr. Wu said, adding that anyone who suffers from one or more of these symptoms should immediately consult their physician.
And yes, it can be difficult to talk about these symptoms.
“There is a component of embarrassment,” Dr. Wu said. “But you can’t let that stop you, it’s too important.”
Another hurdle to overcome is the negative connotations associated with a colonoscopy.
“People think it’s an unpleasant experience,” Dr. Wu said. “They have to prepare the day before and take a day off from work and have someone drive them home. But the actual procedure isn’t so bad; I had a colonoscopy and it really wasn’t so bad. And the preparation the day before – the dose of laxatives – is getting smaller and easier to handle.”
There are four stages of colorectal cancer.
In Stages 1 to 3, the cancer has not yet metastasized. “It is curable and can be removed through surgery,” Dr. Wu said.
In Stage 4, the colorectal cancer has metastasized. “It travels through the blood and lymph nodes and looks for a place to settle and grow, usually the lungs, liver or abdomen,” Dr. Wu said.
Recent advances in research and treatment have made Stage 4 colorectal cancer curable.
“It’s a lot more challenging, but we can make you cancer-free,” Dr. Wu said.