Colorectal cancer, the silent killer
Denise Guldin remembers when she was diagnosed with colon cancer in 1992. "It was like they were talking about somebody else," says the mother of four. "I was seeing some blood in my stool. And, I would occasionally have stomach cramps and diarrhea, but I never imagined it was because of colon cancer."
The discovery
Great strides in treatment
Shrinking tumors in 3D
More about colorectal cancer
The symptoms
Prevention
The discovery
Guldin's tumor was discovered during a colonoscopy performed by William Cody, MD, a board-certified colorectal surgeon at Virtua Health. Performed under anesthesia, a colonoscopy is an exam of the rectum and colon using a lighted instrument called a colonoscope. It provides a clear picture of the entire colon.
"Polyps," explains Dr. Cody, "are growths in the colon that turn into cancer over time. A colonoscopy allows the physician to remove polyps when they are discovered." It was this procedure that enabled Dr. Cody to identify Guldin's tumor at an early, highly treatable stage.
Great strides in treatment
Cancer specialists at the Fox Chase Virtua Health Cancer Program (FCVH) provide the latest treatments for colorectal care, offering services that range from advanced radiation oncology and state-of-the-art chemotherapy to patient participation in national and regional clinical trials.
Surgeons treat colon cancer by removing the tumor along with a section of the surrounding colon. The healthy sections of colon are rejoined and, if the cancer has spread beyond the colon, chemotherapy follows. Guldin's cancer was contained to the colon and she did not need chemotherapy.
And now, groundbreaking treatments are available to remove cancer from the rectum. Radiation and chemotherapy are used prior to surgery to help shrink the tumor. This enables surgeons to preserve more of the rectum and decrease the need for a colostomy, a procedure in which a small pouch is attached to the outside of the body to collect stool if the rectum can't. "There was a time when almost 90% of patients needed a colostomy. Now only 10 to 15% of patients need a permanent one," says Stephen Pilipshen, MD, Virtua colorectal surgeon. "We are also performing a procedure called a colonic J pouch to help alleviate a feeling that some people who have rectal surgery experience —an inability to control bowel movements."
Shrinking tumors in 3D
When using radiation to shrink tumors, radiation oncologists of the FCVH Cancer Program use advanced equipment, including a sophisticated process to create a 360-degree or 3D image of a patient's tumor and the surrounding tissue. Ashraf Youssef, MD, board-certified radiation oncologist for the FCVH Cancer Program, explains that this technology enables physicians to ensure the tumor receives the maximum radiation in precise locations. "We can view the tumor from every angle. The computer shows exactly where the radiation beams will hit, allowing us to adjust them accordingly."
More about colorectal cancer
The colon and rectum don't have a glamorous job, but their healthy function is certainly critical to one's well being. The colon is responsible for forming and storing the body's waste. And the rectum is responsible for expelling it.
While no one knows for sure what causes the colon and rectum to develop cancer, it is known that colorectal cancer often starts as polyps - small growths that form on the colon lining. And there are certain risk factors that make a person more susceptible. These include being over the age of 50, a high-fat diet, a history of polyps, smoking, a family history of colon cancer and a diagnosis of ulcerative colitis.
The symptoms
Often referred to as a silent killer, the symptoms of colorectal cancer are similar to other medical conditions. Signs include diarrhea, constipation or a sensation that the bowel does not empty completely. Some people experience blood in the stool or stool that is narrower than usual. Frequent gas pains, bloating, fullness and cramps can also be a sign as well as unexplainable weight loss, fatigue, and vomiting.
Prevention
The issue that complicates the detection of colorectal cancer is that symptoms are often not noticeable until the cancer is at a later stage. The American Cancer Society recommends that both men and women have a colonoscopy every 10 years starting at the age of 50. Those with a family history should start at age 40. To help prevent colon cancer, it's important to eat plenty of fruits, vegetables, and whole grain foods and to limit the amount of red meats you eat, especially those high in fat. Even small amounts of regular exercise is important as well.