Colo-rectal Cancer Management - FAQs

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Written by Dr. Anitha Paderla, MBBS | Medically Reviewed by Dr. Sunil Shroff, MBBS, MS, FRCS (UK), D. Urol (Lond) on Dec 19, 2019
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Colo-rectal Cancer Management - FAQs

1. Who treats colorectal cancers?

A general surgeon or a gastroenterologist or a Colo-rectal Surgeon treats colorectal cancers.

2. What are the early symptoms of colorectal cancer?

The early symptoms of colorectal cancer are unexplained weight loss, change in bowel habits from what is considered normal for a given individual - either constipation or diarrhea - unexplained anemia (low blood count), and visible blood in the stool. It is also important to remember that colon cancer may be silent and not associated with any symptoms.

3. Does blood in the stool always indicate colorectal cancer?

Blood in the stool could also be due to hemorrhoids, anal fissures or tears, infections of the colon, inflammatory bowel diseases, and colonic diverticula. Blood in the stool may also occur from lesions in the stomach and small intestine such as peptic ulcer disease, and Crohn's disease.

4. Looking at the rectal bleeding is it possible to identify its source?

It may not be possible; bleeding from hemorrhoids and anal fissures is usually bright red, while that from colorectal cancers is occult (hidden). But rectal bleeding of any amount is never normal and should not be ignored, as some causes of rectal bleeding such as colon cancer are more serious than others. So consult your doctor and get the bleeding properly checked out.

5. What is the best colon cancer-screening test?

Colonoscopy is considered to be the "gold standard." It is the only method that has a high sensitivity for all polyps, both small and large, and which presents the capability of removing them at the time of the procedure.

6. Can young people below the age of thirty with no positive family history get colorectal cancer?

In general, it is very uncommon for young people to get colorectal cancer. However, there are two well-recognized hereditary syndromes namely Familial Adenomatous Polyposis (FAP) and Hereditary Non-Polyposis Colorectal Cancer (HNPCC) in which cancer can develop in young people.

7. What are the options available for those people with a positive family history?

If a positive family history is present, children at risk may be screened for a gene mutation with a genetic test. They should also start having sigmoidoscopies or colonoscopies starting at 10 or 12 years of age and repeated every 6 to 12 months to look for the presence of polyps. Once numerous polyps start developing surgery is planned. The good news about these diseases is that the surgical options are very good and now the colon can often be removed by a mini-or laparoscopic approach. The bowel is put directly back together and no bag is necessary. People move their bowels normally.

8. What effect does diabetes have on colon cancer?

People with diabetes have a greater chance of developing colon cancer. They also tend to have lower survival rates and higher recurrence rates.

9. How does smoking increase colon cancer risk?

There are two ways by which smoking can affect the colon. Tobacco smoke transports carcinogens to the colon and tobacco use increases the size of polyps.

10. I was diagnosed with colon cancer a year ago; how often should I have a blood test?

You should have a CEA (carcinoembryonic antigen) blood test every three months for the first two years after your cancer diagnosis, then every six months for about five years after that. CEA testing, combined with CT (computed tomographic) scans, can improve survival rates.

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