By Eduardo Gonzales, MD
A friend was recently diagnosed with colon cancer after seeing a doctor for blood in his stool. Is blood in the stool the usual early sign of colon cancer? How common is this cancer in the Philippines? —firstname.lastname@example.org
According to the Philippine Cancer Society (PCS), colorectal cancer is gaining unwanted ground in the Philippines. It is now the third leading type of cancer in our country. The PCS estimates that at least 8,000 new cases of colorectal cancer occur among Filipinos annually. Colorectal cancer, often simply called colon cancer, is cancer that occurs in the colon (large intestine) or rectum, the terminal segment of the digestive tract.
No one knows for sure what causes colorectal cancer, but we know that one’s chances of getting the disease increases as one gets older—more than 90 percent of cases occur in people who are 50 years old or older. Also associated with increased risk for this malignancy are a family or personal history of colorectal cancer and polyps, inflammatory bowel disease such as Crohn’s disease or ulcerative colitis, and genetic syndromes such as familial adenomatous polyposis (FAP) or hereditary non-polyposis colorectal cancer.
Some lifestyle factors likewise increases one’s odds for colorectal cancer such as a low-fiber and high-fat diet, sedentary way of life, heavy alcohol drinking, obesity, and smoking.
Early colorectal cancer is usually asymptomatic
Fresh (red) or digested (black) blood in the stool is one of the most common signs of colorectal cancer, but it is usually not an early but a late sign. In most instances, colorectal cancer is asymptomatic in its early stage. Incidentally, less than 10 percent of people with blood in the stool have cancer, most have a benign conditions like hemorrhoids, anal fissures or tears, or infections of the colon.
The other signs and symptoms of colorectal cancer are nonspecific and include weight loss, fatigue, weakness, shortness of breath, abdominal pain, cramps, bloating, and change in bowel habits, such as narrow stools, diarrhea, or constipation.
Colorectal cancer is curable
Cancer of the colon is a curable disease, especially if diagnosed early. When localized to the bowel (stage I), the survival rate with treatment is 80 to 95 percent. Even in advance colon cancer (stage IV), patients still have a 10 percent chance of cure.
Surgery is the primary form of treatment in all colorectal cancers. Radiation therapy may likewise be used along with chemotherapy before or after surgery.
How to beat colorectal cancer
The best way to beat colorectal cancer is by regularly undergoing a screening test for the malignancy beginning at age 50 years. After age 75, however, the decision to screen is based on patient’s life expectancy, health status, co-morbid conditions, and prior screening results. Routine screening of people aged 86 years or older is not recommended. People who have the risk factors for colorectal cancer that have been mentioned in a previous paragraph may need earlier (i.e., before 50 years old) and more frequent screening.
The screening tests for colorectal cancer are designed to detect polyps and early cancers in the intestines. Finding and removing polyps is important because virtually all colorectal cancers develop from polyps.
To detect polyps and early cancers, the U.S. Preventive Services Task Force (USPSTF) recommends any one, just one, of the following procedures: 1) flexible sigmoidoscopy every five years; 2) colonoscopy every 10 years; 3) double-contrast barium enema every five years; 4) CT colonography (virtual colonoscopy) every five years.
The USPSTF also considers several other methods to be acceptable screening tests for colorectal cancer including high-sensitivity fecal occult blood tests (FOBT), and stool DNA test (FTI-DNA).
To find out which method is best for you, consult and discuss the matter with your doctor.
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