Embarrassment Doesn’t Kill, but Colorectal
Cancer Does
It comes as to surprise to most of us that
lung cancer is the number-one cause of cancer deaths in the United States, but
the number-two cause may be an eye-opener.
The second leading cause of cancer deaths for both men and women in this
country is colorectal cancer. According
to the American Cancer Society, 148,300 new cases of colorectal cancer will be
diagnosed this year, and 56, 600 people will die from the disease.
Colorectal cancer includes colon, rectum,
appendix, and some anal cancers.
Because of the nature and location of the disease, people are reluctant
to talk about it, even with their doctors.
As a result, although colorectal cancer is easily detected and highly
treatable if found early, most people are still not being screened as they
should for this condition. While 90% of
those cases in which colorectal cancer was detected early survive more than
five years, only 37% of the cancers are found in their early, most treatable stage.
The importance of routine screening for this
disease is highlighted by the designation of March as National Colorectal
Awareness month. Because the most
common symptom of this cancer is the lack of any symptoms, the importance of
regular screening is obvious. Everyone
benefits from routine screenings, not only because there may be no symptoms
indicating a problem, but because in 75% of all new cases, the person has no
known risk factors for the disease other than being at least 50 years old. Also, men and women are equally at risk; the
Cancer Society estimates there will be 72,800 cases of colorectal cancer in men
and 74,700 cases in women in 2003.
Since 90% of colorectal cancer cases occur
after age 50, routine screening is recommended for everyone from age 50
on. Some people are at a higher risk
for the development of this disease and should be screened earlier. They
include people with a family history of non-cancerous colorectal polyps, anyone
with a personal or family history of colorectal cancer, people with a personal
or family history of inflammatory bowel disease (such as Crohn’s disease or
ulcerative colitis), and those who use tobacco, drink alcohol excessively, are
obese, or lead sedentary lifestyles.
Not only is this form of cancer usually
curable when found early, but it is also preventable. Screening tests can reveal the existence of polyps, which are
grape-like growths on the lining of the colon or rectum. Polyps can turn into cancer, so it is best
to remove them before they become a threat.
So colorectal screening is an important tool in both the prevention and
early detection of cancer.
Although colorectal cancer is apt to occur
without symptoms, even in people with no known family history of the disease or
predisposing conditions, sometimes people do experience signs that indicate a
problem. The following symptoms might
signal the presence of colorectal cancer:
--blood
in the stool
--a
change in bowel habits
--diarrhea
or constipation
--vomiting
--constant
tiredness
--weight
loss for no apparent reason
--feeling
that the bowel does not empty completely
--unexplained
anemia
There are four different methods of
Colorectal screening in use. The fecal
occult blood test (FOBT) allows the individual to perform the screening him or
herself at home, and will indicate the presence of blood in the stool. A sigmoidoscopy allows the physician to view
the inside of the rectum and lower part of the colon through a thin, flexible
tube, and is conducted in a doctor’s office or hospital. A lower gastrointestinal exam uses a barium
enema to make the colon and rectum visible in X-rays. The most comprehensive screening measure is a colonoscopy, which
involves the use of a scope and video to examine the lining of the entire colon
and rectum. A colonoscopy not only
reveals cancer, but can also detect polyps, which can be removed during the
screening procedure. This test is also
performed in a hospital or clinic setting.
If cancer is detected during a screening
procedure, it is then treated with surgery, radiation, or chemotherapy, or a
combination of these methods. But the
prognosis following treatment varies greatly depending upon the stage at which
the cancer is found. When the cancer is
found early and has not spread, over 90% of the cases survive beyond the
five-year marker. If the cancer has
spread to the surrounding tissue, the five-year survival rate drops to
66%. And when the cancer has spread to
more distant sites in the body, only 8.5% of those individuals survive five or
more years. Unfortunately, the majority
of people in this country have never been screened for colorectal cancer. In a radio address to the nation in 2000,
former President Bill Clinton urged people to get screened, noting that “none
of us will ever die of embarrassment.”
A few minutes of embarrassment has not killed anyone, but fear of
embarrassment can and does lead to inaction for many people. The result is often deadly.
For further information about colorectal
cancer and screenings, call the American Cancer Society at (860) 242-8277, or
use on-line resources such as the Cancer Research & Prevention Foundation
at www.preventcancer.org, or www.cancerlinks.com/colon_colorectal.html.