Colon and Rectal Cancer: Prevention and Treatment
Roberto Bergamaschi, MD, PhD, Professor of Surgery and Chief, Division of Colon and Rectal Surgery, and Paula I. Denoya, MD, Assistant Professor of Surgery, Division of Colon and Rectal Surgery, answer questions on what you need to know about this highly treatable and often preventable cancer.
How can colorectal cancer be prevented?
Colorectal cancer arises from the lining of the colon or rectum, usually from cells that secrete mucus. In many cases, it starts out as a polyp, which is a premalignant, benign lesion or an overgrowth in the lining of the colon. If left alone, a polyp can grow into cancer. However, with screening, polyps can be detected and removed, thus preventing cancer.
What are the signs and symptoms?
In most cases, colorectal cancer is often symptomless, which is why screening is so important. Some people do experience telltale signs, however, which include:
Anyone experiencing these symptoms, or a combination of them, should speak with their primary care physician.
Who is at risk?
According to the American Cancer Society (ACS), colorectal cancer is the third most common cancer in men and women. Gender does not seem to be a factor, but age is, and risk increases after age 50. People considered to be at higher risk include those with a family history of polyps, colon cancer or uterine cancer; individuals with inflammatory bowel disease; anyone with a personal history of polyps; and persons with inherited syndromes such as familial adenomatous polyposis and hereditary nonpolyposis colorectal cancer, also known as Lynch syndrome. The ACS recommends that people undergo screenings starting at age 50 — preferably via colonoscopy, which is considered the gold standard test — with a follow-up every 10 years if no polyps are detected. Individuals at high risk should start screenings earlier and have more frequent follow-ups.
If cancer is detected, how is it treated?
Colorectal cancers respond well to treatment, which is often relatively uncomplicated. About 30 percent of cases can be treated with surgery alone. Cancers in later stages respond well tochemotherapy and radiation, and overall, the five-year survival rate approaches 65 percent.
What distinguishes Stony Brook's approach?
At Stony Brook University Cancer Center, we offer the latest protocols and treatments for colorectal cancers. We take a multidisciplinary team approach, which ensures coordinated caretailored to the needs of each patient, including collaborative input from cancer experts, surgeons and our additional specialists. The Colorectal Oncology Team also performs robotic-assisted surgery for the treatment of cancers of the colon and rectum. Using the da Vinci® S HDTM Surgical System, our surgeons offer patients another option beyond traditional open surgery and laparoscopic procedures. The major advantage of this minimally invasive technique is that it provides surgeons with enhanced visibility and mobility. This improves accuracy, provides cleaner “margins” (which means that no cancer cells are seen at the outer edge of the tissue that was removed) and helps ensure that all the lymph nodes (difficult to see and reach by conventional methods) can be removed during the procedure. Benefits to the patient include less bleeding, less scarring, less pain and a lowered risk of infection. In addition, Stony Brook has begun offering transanal endoscopic microsurgery, a less invasive procedure than the traditional approach for reaching lesions higher up in the rectum. It can also help return patients to a higher quality of life postsurgery — something that is key to recovery. Stony Brook Medicine is also working to advance the practice of medicine through clinical trials and research. It currently is participating in a multi-institution trial run by the American College of Surgeons Oncology Group to pioneer a minimally invasive laparoscopic treatment for rectal cancers.
For more information about Stony Brook University Cancer Center, call (631) 638-1000.
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