Colon & Rectal Cancer Awareness
Prevention. Colon and rectal cancer can be prevented! By finding and removing precancerous polyps (adenomas) that can develop into cancer, colorectal cancer can be stopped before it ever starts. In addition, screening can detect colorectal cancer early when it is most curable.
All adults over the age of 50 are at risk for colorectal cancer and should be screened for adenomatous polyps and cancer. Some people have a greater than average risk and should work with their doctor to develop an individualized screening plan. While screening is the most important way to prevent colorectal cancer, there are lifestyle changes that can reduce your risk for polyps and colorectal cancer.
Most polyps grow on the end of a stalk, somewhat like a mushroom. When they get larger than the eraser on the end of a pencil (5 millimeters, their cells can gradually change to cancer. Other polyps lie flat against the wall of the colon and are called sessile. Not all polyps will become cancer, but it is important to remove them because we can’t tell which ones will remain harmless and which will become cancerous.
Screening can also find dangerous lesions that are not polyps. Nonpolypoid colorectal neoplasms (NP-CRNs) are flat lesions in the colon that can be missed unless doctors look carefully for them, often using special colonoscopy techniques. One study found them in almost ten percent of patients who had a colonoscopy.
While over 90 percent of colon and rectal cancers are found in people over the age of 50, anyone at any age can get colorectal cancer. People younger than 50 need to protect themselves by knowing their family cancer history and their own medical history. People with a family history of certain cancer or with certain medical conditions may need to begin colonoscopy screening earlier and be tested more often. In addition, everyone, no matter how old they are, needs to know the symptoms of colorectal cancer and have a complete colonoscopy to rule out cancer if they have symptoms.
Colorectal Cancer 2009 Fact Sheet
Colorectal cancer is cancer of the colon or rectum. It is equally common in men and women. An estimated 146,970 people will be diagnosed in 2009, and an estimated 49,920 people will die from the disease. With recommended screening, this cancer can be prevented (by removing polyps before they become cancerous) or detected early, when it can be more easily and successfully treated.
At Risk
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Men and women age 50 and older
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People who use tobacco, are obese or are sedentary
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People with a personal or family history of colorectal cancer or benign (not cancerous) colorectal polyps
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People with a personal or family history of inflammatory bowel disease, such as long standing ulcerative colitis or Crohn’s disease
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People with a family history of inherited colorectal cancer
Risk Reduction
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Be physically active and exercise regularly.
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Maintain a healthy weight.
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Eat a high-fiber diet rich in fruits, vegetables, nuts, beans and whole grains.
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Consume calcium-rich foods like low-fat or skim milk.
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Limit red meat consumption and avoid processed meats.
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Don’t smoke.
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Don’t drink alcohol excessively.
Early Detection
If you are at average risk for colorectal cancer, start having regular screening at age 50. If you are at greater risk, you may need to begin regular screening at an earlier age. The best time to get screened is before any symptoms appear. Use this guide to help you discuss screening options with your health care professional. Consider one of the following:
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Screening intervals for tests that find pre-cancer and cancer:
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Colonoscopy: Every 10 years
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Virtual colonoscopy: Every 5 years
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Flexible sigmoidoscopy: Every 5 years
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Double-contrast barium enema: Every 5 years
What is a colonoscopy? A colonoscopy is an outpatient procedure in which the inside of the large intestine (colon and rectum) is examined. A colonoscopy is commonly used to evaluate gastrointestinal symptoms, such as rectal and intestinal bleeding, abdominal pain, or changes in bowel habits. Colonoscopies are also performed in individuals without symptoms to check for colorectal polyps or cancer. A screening colonoscopy is recommended for anyone 50 years of age and older, and for anyone with parents, siblings or children with a history of colorectal cancer or polyps.
What happens before a colonoscopy? To complete a successful colonoscopy, the bowel must be clean so that the physician can clearly view the colon. It is very important that you read and follow all of the instructions given to you for your bowel preparation well in advance of the procedure. Without proper preparation, the colonoscopy will not be successful and the test may have to be repeated.
If you feel nauseated or vomit while taking the bowel preparation, wait 30 minutes before drinking more fluid and start with small sips of solution. Some activity (such as walking) or a few soda crackers may help decrease the nausea you are feeling. If the nausea persists, please contact your health care provider.
What happens during a colonoscopy? During a colonoscopy, an experienced physician uses a colonoscope (a long, flexible instrument about 1/2 inch in diameter) to view the lining of the colon. The colonoscope is inserted into the rectum and advanced through the large intestine. If necessary during a colonoscopy, small amounts of tissue can be removed for analysis (a biopsy) and polyps can be identified and entirely removed. In many cases, a colonoscopy allows accurate diagnosis and treatment of colorectal problems without the need for a major operation.
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To make the colonoscopy more comfortable for the patient, our team at McKenzie-Willamette are trained in sedation techniques. They are able to assess the needs of the patients and personalize the process for individualized treatment.
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You are asked to wear a hospital gown and remove eyeglasses.
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You are given a pain reliever and a sedative intravenously (in your vein); you will feel relaxed and somewhat drowsy.
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You will lie on the left side, with your knees drawn up towards your chest.
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A small amount of air is used to expand the colon so the physician can see the colon walls.
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You may feel mild cramping during the procedure; cramping can be reduced by taking slow, deep breaths.
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The colonoscope is slowly withdrawn while the lining of your bowel is carefully examined.
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The procedure lasts from 30 minutes to one hour.
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What happens after a colonoscopy?
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You will stay in a recovery room for observation until you are ready for discharge.
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You may feel some cramping or a sensation of having gas, but this quickly passes.
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If medication has been given, a responsible adult must drive you home; avoid alcohol, driving, and operating machinery for 24 hours following the procedure.
After Your Colonoscopy
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Unless otherwise instructed, you may immediately resume your normal diet, but we recommend you wait until the day after your procedure to resume normal activities.
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If polyps were removed or a biopsy was taken, avoid taking aspirin, products containing aspirin, or anti-inflammatory drugs (such as ibuprofen [Advil®, Motrin®], naproxen [Naprosyn®] or indomethacin [Indocin®]) for two (2) weeks after the procedure to help decrease the risk of bleeding; you may take acetaminophen (such as Tylenol®) if needed.
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If you are taking Coumadin®, Plavix®, Ticlid®, or Agrylin®, the physician performing your colonoscopy will advise you when it is safe to resume your blood thinners.
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If a biopsy was taken or a polyp was removed, you may notice light rectal bleeding for one to two days after the procedure; large amounts of bleeding, the passage of clots, or abdominal pain should be immediately reported.
GI Physicians working at McKenzie-Willamette Medical Center
Lane GI Associates
Sarah Brendler, M.D., Nathan Markowitz, M.D. and William Kelley, M.D.
Oregon Medical Group
Harry Park, M.D. and Koi Tran, M.D.