In Pennsylvania, the rate of colorectal cancer-related deaths is higher than the national average.
But while colorectal cancer is the third most-commonly diagnosed cancer and second most deadly in the United States, it can often be treated successfully if detected early.
In fact, if colorectal cancer is diagnosed before it has spread, the survival rate is greater than 90 percent.
What is colorectal cancer?
Colorectal cancer is a disease in which cells in the colon (the large intestine or large bowel) or rectum (the passageway that connects the colon to the anus) grow abnormally. Abnormal growths, called polyps, may form in the colon or rectum, and over time some polyps may turn into cancer. Not all polyps become cancer, and the chance of a polyp turning into cancer depends on the type of polyp:
- Adenomatous polyps (adenomas): These polyps sometimes become cancer, which is why adenomas are called a pre-cancerous condition. The three types of adenomas are tubular, villous and tubulovillous.
- Hyperplastic polyps and inflammatory polyps: These polyps are more common, but they are not generally pre-cancerous. Some people with large (more than one centimeter) hyperplastic polyps might need colorectal cancer screening more often.
- Sessile serrated polyps (SSP) and traditional serrated adenomas (TSA): These polyps are often treated like adenomas because they can have a higher risk of colorectal cancer.
“If cancer forms within a polyp, it can grow into the wall of the colon or rectum,” said Hazem F. Elkassas, MD, who is board certified in internal medicine and medical oncology at Penn Highlands Healthcare. “It starts in the innermost layer and can grow outward through some or all of the other layers of the colon or rectum. Once cancer cells are in the wall, they can grow into blood vessels or lymph vessels and then travel into nearby lymph nodes or to distant parts of the body.”
The extent of the spread (called the stage) of a colorectal cancer depends on how deeply it grows into the wall and if it has spread to other parts of the body.
What are the symptoms?
Colorectal cancer might not cause symptoms right away, but early symptoms may include:
- A change in bowel habits (diarrhea, constipation or narrowing of the stool) that lasts for more than a few days
- A feeling that you need to have a bowel movement that is not relieved by having one
- Rectal bleeding with bright red blood
- Blood in the stool, which might make the stool look dark brown or black
- Cramping or abdominal pain
- Weakness and fatigue
- Unintended weight loss
If you experience any of these symptoms, talk to your primary care provider, who may recommend screening or additional tests, as well as referral to a specialist.
How is it treated?
If you are diagnosed with colorectal cancer, you will be referred to a medical oncologist who will explain your type of cancer, including stage and treatment options. Your medical oncologist will create an individualized cancer treatment plan that may include surgery, radiation therapy, chemotherapy, immunotherapy, targeted therapy or some combination.
Your specialist will work with you to develop a treatment plan based on your cancer stage and personal preferences:
- If you have stage 0 or stage 1 colon cancer, it is possible you may be treated with surgery alone.
- If you have stage 2 or stage 3 colon cancer, you will likely have surgery followed by chemotherapy.
- If your cancer is stage 4, your oncologist may recommend chemotherapy prior to or in place of surgery.
“Because colorectal cancer can often be treated successfully if detected early, we recommend talking to your primary care provider about screening tests,” said Dr. Elkassas. “Colonoscopies not only help screen for colon cancer, they can even help prevent colon cancer by removing polyps before they turn into cancer.”
The Hahne Cancer Centers at Penn Highlands Healthcare provide comprehensive cancer care including surgery, chemotherapy and radiation therapy. Penn Highlands’ oncology doctors see patients throughout Pennsylvania where they also provide outpatient diagnostic testing, chemotherapy, immunotherapy and hematology services. For more information, visit www.phhealthcare.org/cancercare.