What is colorectal cancer?
Widely considered one of the most common forms of cancer, colorectal cancer (colon and rectum) is highly curable when detected early. Cancer of the colon and rectum is currently the second most common cause of cancer-related deaths in the United States. As part of the digestive system, the colon and rectum comprise a long tube commonly known as the large intestine, with the colon in the upper portion of the intestine and the rectum in the lower section. Cancer occurs when cells grow abnormally causing both organs to function improperly, or while originating from the growths of polyps (non-cancerous growths) contained in the inner lining of the intestine.
Cause and symptoms:
Today, it is estimated that the cause of most cases of colorectal cancer are unknown, with the other percentage of cases considered hereditary (10%). One in nineteen Americans will be diagnosed with some form of colon cancer in their lifetime due to the high incidence and the relative lack of symptoms associated with polyps. Overall risk is low, with both men and women affected equally, and men at higher risk for rectal cancer. Some of the more common risk factors for developing colorectal cancer include: age, poor diet, inflammatory bowel disease, history of polyps, smoking, and genetics. When detected early with routine screening after the age of 50, colorectal cancer is very curable. Once it has spread to the lymph nodes and other sites, the prognosis is not as favorable, although long-term survival can still be obtained. Symptoms include rectal bleeding, change in bowel habits, weight loss, bloating and distension.
Rectal examination: physician screens for polyps or tumors
Blood tests: a blood count looking for anemia.
Tumor marker tests: CEA and CA 19-9 are cancer markers that can be elevated in patients with colorectal cancer.
Fecal blood test: screening for blood in the stool.
Sigmoidoscopy: a tube to examine the left side of the colon, sigmoid, and rectum.
Colonoscopy: a longer tube that allows full examination of the entire colon and rectum.
CAT scan: an x-ray to determine spread to other organs, such as the liver.
PET scan: a study that detects glucose activity in cancer cells; occasionally cancers are detected which are not seen using other imaging modalities.
Dr. Bilchik and his colleagues perform surgery on the colon and rectum using minimally invasive techniques, including a camera with very small incisions. In most cases, patients are eating the day following surgery, and typically leave the hospital within a few days, with minimal discomfort. Our surgeons have also developed new techniques for more accurate staging so that physicians can more carefully select patients that may benefit from chemotherapy. We also test the tumor for certain genes that may guide therapy. For rectal cancer, patients at CORI rarely require a colostomy, while meticulous care is undertaken to preserve continence and sexual function. As both a surgeon and researcher, Dr. Bilchik is internationally recognized for his colorectal cancer studies, and regularly participates in national meetings. Currently, he has ongoing clinical trials in collaboration with surgeons and scientists from three continents.