Colorectal Cancer and Polyps

Colorectal cancer, which begins in either the colon or the rectum, is one of the most common types of cancer in the Western world.

Colon cancer affects the large intestine (colon), whilst rectal cancer is located in the rectum, last segment of the colon.

Colorectal cancer often forms slowly, over several years. It typically starts when a non-cancerous polyp occurs in the lining of the large intestine. This condition is thought of to be highly preventable, with colonoscopy being such an important tool to allow the detection pre-malignant polyps and their removal them before the cells become cancerous.

Adenomatous polyps are viewed as a precancerous condition, because these may develop into cancerous tumours. Whilst inflammatory polyps are generally thought to be benign, they may require monitoring.

Colorectal cancer can occur at any age, however it typically affects people over the age of 40. It is often referred to as a “silent” disease, because patients often have no symptoms until the cancer is advanced. If found early, the cure rate is over 80% or better, therefore regular screening is critical.

Although anyone may develop colorectal cancer, several factors can increase your risk, including:

• Family history of colorectal cancer or polyps
• Obesity
• Smoking
• Alcohol Abuse
• History of bowel polyps
• History of cancers affecting other organs, particularly the breasts, uterus, ovaries
• Inflammatory bowel disease (ulcerative colitis or Crohn’s disease)
• Poor diet. Consumption of a large amount of red meats, such as pork, beef, or lamb, and processed meats like deli meat, increase your risk of colorectal cancer. A lack of fibre and other important nutrients may also increase your risk of developing colon cancer

When should I start to be screened?

For most individuals, screening by colonoscopy should start at 50 years of age. However if a family member has been diagnosed with colorectal cancer, it may be prudent to start the screening process 10 years before they were diagnosed.

At PIMS, we provide the following for our colorectal patients:

1. Highly trained surgeons and gastroenterologists who work together and strive to deliver excellent outcomes
2. The latest in advanced diagnostic techniques and minimally invasive surgery
3. Multidisciplinary and personalised care, with a treatment plan which takes into account your specific circumstances

Can I prevent Colon Cancer?

Sometimes. Adopting a healthy diet and an active lifestyle can help you maintain a healthy weight, which are great ways to reduce your chances of developing colon cancer. High fibre diets are much better than those laden with fat and cholesterol, and minimising red meat consumption is also helpful. Eating charred foods, such as barbecued meats, may increase your chance of developing colon cancer.

Is Colon Cancer hereditary?

Sometimes. If someone in your family has had a history of bowel cancer, polyps, or other types of cancers, you should tell your doctor so that they can assess your risk.

What are the symptoms of Polyps and Colorectal Cancers?

Early cancers and polyps typically do no cause any symptoms, which is why screening (colonoscopy) is critical in prevention.

When symptoms develop, most commonly they are rectal bleeding, as well as changes in bowel habits such as constipation or diarrhoea.

With more advanced cancer, patients may experience abdominal pain, fatigue, nausea or vomiting, or unexplained weight loss.

How can Colorectal Cancer be prevented?

A Colonoscopy is the best screening and prevention tool for colorectal cancer.

Early detection and removal of pre-cancerous polyps allows prevention of colorectal cancer. If polyps are found, the chance of future cancer increases, and in that situation, routine colonoscopies every 3 – 5 years are recommended, instead of every 10 years. If you notice any bleeding from the back passage, dark stools, a change in bowel habits, or unexpected weight loss, make an appointment to see one of our general surgeons or gastroenterologists at PIMS as soon as possible.

When should I start screening for Colon Cancer?

Screening should commence at the age of 50, but in higher risk patients it should begin earlier. Polyps, which may turn into cancer, occur in one in four people over age of fifty, and are readily picked up with a Colonoscopy.

How is Colorectal Cancer treated?

Treatment of colorectal cancer depends on a number of factors, including how deep the tumour has penetrated into the wall of the bowel.

Following diagnosis, it is likely that several tests including tumour markers (CEA blood test), CT scan and PET scan of the chest, abdomen, and pelvis will be arranged in order to determine if the cancer has spread to other parts of the body. Often, a rectal ultrasound or pelvic MRI may also be performed to determine how deep the tumour has penetrated and to determine if any lymph nodes have been invaded.

If the cancer appears to be in an early stage, then surgery is the next step. This involves removal of the involved segment of colon, together with the mesentery which contains the lymph nodes, followed by reconnection of the bowel. In most cases, this can be accomplished by minimally invasive surgery such as laparoscopy. The tumour tissue is then evaluated by a pathologist, and our team of specialists will tailor an individualised treatment plan to meet you specific needs.