Colorectal Cancer, How to Spot It and What You Should Know

multi generational family photo

I felt like I needed to address this sobering subject because it’s the silence that gives it control. 

Colorectal cancer isn’t always associated with symptoms, nor is it ‘only’ (mostly though) found in people over 50. We’re seeing that young people are affected too. 

The news of Black Panther star, Chadwick Boseman’s death, struck a chord with everyone that day. It left pain and emptiness in our hearts and a somber feel in many households, including mine. 

Seeing someone so charismatic —so impactful to all the lives he touched, have his life taken too soon, is cause to spread the word. Chadwick was only 43 when he passed from colon cancer. He was diagnosed at 39, which seems so young. 

We used to think colon cancer predominantly affected people over 50, but the number of colon cancer in those younger than 55  is increasing 2% every year.  

Chadwick’s tragedy cast a light on a disease that’s been lying under the radar, especially in people younger than 50. It‘s a disease that isn’t talked about much and often caught on accident. 

It’s time to amplify the #nevertooyoung movement for colon cancer awareness because 10% of colorectal cancer cases are under 50 years old —and the world needs to know that!

As a hospitalist physician who has seen many colorectal cancer patients, I want to increase awareness with you and your loved ones. 

I’d love to share what I know and encourage you to do the same. Chadwick’s tragedy should never repeat, and with proper awareness, colon cancer can is preventable.

It can be hard to detect colon cancer because the symptoms aren’t always blatantly obvious. But there are things to look out for, and risk factors to be aware of. 

We recommend starting screening at age 45. Depending on your risk factors, have a heightened awareness and start screening earlier than 45. 

Let’s get in on the facts of colorectal cancer…

What is colorectal cancer?

Colorectal means it begins either in the colon or rectum. Polyps form in the lining of the colon or rectum. They may remain benign (non-cancerous), or the cells turn into irregular cells (cancer cells) and multiply with abnormal overgrowth. As it progresses, this type of cancer can spread to the rest of the body.

Colorectal cancer is the 3rd most common cancer and the 2nd leading cause of cancer death. Geez! It’s important to note that the likelihood of recovery is high, and 90% of people do survive if caught early enough.

Who can get it?

Colon cancer can happen to anyone at any age. It’s most prevalent in ages 50 and up but like I mentioned above, the rates have been steadily increasing for people under 50. And for this reason, we need to all be aware of the disease.

Women and men of all ethnicities are equally susceptible. However, the African American community has the highest incidence and the highest death rates. This fact may be due to certain socioeconomic barriers that get in the way of African Americans being screened regularly. 

Even though colon cancer does not discriminate, some people are at higher risk than others. In this case, have a conversation with your doctor, and screening should likely start earlier than 45. 

HIGH-RISK FACTORS

  • Family history of colorectal cancer or polyps
  • Personal history
  • History of inflammatory bowel disease, Crohn’s disease or ulcerative colitis
  • Previous history of receiving cancer radiation treatment to the abdomen or pelvic area

LIFESTYLE FACTORS

  • Obesity
  • Smoking
  • Heavy alcohol
  • Sedentary lifestyle
  • Too much meat and not enough fruits, veggies and grains 

If you feel like you fall into one of the categories above, consult your physician — even if you don’t have symptoms.

75% of colorectal cancers occur in people with no known risk factors so regular screening is super important.

Speaking of symptoms, what are they?

At the early stages, colorectal cancers might not have any symptoms or are too subtle to seemingly warrant medical attention. For this reason, ask your family about their history with colon cancers and listen to your own body when something seems not right. When present, here’s what the symptoms look like…

  • Change in bowel habits

Having diarrhea on and off, constant diarrhea or experiencing constipation could be signs of an issue. Take note if your stools look different, they are smaller or more narrow.

  • Persistent pain or discomfort in your tummy

Feeling crampy, gassy, bloated or full, or a feeling that you can’t fully empty your bowel could indicate an issue.

Nausea and/or vomiting are sometimes associated with this symptom.

  • Rectal bleeding

Check-in on your poop. Bright red streaks or dark red, black and tarry stool are cause for concern.

  • Fatigued or overly exhausted

Sometimes it’s hard to tell because life runs us ragged and we might feel tired all the time. I’m a mom, I know. But if you’re feeling weak or truly fatigued for more than just a day and there are many days when you think you should have energy but you don’t, consult your doctor. You just never know.

This feeling can go hand in hand with anemia. A blood test can help determine this. 

  • Sudden unexplained weight loss

While losing weight seems to be on everyone’s to-do list, sudden or unexplained weight loss is concerning, especially if nausea and vomiting are present.

What does screening involve?

If you see these signs, meet one or more of the risk factors above OR are 45 years or older, consult your doctor and discuss screening. Take the initiative by bringing it up.

There are 4 standard tests to screen for colorectal cancer. I’ll keep it simple but still give you the low down.

  1. Stool tests (3 types)-every 1-3 years 

If they come back positive or abnormal, a colonoscopy is required.

  1. Colonoscopy-repeated every 10 years 

A scope inspects the entire colon and if polyps are present they can be biopsied at that time. This procedure requires sedation and bowel prep (a drink to prep the colon).

  1. CT colonography (virtual colonoscopy)-repeated every 5 years 

A type of CT scan, typically reserved for those who can’t undergo a colonoscopy. It doesn’t require sedation.  If the test comes back abnormal, a standard colonoscopy is needed.

  1. Flexible sigmoidoscopy -every 5 years

No sedation required with this procedure. It does not examine the whole colon. Polyp removal can occur during the process and a colonoscopy is necessary if the polyp is abnormal.

You should never feel hesitant to speak with your physician if you have any concerns. That one conversation could be the one that saves your life. Be your own advocate!

Get your colon screenings!

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