Oncology

Published on April 4th, 2018

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Get Real About a Gut Check

Even though colon cancer is still a leading cause of death in the U.S., there’s some good news to report. Noel Martins, MD, section chief of the gastroenterology division at St. Luke’s University Health Network, brought us up to date.

We’ve heard that colon cancer is the third most common form of the disease, and the second leading cause of cancer-related deaths. Is that true?
Partly. It’s still the third-most common form, but it’s now the third-most common cause of cancer deaths. So we’re making progress!

Just how common is colon cancer? Could you give us some figures?
About 130,000 people will be diagnosed this year, and 50,000 will die from colon cancer. It’s actually one of the few cancers where the rates are going down.

How do those figures break down? More men than women, or more prevalent in a certain age group?
According to current data, men tend to develop polyps and colon cancer more often than women, but not by much. It seems African-American men and Ashkenazi Jews are at greater risk than the general population, but the reason for that hasn’t been determined. Overall, the lifetime risk for men is 1 in 22; for women, it’s 1 in 24.

Although the typical colon cancer patient is over 50 years of age, it’s beginning to appear in younger individuals.

Why is that happening?
The reasons are unclear, but poor dietary habits—lots of red meat, little fiber, few fruits, and vegetables—and a lack of exercise could be contributing factors.

You said earlier that the rate of cancer deaths is going down. Is there a reason for that?
More people are being screened every year, and that enables us to detect possible cancers earlier. And the earlier it’s detected, the better the chances for a cure.

Are there any positive steps people can take to help lower their risks?
There are several. Get a colonoscopy, of course, at regular intervals guided by your doctor. The risk for developing colon cancer increases as we age and gets bigger over time. That is, you have a certain risk level at age 50; a higher one at age 60; still higher at 70, and so on.
Individuals that have family histories of colon polyps or colon cancer, suffer from an inflammatory bowel disease such as ulcerative colitis, or inherited conditions like Lynch syndrome are already at greater risk.

What other steps can people take?
Be aware of other indicators. If you find blood in your stool or in the toilet, have an unintentional weight loss, or you see a persistent change in your bowel habits—all of these are potential signs of cancer and should be discussed with your doctor.

Eat less red meat and more fruits, vegetables, and other high-fiber foods. Be more active, and get your BMI [body mass index] down. And quit smoking.

Then What Happens?

Let’s say your colonoscopy detects a polyp or two. What are they, exactly?
These small clumps of cells develop on the walls of the colon. They’re generally classed as “sessile” (raised just a bit above the colon wall) or “pedunculated” (sort of tree- or mushroom-shaped).

“Polyps are often removed during the colonoscopy itself,” says Asim Ali, MD, Medical Director of GI Oncology, St. Luke’s University Health Network. “Surgical instruments can be inserted through a conduit on the colonoscope. A smaller polyp can be removed right away; if the mass is relatively large, a sample of it can be taken,” he says.

The simple presence of a polyp does not automatically mean a cancer diagnosis. “Any tissue we remove is automatically sent to the pathology department for biopsy,” Dr. Ali says. “If it’s a benign growth, patients will be retested at a later date, and they’ll follow up with a gastrointestinal specialist. But if it’s malignant, a team of oncologists and surgeons will determine the appropriate course of treatment. At St. Luke’s, we use a multidisciplinary team, including a ‘navigator’ that will help you get connected with proper specialists, handle communications among the different doctors, even set up your appointments.”


Originally posted on Lehigh Valley Marketplace. View originally article here.


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