Screening and early detection are keys to effective colorectal cancer treatment

March 30, 2020
Virgilio George, M.D., talks with a patient
Virgilio George, M.D., recommends regular screenings and a healthy diet to help prevent colorectal cancer. Photo by Sarah Pack

Though it no longer surprises him, given that colorectal cancers are increasing in young people, surgeon Virgilio George, M.D., still hates to see young people come into his office often with advanced stages of cancer.

He recalls a recent patient who was just 34 and looking forward to her wedding when she discovered she had an advanced stage of colon cancer. Fortunately, she didn’t ignore the symptoms and sought treatment before the cancer had spread, but not everyone is so lucky, said George, who is part of Hollings Cancer Center at the Medical University of South Carolina and chief of colorectal surgery at MUSC Health.

With March being Colorectal Cancer Awareness Month, he wants everyone to know the symptoms and screening recommendations for colorectal cancer and what can be done to prevent and treat it.

Colorectal cancer is the second leading cause of cancer-related deaths in the United States for both men and women combined. This year, approximately 140,000 new cases of colorectal cancer will be diagnosed, and about 53,200 people will die from the disease. Even more alarming, colorectal cancer rates have been increasing since the mid-1980s in adults ages 20 to 39, and since the mid-1990s in adults ages 40 to 54, with younger age groups experiencing the steepest increase.

“This is something that young people need to know about and be aware of to watch for symptoms,” he said.

These symptoms can include a change in bowel habits, such as diarrhea and/or constipation; rectal bleeding with bright red blood or blood in the stool, which may make the stool look dark; cramping or abdominal (belly) pain; and weakness and fatigue.

“But,” he added, “colorectal cancer is a disease that can be prevented through regular screenings, a healthy diet and regular exercise.”

How can I lower my risk?

To lower your risk of colorectal cancer, the American Society of Colon and Rectal Surgeons recommends that you:

  • Get regular colorectal cancer screenings after age 45. Between 80% and 90% of colorectal cancer patients are restored to normal health if their cancer is detected and treated in the earliest stages.
  • Eat a low-fat, high-fiber diet.
  • If you use alcohol, drink only in moderation. If you use tobacco, quit. If you don't use tobacco, don't start. Alcohol and tobacco in combination are linked to colorectal cancer and other gastrointestinal cancers.
  • Exercise for at least 20 minutes three to four days each week. Moderate exercise such as walking, gardening or climbing steps may help.

Can colorectal cancer be cured?

Since there are very few symptoms associated with colorectal cancer, regular screening is essential. Screening is beneficial for two reasons. Colorectal cancer is preventable if polyps that lead to the cancer are detected and removed, and it is curable if the cancer is detected in its early stages.

“If detected, colorectal cancer requires surgery in nearly all cases for a complete cure, sometimes in conjunction with radiation and chemotherapy,” George said. “Between 80% and 90% of patients are restored to normal health if the cancer is detected and treated in the earliest stages. However, the cure rate drops to 50% or less when diagnosed in the later stages.”

Studies also have shown that patients treated by colorectal surgeons, experts in the surgical and nonsurgical treatment of colon and rectal problems, are more likely to survive colorectal cancer and experience fewer complications, he said. This is attributable to colorectal surgeons' advanced training and the high volume of colon and rectal disease surgeries they perform.

Who is at risk for colorectal cancer?

The risk of developing colorectal cancer increases with age. All men and women ages 45 and older are at risk for developing colorectal cancer and should be screened. Some people are at a higher risk and should be screened at an age younger than 45, including those with a personal or family history of inflammatory bowel disease; colorectal cancer or polyps; or ovarian, endometrial or breast cancer.

Current screening methods include:

  • Fecal occult blood testing, a simple chemical test that can detect hidden blood in the stool.
  • Flexible sigmoidoscopy, a visual examination of the rectum and lower portion of the colon, performed in a doctor's office.
  • Double contrast barium enema / barium x-ray.
  • Colonoscopy, a visual examination of the entire colon.
  • Digital rectal exam.

“Colorectal cancer screening costs are covered by Medicare and many commercial health plans,” he said. “You should find out from your colorectal surgeon or other health care provider which screening procedure is right for you and how often you should be screened.” 

About the Author

Dawn Brazell
MUSC Hollings Cancer Center

Keywords: Cancer