Colorectal cancer, also known as colon cancer is the second leading cancer killer in the United States. Affecting both men and women, more than 50,000 cases of colon cancer are diagnosed annually. Dr. Eric Avezzano, gastroenterologist with Pascack Valley Medical Group, spoke with us about what you need to know about colon cancer and the patient journey through the treatment of colon cancer.
“Colon cancer arises in the large intestine, another name for the colon,” said Avezzano. “Depending on the individual, the large intestine is anywhere between four and five feet long. There’s quite a bit of large bowel that is susceptible to getting that cancer. In most cases, the cancer starts in the form of polyps, which originate when they are benign at their smallest stage. As they grow, they have a risk of turning into malignant or cancerous polyps.”
Colonoscopies are the most successful strategy in colon cancer prevention.
“With a colonoscopy, we are able to examine the bowel to see if any polyps have developed,” said Avezzano. “Based on the tissue that’s removed, we assess the risk of the patient going forward and are able to determine how often they should be getting a colonoscopy to prevent cancer development. When people make themselves available for this screening test, they have the opportunity to reduce their cancer risk.”
Some individuals are at a higher risk of developing colon cancer than others.
“People with an immediate family member who has had colon cancer are considered high risk,” said Avezzano. “As doctors, we want to get a good understanding of your family health history. If there is a history of colon cancer, screenings will need to begin at an earlier age. Individuals who have had colitis are also at a higher risk of developing colon cancer.”
Previously, the standard recommendation for colonoscopies was to start screenings by age 50. For the African American population, which has been noted to develop colon cancer at an earlier age, the age recommendation is 45. For individuals with an immediate family member who has had colon cancer, screenings should begin at age 40 or 10 years earlier than the family member who had colon cancer (i.e.: If your father was diagnosed at age 47, begin screenings at age 37).
“In 2018, after looking at recent trends and data, the American Cancer Society saw an increase in individuals in their 40s being diagnosed with colon cancer,” said Avezzano. “Due to this, they now recommend that the age be reduced to be more in configuration with the African American population and the number of cases being diagnosed in younger individuals.”
Treatment for colon cancer depends on the stage of the cancer when diagnosed.
“As with most cancers, early detection for colon cancer is extremely important,” said Avezzano. “If you diagnose colon cancer in its earliest stage, it will be confined to the polyp and will hopefully not have attached to the colon yet. In this stage, the polyp can be removed during the colonoscopy, making things relatively simple and leaving very little chance of metastasis.”
If polyps do attach to the colon wall, more aggressive treatment is needed.
“Depending on its degree of involvement and the aggressiveness at which the polyps have traveled, chemotherapy is the typical treatment method,” said Avezzano. “Even at its less involved stage of metastasizing, surgery could be needed along with radiation. The more advanced the cancer is at the time of detection, the more difficult the treatment.”
Avenzzano stresses that early detection is the key to managing colon cancer, making colonoscopies top priority.
“Colonoscopies give us an opportunity to both diagnose and treat the polyps at the same time,” said Avezzano. “The technology has advanced greatly over the years, allowing for less discomfort for patients and more accurate results. In Bergen County, we are approaching two out of every three age eligible individuals getting regular colonoscopies. This shows that people are seeing the importance of these screenings. We want to see the entire country follow suit so we can continue to prevent colon cancer. It’s all about continuing to raise awareness around the importance of regular colonoscopies.”
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