Colon and Gastrointestinal (GI) Cancer
What is Gastrointestinal Cancer?
The GI tract consists of many cells that act like nerve and hormone-making cells. They do not form an actual organ but they are scattered through out the esophagus, stomach, pancreas and intestines. These cells help release digestive juices and control the speed at which food moves through the digestive tract. Like other cells in the body, they go through changes that cause them to grow too much and form tumors. These tumors can grow anywhere along the GI tract. The most common places are in the esophagus, stomach and large intestine.
What is Colorectal Cancer?
Colorectal cancer is a term used to refer to cancer that starts in either the colon or the rectum. Colon cancer is a form of gastrointestinal cancer. These cancers have many features in common. In most cases, colorectal cancers develop slowly over many years. We now know that most of these cancers begin as a polyp—a growth of tissue that starts in the lining and grows to the center of the colon or rectum which may or may not be cancerous; however, a type of polyp known as an adenoma can become cancerous. Removing a polyp early may prevent it from becoming cancer. Over 95 percent of colon and rectal cancers are adenocarcinoma. These are cancers that start in the cells lining the inside of the colon and rectum.
What Are the Symptoms of Colon and Gastrointestinal Cancer?
Most GI cancers grow slowly and the symptoms are often vague and do not occur until late in the process. The symptoms for colon cancer are:
- Changes in bowel habits such as constipation or diarrhea
- Change in the size or the color of the stool
- Abdominal pain
- Blood in the stool
- Chronic fatigue
- Unexplained anemia
The symptoms for gastrointestinal cancers as a whole are:
- Chest pain
- Difficulty swallowing
- A feeling of food getting stuck
- Nausea and vomiting
- Weight loss
Am I At Risk For Colon Cancer?
There are various risks of colon cancer which include:
- Age – The chances of developing colorectal cancer increase markedly after age 50. More than 90 percent of people diagnosed with colorectal cancer are older than 50.
- Personal Health History – If you have a history of adenomatous polyps (adenomas), you are at an increased risk of developing colorectal cancer. This is especially true if the polyps are large or if there are many of them. If you have had colorectal cancer, even though it has been completely removed, you are more likely to develop new cancers in other areas of the colon and rectum. In addition, the chances of this happening are greater if you had your first colorectal cancer when you were younger than age 60. If you suffer from inflammatory bowel disease (including ulcerative colitis and Crohn's disease), your risk of developing colorectal cancer is increased.
- Family history of colorectal cancer – Up to 20 percent of people who develop colorectal cancer have other family members who have been affected by this disease.
- Racial and ethnic background – African Americans have the highest colorectal cancer incidence and mortality rates of all racial groups in the United States for reasons not currently understood.
Inherited syndromes such as:
- Familial Adenomatous Polyposis (FAP) – FAP is caused by mutations in the APC gene, inherited from parents. Approximately one percent of all colorectal cancers are due to FAP. Hundreds or thousands of polyps in the colon and rectum are developed by those with the syndrome, usually in their teens or early adulthood. Cancer usually develops in one or more of these polyps as early as age 20. By age 40, almost all people with this disorder will have developed cancer if preventive surgery (removing the colon) is not done.
- Hereditary Non-Polyposis Colon Cancer (HNPCC) – HNPCC, also known as Lynch syndrome, is another genetic syndrome, accounting for three to four percent of all colorectal cancers. HNPCC can be caused by inherited changes in a number of different genes that normally help repair DNA damage.
How is Colon/Gastrointestinal Cancer Diagnosed?
There are multiple ways to diagnose colon/gastrointestinal cancers. Cancer of the colon and/or rectum is usually diagnosed through a colonoscopy. Colonoscopy screening is recommended beginning at age 50 for men and women and should be performed once every 10 years for those at normal risk. For those who have a family history of polyps or colorectal cancer, a history of familial polyposis or history of ulcerative colitis or Chron's disease, screenings may need to begin earlier and be completed more frequently.
Alternative screening options include:
- Fecal Occult Blood Testing (FOBT) or Fecal Immunochemical Test (FIT)
- Double Contrast Barium Enema
- Flexible Sigmoidoscopy + FOBT
A colonoscopy is considered the gold standard in colon cancer screening, but any screening method that is a complete colon evaluation can reduce the risk of developing colon cancer.
If any of the above mentioned screening tests are abnormal and a cancer diagnosis is made, your physician may order several different radiologic tests such as a CT scan, a MRI, a PET scan or a bone scan. These tests will determine exactly where the cancer is located and if it has spread to other areas of the body, including the bones.
If the cancer is located in the upper portion of the GI tract, your physician may order an esophogastroduodenoscopy (EGD). In this test, a lighted scope with a camera is passed through the mouth, into the esophagus, the stomach and the first part of the small intestine. Biopsies can be taken with this test.
If the cancer is located in the colon, your physician will order a colonoscopy. With this test, a lighted scope with a camera is passed through the anus and through the colon. Biopsies can be taken with this test also. There are also specialized scopes call endoscopic ultrasound scopes that will allow internal ultrasounds to be done. This test can tell the physician if the cancer has spread to the local lymph nodes. The physician can also do needle biopsies with the ultrasound scopes.
How is Colon/Gastrointestinal Cancer Treated?
Once a gastrointestinal cancer is found and staged, the cancer care team will suggest one or more treatment plans. This is an important decision, so you should take time and think about all of your options.
The main factors in selecting treatment options for a gastrointestinal (GI) tumor/cancer are:
- Its size and location
- Whether it has spread to lymph nodes, liver, bones, or other organs
- Whether you have any other serious medical conditions
- Whether the tumor is causing bothersome symptoms
Theses cancers may be treated with surgery, chemotherapy, radiation, immunotherapy or combinations. The treatment is determined by location, size of the tumor and the over all health of the patient.
How Can I Learn More?
Please take an active role in your health care. Call the Colon Cancer Screening Program at (502) 210-4497 to schedule your screening colonoscopy.