Colorectal cancer symptoms can be embarrassing to address or easy to dismiss. But discussing your bowel movements with your doctor can be a lifesaving conversation.
The most common signs and symptoms are rectal bleeding, which can be painless, diarrhea or constipation. However, what makes colon and rectal cancers scary is that there usually are no symptoms.
Anyone can develop colorectal cancer, but chances increase markedly after age 50. The recommendation for people over 50 is to have a digital rectal exam and a colonoscopy, in conjunction with radiology tests, to look for either precancerous or cancerous conditions. Tests can be done earlier if a direct relative — mother, father or sibling — has had colorectal cancer.
Screenings are important because often, the cancers develop from precancerous lesions, and if they are detected early, they can be removed right away.
To make the most timely and accurate assessment of the patient, institutions like The Johns Hopkins Hospital are using a multidisciplinary approach to colorectal cancer. This means a team of experts from different specialties — such as oncology, surgery and radiology — discusses each case and then tailors a care plan to the specific needs of the patient.
On that same line, almost all patients with colorectal cancer nowadays undergo some form of genetic testing, which looks at specific gene defects. That information helps physicians decide the type of chemotherapy to which the patient will respond best after surgery.
There are three minimally invasive approaches to surgery for colorectal cancer.
The laparoscopic approach places cameras and instruments in small incisions to see exactly where the cancer is located, detach it, and remove the part of the colon or rectum that has the cancer. Transanal minimally invasive surgery allows physicians to operate through the anus, freeing up the rectum in difficult places. Robotic surgery can also remove portions of the colon and the rectum, and put everything back together.
Technology is advancing at a very rapid pace. Every two or three years, there is a new piece of equipment that makes it easier to do these complex surgeries without making large incisions, ultimately improving the patient’s recovery time.
Over the last 10 years, dramatic improvements have allowed physicians to treat patients with colorectal cancer and advance their quality of life. Early diagnosis is key.
It makes having that conversation with your doctor about bowel movements and undergoing the recommended screenings worth it.
Jonathan Efron, M.D., heads the Division of Colorectal Surgery at The Johns Hopkins Hospital in Baltimore, Maryland. For more information, visit hopkinsmedicine.org.