Treatment and Diagnosis of the colon and rectum

colon and rectum
A person with colon cancer will be diagnosed in one of two ways: 1. It is found on a routine screening test. 2. Symptoms lead a person to the doctor, and tests to find the cause of the symptoms reveal colon cancer. Ideally, every case of colon cancer would be found with routine screening. This is because in the early stages, people with colon cancer typically have no symptoms at all, and colon cancer is most curable when found early, at the time it’s least likely to cause symptoms. Even better is when a routine screening identifies polyps or adenomas. If these growths in the colon are left untreated, they may develop into colon cancer. In cases where they’re caught early, the growth can be removed before it even has a chance to turn into cancer.
From 2003-2007, the median age at diagnosis for cancer of the colon and rectum was 70 years of age3X Close Table I-11 (http://seer.cancer.gov/csr/ 1975_2007/results_single/ sect_01_table.11_2pgs.pdf). Approximately 0.1% were diagnosed under age 20; 1.1% between 20 and 34; 3.8% between 35 and 44; 12.4% between 45 and 54; 19.2% between 55 and 64; 24.4% between 65 and 74; 26.8% between 75 and 84; and 12.2% 85+ years of age.
How can Colo-Rectal cancer be Prevented? Increased intake of fiber and Vitamin A, and decreased fat in the diet, are thought protective against bowel cancers. For high risk patients, early detection with occult blood tests and periodic colonoscopy and polyp removal is appropriate. For the rare very high risk patient, who has a genetic disease with multiple polyps, prophylactic removal of the colon may be reasonable since almost 100% of these patients will get colon cancer if it isn't removed. Any prolonged rectal bleeding, whether bright and red or black and tarry must be promptly evaluated, and not just ignored as "hemorrhoids."
The National Comprehensive Cancer Network includes the following treatments for rectal cancer: Surgery, Radiation Therapy, Chemotherapy
Introduction to Radiation Therapy. Radiation therapy is one of the many tools used to combat cancers. Radiation treatments utilize high-energy waves such as x-rays to kill cancer cells. Radiation can be used alone or in conjunction with other treatments (e.g. chemotherapy and surgery) to cure or stabilize cancer. Like other therapies, the choice to use radiation to treat a particular cancer depends on a wide range of factors. These include, but are not limited to, the type of cancer, the physical state of the patient, the stage of the cancer, and the location of the tumor.
Polyps of the Colon and Rectum. Polyps should be removed completely with a snare or electrosurgical biopsy forceps during total colonoscopy; complete excision is particularly important for large villous adenomas, which have a high potential for cancer. If colonoscopic removal is unsuccessful, laparotomy should be done. Subsequent treatment depends on the histology of the polyp. If dysplastic epithelium does not invade the muscularis mucosa, the line of resection in the polyp's stalk is clear, and the lesion is well differentiated, endoscopic excision and close endoscopic follow-up should suffice. Patients with deeper invasion, an unclear resection line, or a poorly differentiated lesion should have segmental resection of the colon. Because invasion through the muscularis mucosa provides access to lymphatics and increases the potential for lymph node metastasis, such patients should have further evaluation (as in colon cancer. The scheduling of follow-up examinations after polypectomy is controversial. Most authorities recommend total colonoscopy annually for 2 yr (or barium enema if total colonoscopy is impossible), with removal of newly discovered lesions. If two annual examinations are negative for new lesions, colonoscopy is recommended every 2 to 3 yr.