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February 23, 2007

12 myths about colon cancer

U-M experts debunk fears, misconceptions about this disease

ANN ARBOR, MI – Colon cancer is the second leading cause of cancer death in the United States, and the No. 1 cause of cancer death among non-smokers. More than 150,000 Americans will be diagnosed with colon cancer this year, and 52,000 will die from the disease.

It doesn’t have to be that way.

Press release image“Most colorectal cancers are predictable by early diagnosis and screening. If colonoscopy can identify a problem early, we could completely prevent colorectal cancer,” says D. Kim Turgeon, M.D., clinical associate professor of gastroenterology at the University of Michigan Medical School.

In fact, colorectal cancer screening prevents more deaths due to early detection than breast or prostate cancer screening.

Here, experts from the University of Michigan Comprehensive Cancer Center address some of the common myths and misconceptions about colorectal cancer.

Myth 1: Colon cancer is a white man’s disease.
Truth: Colon cancer affects both men and women equally, and it affects people of all races. In 2007, the American Cancer Society estimates, 55,290 men and 57,050 women will be diagnosed with colon cancer. About equal numbers will die from the disease: 52,000 Americans altogether. The No. 1 risk factor for colon cancer is age.

Myth 2: I don’t have any symptoms, so I must not have colon cancer.
Truth: “One of the most common misconceptions is that symptoms will be evident if a person has colorectal cancer. In fact, the most common symptom is no symptoms at all,” says Emina Huang, M.D., assistant professor of surgery at the U-M Medical School. More than half of people diagnosed with colon cancer have no symptoms. Symptoms such as a change in stool, rectal bleeding, abdominal pain and unexplained weight loss can all signal colon cancer. But once these symptoms begin to develop, it may be a sign of more advanced disease. Half of people diagnosed after symptoms develop will die from colon cancer.

Myth 3: Colonoscopy is difficult to prepare for.
Truth: Preparing for a colonoscopy involves cleaning the colon with the help of prescription and over-the-counter medications. Typically these are liquid drinks that must be consumed a day or two before the procedure. “People shouldn’t be afraid of it because they don’t want to drink the laxative. There are many more options so you can find something that is tolerable,” Turgeon says. Ask your doctor or pharmacist about your options.

Myth 4: Colonoscopy is unpleasant and uncomfortable.
Truth: It’s not as bad as you think. Most people agree the prep is the worst part (see Myth 3). During the actual procedure, patients are sedated to eliminate discomfort. The procedure itself takes 15-30 minutes and you can resume normal activities the next day.

Myth 5: I saw Katie Couric get a colonoscopy on the Today Show, so I should get one too.
Truth: Colonoscopy screening is recommended for men and women beginning at age 50, unless other risk factors exist. If you’re 50 or older, talk to your doctor about screening. If you are younger than 50 but have other risk factors – such as family history, obesity, smoking, ulcerative colitis or Crohn’s disease – talk to your doctor about your screening needs. But remember, age is the most significant risk factor for colon cancer.

Myth 6: Colonoscopy is the only way to screen for colon cancer.
Truth: There are several screening options for colorectal cancer, including flexible sigmoidoscopy, fecal occult blood test and double-contrast barium enema. But colonoscopy is considered the gold standard. It detects more cancers, examines the entire colon, and can be used for screening, diagnosis and removing polyps in one visit.

Myth 7: A polyp means I have cancer.
Truth: Polyps are benign growths that, if left unchecked, have the potential to develop into cancer. Polyps can be easily removed during colonoscopy. Not all polyps are pre-cancerous.

Myth 8: Colonoscopy is just a screening technique.
Truth: Colonoscopy is an all-in-one tool. It can find and remove polyps and small cancers all during one procedure. If your colonoscopy reveals a polyp, your doctor will remove it immediately. By removing the polyp at this stage, it prevents it from becoming cancerous. If colonoscopy reveals cancerous lesions, further treatments may be necessary.

Myth 9: If I have colon cancer, it means I am dying.
Truth: When colon cancer is caught early, it has a 95 percent survival rate. That’s why screening is so important. Once colon cancer has spread to the liver, it’s usually deadly, with only a 9 percent survival rate. But even then, treatments are improving. Radiation oncologists at U-M have developed a method to shrink tumors that spread to the liver, in some cases allowing them to be removed with surgery. This has led to higher survival rates even in the most advanced cases.

Myth 10: Surgery will be disfiguring and recovery painful.
Truth: New surgical advances allow for minimally invasive procedures that leave only a small scar. Patients undergoing laparoscopic surgery may have an easier recovery than patients who have open surgery. Some evidence suggests cancer control is better with a minimally invasive approach. 

Myth 11: If I have colon surgery, I’ll need a colostomy bag.
Truth: A colostomy, in which surgeons create an artificial, external method to collect excrement, is rarely done anymore. Surgical techniques have improved so that the cancer can be effectively removed while sparing the rectum. In the past, cancers within 4 inches of the anus routinely required removing the anus for effective surgical control. Now, 80 percent of these cancers may be effectively removed while sparing the anus.

Myth 12: Few research advances focus on colon cancer.
Truth: Much exciting research is occurring in colon cancer. At U-M, research has focused on improving radiation techniques, including using radiation to shrink tumors that have spread to the liver. Researchers are also working with colon cancer stem cells, the small number of cells within a tumor that fuel its growth. It’s believed that identifying the cancer stem cells will allow more effective drugs to be developed. Other research is looking at multiple genes involved in colon cancer and at improving screening techniques so more cancers can be detected early. This includes searching for markers in blood, stool or urine that might provide an easier screening tool to early signs of colon cancer. In the area of prevention, researchers are looking at the effects of curcumin (found in curry), resveratrol (found in red wine), ginger and the Mediterranean diet on the growth and development of colon cancer.

For information about colon cancer, or call the Cancer AnswerLine at 800-865-1125.

For information about colon cancer screening

 

Written by Nicole Fawcett

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