Frequently Asked Questions about Colorectal Cancer

This information was provided by The Gynecologic Cancer Foundation. www.thegcf.org.

Q: What is colorectal cancer?
A: Colorectal cancer is cancer that starts in either your colon or your rectum, which together make up the lower part of your digestive tract. It is the fourth most common cancer for both men and women. Cancer usually does not start in both the colon and rectum. But both types of cancer have a lot in common. So they are often referred to as “colorectal” cancer.

Q: Who gets colorectal cancer?
A: Colorectal cancer is the fourth most common cancer in the United States. Anyone can develop it, even younger people. There are, though, some people at higher risk. People with a family history of this cancer are at risk. So are people who have had it before. Age is also a factor. The risk starts going up at age 40. More than 90 %are older than age 50. More than 66% are older than age 65. It also affects men and women in nearly equal numbers. African-Americans develop colorectal cancer at a higher rate than other ethnic groups. Jews of Eastern European descent may also be at higher risk.

Q: Is there some way to find colorectal cancer early?
A: Screening tests help find the cancer early. It can then be treated before it spreads. These tests also help find polyps before they become cancer. One test is a fecal occult blood test. This test checks for blood in the stool. For a sigmoidoscopy, the doctor inserts a lighted tube to see inside the rectum and the lower colon. For a colonoscopy, the doctor inserts a lighted tube inside the rectum and the entire colon. During either test, the doctor can remove polyps or other abnormal tissue or a biopsy. The doctor can then look at the tissue under a microscope for signs of cancer. Finding the cancer early can allow for treatment before it has spread.

Q: What are the risk factors of colorectal cancer?
A: There is really no way to know for sure if you’re going to get colorectal cancer. Certain factors can make you more likely to get colorectal cancer than another person. These are called risk factors. However, just having one or more risk factors does not mean you will get cancer. In fact, you can have all the risk factors and still not get colorectal cancer, or you can have no known risk factors and still get it.

See if any of the following statements in bold type apply to you. If any do, you may be at an increased risk for colorectal cancer.

( For detailed information concerning risk factors, visit www.wcn.org )

  • I am older than age 50.
  • People in my immediate family have had colorectal cancer.
  • I have had colorectal cancer before.
  • I have had polyps in my colon or rectum.
  •  I have the condition familial adenomatous polyposis, also called FAP.
  • I smoke.
  • I don’t have a bowel movement at least once a day.
  • I have had ovarian, uterine, or breast cancer.
  • I’m overweight.
  • I drink more than one alcoholic drink a day.
  • I eat a lot of red meat.
  • I have inflammatory bowel disease, also called IBS.

Factors That May Increase Your Risk:

The following risk factors are still being studied. If any of these statements apply to you, you may be at a higher risk for colorectal cancer.

  • I’m African American.
  • I’m Jewish.
  • I eat a high-fat diet.
  • I eat a high-sugar diet.

Q: What are the symptoms of colorectal cancer?
A: People with colorectal cancer often do not have symptoms until the cancer gets large. By the time symptoms appear, the cancer may have spread to other organs. That means a cure may not be possible. That’s why routine screening is important. As cancers in the colon and rectum grow, warning signs will arise. You should tell your doctor and get prompt medical attention if you notice any of these signs.

  • A change in bowel habits that lasts for more than a few days. This includes diarrhea, constipation, or a sensation that your bowel is still not empty after a bowel movement.
  •  Bright red or very dark blood in your stool. This can be a symptom of several things besides cancer. If you have this symptom, see a doctor right away.
  • Constant tiredness
  • Stools that are thinner than usual.
  • Stools that appear slimy or that have a mucous film on them
  • Persistent gas pains, bloating, fullness, or cramps
  • Unexplained weight loss
  • Vomiting
  • Pain
  • Yellow skin, also called jaundice

These symptoms may be caused by colorectal cancer or by other, less serious conditions. It is important to check with a doctor to be sure.

Q: What are the types of treatment for colorectal cancer?
A: Treatment choices depend on several things.

  • The person’s age and general health
  • The location of the cancer in the large bowel
  • Whether it has moved into the bowel wall
  •  How far it has advanced

Surgery is the most common treatment. The goal is to remove the cancer. Even then, these other treatments may be used.

  • Radiation therapy
  • Chemotherapy
  • Biologic therapy

Q: Should everyone get a second opinion for a diagnosis of colon cancer?
A: There are many reasons someone might want to ask for a second opinion. Here are some.

  • A person is not comfortable with the treatment decision.
  • The type of cancer is rare.
  • There is more than one way to treat the cancer.
  • A person is not able to see a cancer expert.
  • A person would like confirmation of the treatment decision.

Q: How can someone get a second opinion?
A: Here are ways to find someone for a second opinion.

  • Ask a primary care doctor. He or she may be able to suggest a specialist. This may be a surgeon, medical oncologist, or radiation oncologist. Sometimes these doctors work together at cancer centers or hospitals. Never be afraid to ask for a second opinion.
  • Call the National Cancer Institute’s Cancer Information Service. The number is 1-800-4-CANCER (1-800-422-6237). They have information about treatment facilities. These include cancer centers and other programs supported by the National Cancer Institute.
  • Consult The Official ABMS Directory of Board Certified Medical Specialists. This book from the American Board of Medical Specialists lists doctors by state. It gives their specialty, background, and training. It is available at most public libraries. You can also view it online at www.abms.org.
  • Seek other options. Check with a local medical society, a nearby hospital or medical school, or a support group to get names of doctors who can give you a second opinion. Or ask other people who've had cancer for their recommendations.

Reviewed By: Deborah Berg, RN, BSN
Oncology Nurse Consultant
Reviewed By: Marc K. Wallack , MD
Chairman, Department of Surgery, St. Vincent's Hospital Manhattan, New York, NY