Colon cancer, also called colorectal cancer, is the third most common cancer diagnosed in the United States. According to the American Cancer Society, it’s estimated there will be 106,180 new cases of colon cancer and 44,850 new cases of rectal cancer for 2022. “Colorectal cancer is the third leading cause of cancer-related deaths in men and in women, and the second most common cause of cancer deaths when numbers for men and women are combined. It’s expected to cause about 52,580 deaths,” this year. The ACS says, “Overall, the lifetime risk of developing colorectal cancer is: about 1 in 23 (4.3%) for men and 1 in 25 (4.0%) for women.”

Over two decades ago a shift started in demographics for colon cancer and there’s been a reduced amount of cases with older people and an uptick in young adults under the age of 50, and health officials aren’t exactly sure why. The ACS states, “The rate of people being diagnosed with colon or rectal cancer each year has dropped overall since the mid-1980s, mainly because more people are getting screened and changing their lifestyle-related risk factors. From 2013 to 2017, incidence rates dropped by about 1% each year. But this downward trend is mostly in older adults and masks rising incidence among younger adults since at least the mid-1990s. From 2012 through 2016, it increased every year by 2% in people younger than 50 and 1% in people 50 to 64. “

Like all other cancers, colon cancer is deadly, but with early detection it’s successfully treatable and there are ways to lower the risk. “Up to 80% of colon cancer is preventable through lifestyle, nutrition and physical activity,” Anton Bilchik, MD, PhD, surgical oncologist and division chair of general surgery at Providence Saint John’s Health Center and chief of medicine at Saint John’s Cancer Institute  in Santa Monica, CA tells us. Eat This, Not That! Health spoke with cancer experts who share what to know about colon cancer and ways to help avoid it. As always, please consult with your physician for medical advice. Read on—and to ensure your health and the health of others, don’t miss these Sure Signs You’ve Already Had COVID.

Dr. Bilchik says, “Most patients with colon cancer do not have obvious symptoms especially if it is at an early stage. Symptoms can be non-specific such as rectal bleeding, unexplained weight loss, bloating, abdominal pain, nausea and vomiting.”

Misagh Karimi, M.D., medical oncologist specializing in gastrointestinal cancers at City of Hope Orange County Lennar Foundation Cancer Center in Irvine, California, and director of clinical operations at City of Hope Newport Beach Fashion Island explains, “Patients with colorectal cancer may not have any symptoms at all, or their symptoms may be the same as those of other gastrointestinal issues. Without symptoms, polyps containing cancer cells can remain in the colon wall for not just months, but for years. Once severe symptoms arise, the cancer has usually progressed to a more advanced stage.

This is one of many reasons why people should know their family medical history and tell their physician if something feels wrong. If the symptoms might be caused by colorectal cancer, there are screening tests that can be done to find the cause. At City of Hope, we offer state-of-the-art colorectal cancer screenings, including colonoscopies, stool DNA testing and genetic testing.”

Toufic Kachaamy, MD, FASGE, AGAF Interventional Program Specialist, Cancer Treatment Centers of America (CTCA) says, “Rectal bleeding, especially in young adults. It is often attributed to hemorrhoids and leads to delays in diagnosis. Every rectal bleeding needs to be evaluated. Speak to your doctor about a colonoscopy if you experience this symptom.”

Dr. Karimi says, “Warning signs that people should notify their doctor of include: a change in bowel habits that lasts for an extended length of time (more than a few days), bleeding of the rectum, blood in the stool, abdominal pain, cramping, weakness or fatigue, bloating, unintended weight loss, nausea and vomiting. These symptoms could be similar to symptoms of gastrointestinal diseases or conditions unrelated to cancer, and it is important to bring these concerns to your physician so they can be addressed.” 

 Dr. Karimi advises, “If you have been diagnosed with colorectal cancer, consult with a physician who specializes in the disease before starting treatment. A colorectal cancer specialist with knowledge of the latest advances in research and treatment can help you fully understand your options so you can make the best possible decisions. With access to specialized expertise and leading-edge therapies, the prognosis for colorectal cancer can be very positive.

The following questions can help guide the conversation with your physician: 

• What stage of cancer do I have? What does that mean?
• What are my treatment choices? Which do you recommend for me? Why?
• Should I get a second opinion?
• What are the expected benefits of each kind of treatment?
• What are the risks and possible side effects of each treatment? What can be done to control the side effects?
• Will I have more than one kind of treatment? How will my treatment change over time?
• How long is it going to take for me to recover from treatment?
• Will I be able to work or go to school while I’m being treated?
• What are the chances of the cancer coming back?
• How long will the treatment take?
• What can I do to prepare for treatment?
• Would a clinical trial be right for me? Can you help me find one?
• What kind of support do you have for me and my family?

Dr. Kachaamy says, “Diagnosis of cancer is a stressful event. Many questions will come to mind but here are a few suggestions:

• Which stage am I in?
• What are my chances of long-term remission (being cancer free for over five years)?
• Are you working in a multidisciplinary fashion with many specialties involved in my care?
• If I need surgery, how specialized is my surgeon in my condition?
• Is my oncologist a specialist in colon cancer?”

Dr. Karimi shares, “I recommend to my patients a nutritious, whole-food diet that is high in fiber (especially in fruits and vegetables). Eating meat in moderation is beneficial, as research studies show an association between colorectal cancers and high levels of meat consumption over long periods of time. Other healthy habits I advise for people to adopt is minimizing alcohol consumption and avoiding tobacco products.

We also know that exercise is a huge component in an individual’s overall health, and we are seeing that more time exercising and less time sitting does impact the risk of colorectal cancer. Half of the patients diagnosed that are in the younger demographic are overweight. As a medical oncologist who sees patients every day, I see firsthand how hard it can be to change your behavior, but even small changes make a big difference. Try getting in the habit of walking for an extra 10 minutes a day or choosing whole foods over highly processed foods when you want a snack. The best way to stop cancer is to prevent it in the first place, and the sooner you make healthy choices, the greater the potential benefits.”

Dr. Bilchik recommends the following healthy habits to help reduce the risk of colon cancer: “Diet that includes fruit and vegetables. Limit intake of red meat and processed food. Exercise at least 30 minutes/day – five days/week, avoid smoking, weight loss programs if overweight and stress reduction.”

​​Dr. Kachaamy emphasizes, “Routine screenings are very important. You should stick to whichever program you enroll in and not procrastinate. Having appointments on the books in advance makes it easy to follow through, so make an appointment early and not last minute. Yearly screenings for colon cancer are done with stool testing. A colonoscopy for your first screening is standard, and if you are at an average risk, should be done every ten years.”6254a4d1642c605c54bf1cab17d50f1e

Dr. Karimi states, “It’s very important to undergo recommended screenings and it’s not too early to think about them if you’re in your 40s. The American Cancer Society recommends that people of average risk of colorectal cancer start regular screening at age 45. Follow-up colonoscopies should be done every 1-3 years, depending on the individual’s risk and findings from the first test.  Screenings can help prevent colon cancer by detecting growths (polyps) that can be removed before they turn into cancer. In most cases, colon cancer starts as a polyp. Often, polyps can be removed during a colonoscopy. If cancer cells are still in the colon after a colonoscopy, that section can be removed with surgery, which is often minimally invasive. If the cancer has spread beyond the colon, you may also need chemotherapy or radiation therapy.

In recent years, we’ve seen the advancement of colorectal cancer treatment with targeted therapies and immunotherapy drugs. And there are exciting innovations developing at City of Hope. Our scientists are researching a cancer-killing virus that could help the immune system fight colon cancer, as well as a botanical agent that may help treat chemo-resistant colorectal cancer.

It is important for individuals to keep up screenings and medical appointments. Please do not delay a colonoscopy or let anxiety keep you from getting screened. Colorectal cancer is highly treatable when it is found early. Your physician and care team can answer questions about your individual health risks related to colorectal cancer, and if you are age 45 or older, please inquire about getting screened. These tests can save your life.”