No one likes to talk about it, but colorectal cancer (of the colon or rectum) is the second leading cause of cancer deaths in Alberta.
- It accounts for 12 per cent of cancer cases in Alberta and 11 per cent of cancer deaths.
- On average 1,400 Albertans are diagnosed with colorectal cancer each year, and 580 Albertans die of the disease.
Screening Saves Lives
It doesn’t have to be this way. Screening tests can radically reduce the number of colon cancer deaths.
With screening, colorectal cancer can be detected early when it is most treatable . Often screening can even prevent it , by making it possible to spot and remove pre-cancerous lesions before they become malignant.
Want to make this largely preventable disease rare?
Screening is the solution. That's why the Alberta Cancer Board has started a five year colorectal cancer screening program. Our goal is to make people more aware of the disease and what they can do to prevent it or catch it early.
If you are between the ages of 50 – 74 , or are at high risk of developing colorectal cancer, ask your doctor about about getting screened. If you don't have a doctor, you can call Health Link Alberta.
Colorectal cancer grows slowly and often has no symptoms until a later stage of the cancer. This makes regular screening especially important to detect the disease before it is advanced.
When symptoms of colorectal cancer are present, they may include those listed below.
- blood in the stool
- nausea, vomiting and abdominal distention
- abdominal pain or discomfort (bloating, gassiness)
- pelvic pain
- loss of appetite and weight loss
If you have one or more the above symptoms, see your doctor. The symptoms may be caused by something else, but it is important to find out quickly.
Screening Tests: How Colorectal Cancer is Found
Screening tests dramatically increase the chances of finding colorectal cancer or a pre-cancerous condition while it can still be treated or prevented. Here are the most common tests. Which test your doctor recommends depends on your situation.
- Fecal occult blood test (FOBT): You’ll be given a special kit to use at home to collect stool samples. Then, in a lab, a chemical reaction can tell whether there is any blood in the stool, even an amount so small you couldn’t have seen it. If the test is positive, other tests (such as those below) will be done to find out if there are polyps, cancer or other reasons for the bleeding.
- Sigmoidoscopy: Sigmoidoscopy is sometimes done in your doctor’s office. A sigmoidoscope is a flexible, lighted tube about the thickness of a finger. It is put into the lower part of the colon through the rectum. This lets the doctor look at the inside the rectum and part of the colon for cancer or polyps. It only goes part-way up the colon, but that’s far enough to spot about half of colorectal cancers. And if any problems are found, it is often possible to remove them right then and there.
- Colonoscopy: Colonoscopy is a way to examine the rectum and the whole colon, using a long, flexible, lighted tube. The patient needs to be on a liquid diet and take a laxative one to three days before the test to empty the colon. They'll be given medication to calm them and relieve pain. As with sigmoidoscopy, if the doctor finds polyps, cancer or other abnormal growths, they can be removed or biopsied during the procedure. Patients usually remember little of the procedure and have recovered fully by the next day.
How do I Get a Screening Test Done?
Ask your doctor. If you don’t have a doctor, find one at the Alberta College of Physicians & Surgeons' Find a Physician website or call Health Link Alberta toll-free at 1-866-408-5465.
Who is at Increased Risk of Colorectal Cancer?
Some people are at high risk of developing colorectal cancer, including those with:
- A family history (parent, child or sibling) of colorectal cancer
- Some hereditary conditions such as:
- Familial adenomatous polyposis
- Hereditary non-polyposis colon cancer
- Some previous medical conditions such as:
- Inflammatory bowel disease (ulcerative colitis and Crohn’s Disease)
- History of previous uterine, ovarian, breast or small bowel cancer
- Previous colorectal polyps or cancer
If you are at high risk of colorectal cancer, ask your doctor about your personal risk and the right test for you.
Family History: The Genetic Link
Most people who get colorectal cancer are 50 or older, but people who have a family history of the disease are at higher risk, even as young adults. A family history means one or more first degree relatives – parent, sibling or child – who has had colorectal cancer.
If you do have a family history of the disease you should have your first colonoscopy 10 years earlier than the age at which your relative was diagnosed, or starting at age 50, whichever comes first.
How Can I Lower My Risk?
From what we know so far, the risk of developing colorectal cancer may decrease with:
- Eating a balanced diet (high in dietary fibre, plenty of fruit and vegetables)
- Regular exercise
- Maintaining healthy body weight
- Having regular colorectal cancer screening after age 50
Stages and Treatment
Treatment for colorectal cancer will vary depending on the stage of cancer at diagnosis and the overall health of the patient.
Cancer cells have penetrated into the layer of tissue beneath the lining of the colon. In this case surgical removal of the tumour and some lymph nodes in the area is recommended.
Cancer cells have penetrated deeper into the muscle that contracts to move the bowel. Surgery alone remains an option but doctors may advise chemotherapy aimed at trying to destroy any remaining cancer cells.
For patients with stage 2 rectal cancer, radiation therapy in combination with chemotherapy is usually offered before or after surgery. A colostomy may be required - see below.
Cancer has spread to tissue (lymph nodes) surrounding the colon or rectum. Surgery followed by chemotherapy is recommended. For patients with stage 3 rectal cancer, radiation therapy in combination with chemotherapy is usually offered before or after surgery. A colostomy may be required.
The tumour has spread to other organs. Depending on the tumour, surgery may or may not be appropriate. Treatment will involve chemotherapy along with a biologic drug to target specific cancer cells. Additional surgery to remove cancer that has spread to other organs may also be required.
Factors Affecting Prognosis
If you or a friend are diagnosed with colorectal cancer, how things will develop depends on a combination of:
- Stage of cancer (see above)
- Patient’s age and general health