Colorectal cancer

Question 1

Do I need colorectal cancer screening, and what does it involve?

Accepted Answer

Colorectal cancer screening looks for cancer in the colon or rectum before any symptoms appear. Finding cancer early can make it easier to treat. Colorectal cancer is one of the conditions doctors commonly screen for, and your care team can help you decide when to start and which test fits you best. There are several types of screening tests to choose from. A colonoscopy lets a doctor look at your entire colon and rectum using a scope: a thin, flexible tube with a light and a tiny camera attached. A flexible sigmoidoscopy works the same way, but it only checks the rectum and the lower part of the colon. A virtual colonoscopy, also called CT colonography, is an x-ray test that looks inside the colon without using a scope. Other screening tests use a stool sample instead of a scope. During a colonoscopy, doctors can also find polyps, which are extra growths of tissue in the colon. Most polyps are not dangerous, but some may turn into cancer, or already be cancer, so doctors remove and test them to be safe. Talk with your care team about which screening test, and what timing, makes sense for you.

Question 2

What does colorectal cancer staging mean, and why does it matter?

Accepted Answer

Staging is how doctors find out how serious a cancer is. This helps guide treatment for colorectal cancer. Treatment depends on several things. These include how serious the cancer is, your age, and your health. The type of cancer also matters. Colon cancer and rectal cancer are not treated the same way. For example, rectal cancer care can include active surveillance. This means regular tests check if the cancer is changing. Doctors use several tests to learn how serious a cancer is. These can include a physical exam and a digital rectal exam. Doctors may also use a colonoscopy, a biopsy, or other blood and tissue tests. A colonoscopy lets a doctor look inside the whole colon and rectum. It can find polyps, which are growths that can sometimes turn into cancer. Removing polyps before they become cancer can help prevent colorectal cancer. Screening tests are done before any symptoms appear. They can help find cancer early, when it may be easier to treat. Staging affects which treatments make sense. Talking with your care team about test results can help. This can help you understand your treatment plan.

Question 3

What should I expect during a colonoscopy?

Accepted Answer

A colonoscopy lets your doctor look inside your rectum and colon. The doctor uses a tool called a scope. A scope is a long, thin tube with a light and a small camera. A colonoscopy checks your entire colon and rectum, not just part of it. During the test, your doctor can see problems like inflamed tissue, ulcers, and polyps. Polyps are growths on the lining of the colon, and some can turn into cancer. Doctors use colonoscopy to find the cause of symptoms such as bleeding or belly pain. Other symptoms include ongoing changes in bowel habits or weight loss with no clear reason. Colonoscopy is also used to screen for polyps and cancer before symptoms appear. Screening tests look for signs of disease before you have any symptoms. This can help find problems early, when they may be easier to treat. If your doctor finds a polyp during the colonoscopy, it can be removed at the same time. Your care team can explain what to expect before, during, and after your colonoscopy.

Question 4

What tests can diagnose colorectal cancer?

Accepted Answer

Doctors use a number of tests to find out whether someone has colorectal cancer. These can include a physical exam, a digital rectal exam, a colonoscopy, stool tests, and a biopsy. A colonoscopy uses a scope — a thin tube with a light and a tiny camera — to look at the whole colon and rectum. A flexible sigmoidoscopy is similar, but it checks only the rectum and the lower part of the colon. A virtual colonoscopy, also called CT colonography, is an X-ray test that looks inside the colon without using a scope. A stool test checks a sample of stool for signs of blood. During a digital rectal exam, a doctor feels inside the rectum for anything unusual. If a polyp — a small growth on the colon lining — is found during a colonoscopy, it can be removed and tested. Doctors may also take a small tissue sample, called a biopsy, along with other blood and tissue tests. Screening tests look for signs of disease before symptoms appear, which can help find cancer early. A care team can explain which combination of tests fits a person's situation.

Question 5

What's the difference between a stool test and a colonoscopy for screening?

Accepted Answer

A stool test and a colonoscopy are both screening tests for colorectal cancer. They check for cancer in different ways. A stool test checks a sample of stool for signs of trouble. A colonoscopy is a procedure where a doctor looks inside the rectum and colon. The doctor uses a scope — a thin tube with a light and camera. During the colonoscopy, the doctor can also find polyps. Polyps are growths in the colon that can sometimes turn into cancer. A doctor can remove polyps during the same colonoscopy visit. Screening tests look for signs of a disease before any symptoms appear. They can help find cancer early, when it may be easier to treat. A care team can explain which test fits someone's situation. They can also explain how often it is needed.

Question 6

How often do I need colorectal cancer screening?

Accepted Answer

How often you need colorectal cancer screening depends on your age, your health, and other risk factors. Your care team is the best person to set your schedule. Screening tests look for signs of disease before you have any symptoms. This can help find cancer early, when it may be easier to treat. The types of screening tests include stool tests and procedures such as a colonoscopy and a flexible sigmoidoscopy. A colonoscopy uses a scope, a long, thin tube with a light and a tiny camera, to look at your entire colon and rectum. A flexible sigmoidoscopy is similar, but it checks only the rectum and the lower part of the colon. During a colonoscopy, a doctor can also find growths called polyps. Some polyps can turn into cancer over time, so doctors remove and test them. Having polyps removed before they become cancerous is one way screening can help prevent colorectal cancer. Which test you need, and how often, depends on things like your age and family history. Talk with your care team about how often you need screening and what type of test is right for you.

Question 7

What can increase my risk of developing colorectal cancer?

Accepted Answer

Several factors can raise a person's risk of colorectal cancer. Risk goes up simply with age. A personal or family history of colorectal cancer also raises risk. Having had adenomas, a type of polyp, raises risk too. Adenomas can sometimes turn into cancer over time. Inherited genetic syndromes can also raise risk. Examples include familial adenomatous polyposis (FAP) and Lynch syndrome. Having chronic ulcerative colitis or Crohn's disease for 8 years or more raises risk. Smoking cigarettes raises risk, and so does drinking three or more alcoholic drinks a day. Having obesity is linked to higher risk as well. Black people have a higher risk of colorectal cancer than other groups. They also have a higher risk of dying from it. Colorectal cancer develops from changes in a person's DNA, the body's genetic material. Some changes are inherited, while others happen during life for unclear reasons. Lifestyle and environment can affect risk as well. A polyp is extra tissue that grows inside the colon. Some polyps can become cancer, so doctors remove and test them. Avoiding risk factors a person can control may help prevent some cancers. These include not smoking and limiting alcohol. Regul

Question 8

What warning signs should I watch for with my colon or rectum?

Accepted Answer

Your care team can tell you what signs to watch for in your colon or rectum, since this depends on your own health. Cancer in the colon or rectum often causes no symptoms, especially in its early stages. Polyps, which are small growths in the colon, usually have no symptoms either. Because problems can hide without symptoms, doctors use screening tests to look for them early. One common test, called a colonoscopy, uses a thin, flexible scope with a camera. This scope lets the doctor see problems such as polyps and cancer inside the colon and rectum. These scope tests are also used to screen for polyps and cancer, finding a problem before symptoms appear, when it may be easier to treat. Most polyps are not dangerous, but some can turn into cancer or already be cancer. Because of this, doctors remove polyps found during the test and have them checked to be safe. Your care team can tell you what signs to watch for in your own case. They can also tell you when to call them and how often you need screening tests.

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