Quality of Life Interventions from the Columbia University Department of Surgery

Colon Cancer: Screening, Prevention, and Treatment

Daniel L. Feingold, MD

Assistant Professor of Surgery

Section of Colon and Rectal Surgery

Herbert Irving Comprehensive Cancer Center

Columbia University Medical Center

In Affiliation with NewYork-Presbyterian Hospital

Phone: 1-800-227-2762

The past 15 years have seen deaths from colon cancer steadily decreasing. This shift is due in part to increased
screening. It also stems from innovations in treatments for the disease, such as the widespread adoption of
laparoscopic surgery for colon procedures.

Polyps and Colon Cancer

Nearly all cases of colon cancer begin with precancerous polyps, growths that develop on the walls of the intestine. If
these polyps are detected and removed early, development of colon cancer may be prevented.

Who is at risk?

All individuals are at risk for developing colon cancer, especially people over 50 years of age. One quarter of the
American population will develop precancerous polyps after age 50.

Certain lifestyle habits increase risk, including a high-fat, low-fiber diet, a sedentary lifestyle devoid of regular exercise,
tobacco smoking, and excessive alcohol consumption. In addition, your risk increases if you have a "first degree"
relative (mother, father, or sibling) who has developed colon cancer. Certain diseases are also believed to place
individuals at higher risk, including inflammatory bowel diseases such as ulcerative colitis and Crohn's disease and
inherited polyposis syndromes like Gardner's.

Screening for Colon Cancer

If precancerous polyps are found and destroyed, they never have the opportunity to become cancerous. Thus, the key
strategy for maintaining colon health is a proper screening program. Tests to screen for colon polyps (and cancer)
·         Fecal Occult Blood Test (FOBT)
Checks for occult (hidden) blood in the stool.

•Flexible Sigmoidoscopy
Employs a flexible, lighted tube to examine the inside of the rectum and lower portion of the colon. Polyps may be
removed, and tissue samples collected.
Employs a flexible, lighted tube to examine the entire colon. Polyps may be removed, and tissue samples collected.
•Double Contrast Barium Enema
An X-ray taken after the patient has undergone an enema containing a dye (barium). The barium outlines the intestine
(and any polyps) on the X-ray film.
To find out which screening tests are appropriate for you, ask your doctor.

Treatments for Colon Cancer

Laparoscopy has been widely incorporated into colon cancer operations. Compared to open surgery, laparoscopy
shortens hospital stay, reduces need for pain medication, and has the potential to promote faster recovery. Meanwhile,
additional innovations are continually improving the outcomes and safety of colon cancer treatment.

·         Surgeons have fused colonoscopy, laparoscopy, and open surgery for patients requiring more complex
procedurees, improving outcomes and reducing the need for open surgery.

·         Targeted chemotherapy treatments are dramatically building on the efficacy of conventional chemotherapy.

·         Combining chemotherapy with surgery (known as adjuvant chemotherapy) may enable a surgeon to avoid a
radical surgical procedure.

If you or someone you love has colon cancer, our team recommends selecting a treatment facility that provides
multiple advanced treatment options.
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