Reducing Colon Cancer Risk
- “Veronica Mars” star Kristen Bell, 45, shares her experience preparing for her colonoscopy, which screens for colon cancer. This meant frequent bathroom trips for the actress. However, she’s glad she got her colonoscopy because of the doctor’s ability to address early signs of cancer before it becomes a problem.
- Colon cancer is very treatable and curable if caught early. Colon cancer screenings can involve at-home tests such as Cologuard, but a colonoscopy is more effective, according to SurvivorNet experts. A colonoscopy involves a long, thin tube attached to a camera used to examine the colon and rectum for polyps (small growths in the colon that aren’t yet cancerous). If found, doctors can remove them during the procedure.
- “When we see a polyp, we actually physically take the polyp out through the colonoscope,” Dr. Zuri Murrell, a colorectal cancer surgeon and Director of the Cedars-Sinai Colorectal Cancer Center.
- Dr. Murrell further explains that doctors put a wire through the colonoscope “with a little bit of a flange at the end, and pull the polyp out.” He adds there is “no pain” during the procedure.
- Colorectal screenings are recommended to begin around age 45. However, people at increased risk – such as having a family history of the disease – may want to screen sooner. Discussing your screening options with your doctor is recommended.
- Over the years, colon cancer treatment advances have become more precise with targeted treatments, meaning doctors often test for specific changes or genetic mutations that cause cancer growth.
On Dax Shepard’s podcast, Kristin Bell explains how the procedure went, how she prepared for it, and what she wishes she had known before her colonoscopy.
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“I’d never had one before. You can’t eat for 24 hours before it. It used to be that you took this liquid, but now there are pills [you take]. They were quarter-sized pills, and you had to take 15 of them 10 hours before and then 5 hours before. So I took them at night before I went to bed.”
Bell describes how she wasn’t fully aware of how the pills would affect her.
“I wasn’t prepared for what was going to happen after [I took the pills]. It’s absolute Draino. You have to wake up at 3 in the morning and do it again,” Bell explained.
Bell says she wishes she had known before her colonoscopy that you don’t eat for 24 hours prior. She also wishes she had known, “You also don’t sleep for 24 hours because you’re up power-washing your insides. You can’t go to bed.”
When the time finally arrived for her to undergo her colonoscopy, she was exhausted but also excited. “You know I love doctors. I’ve got a thousand questions [for them]. Everyone was super nice. It was super easy.” Bell says, “It was absolutely great,” and she loved the bedside manner of her doctors.
“The cool thing about colonoscopies today,” says Bell, “is the doctor can remove polyps as they find them.”
This added benefit goes a long way to lowering overall cancer risk, says Dr. Zuri Murrell, a colorectal cancer surgeon and Director of the Cedars-Sinai Colorectal Cancer Center.
WATCH: Understanding the Function of the Colon and the Rectum
“When we see a polyp, we actually physically take the polyp out through the colonoscope,” Dr. Murrell explained.
“What does that mean? That means we basically put a wire through with a little bit of a flange at the end, and we pull the polyp out. Now, note there is no pain with that. Inside the colon, there are no pain fibers. So, there’s no pain,” Dr. Murrell added.
Colon cancer is very treatable and curable if caught early. Colon cancer screenings can involve at-home tests such as Cologuard, but a colonoscopy is more effective, according to SurvivorNet experts.
The cancer starts when abnormal lumps called polyps grow in the colon or rectum. It takes up to 10 years for a colon polyp to become full-blown cancer, according to SurvivorNet experts.
Colon Cancer Warning Signs
The most poignant signature of colon cancer is a change in bowel habits. Changes in the size or shape of bowel movements may cause constipation or diarrhea. A change in stool color, particularly black or tarry stools, can indicate bleeding from a tumor deep in the colon.
WATCH: Colon cancer symptoms.
Other symptoms can be harder to pinpoint, such as abdominal pain and unintentional weight loss. Finally, some tumors bleed a small amount over a long period, resulting in anemia (low red blood cell count) that is picked up on blood work.
Expert Resources for Colon Cancer Screening
- Colon Cancer Screening Options And Genetics: Myth Busting With Dr. Heather Yeo
- Colon Cancer Screening is Extremely Important; Guidelines Now Say to Start at Age 45 if There Is No Family History
- Colorectal Cancer Screening: a New Study Questions the Effectiveness of Colonoscopies But Specialists Reinforce its Importance
- All Americans Should Begin Colorectal Cancer Screening at Age 45, According to New Guidelines; Previous Age Was 50
Colon Cancer Cases Rising in Adults Under 50—Screening Rates Are Climbing Too, Especially Among 45-49 Year Olds
The average age at which people are diagnosed with colon cancer is 68 for men and 72 for women, according to the American Cancer Society.
However, the National Cancer Institute reports that since the 1990s, colorectal cancer cases have been rising among adults younger than 50. Research published in CA: A Cancer Journal for Clinicians found that cases in people younger than 55 “increased from 11% in 1995 to 20% in 2019.”
“We know rates are increasing in young people, but it’s alarming to see how rapidly the whole patient population is shifting younger, despite shrinking numbers in the overall population,” cancer epidemiologist and lead study author Rebecca Siegel said.
WATCH: Understanding the Function of the Colon and the Rectum
Researchers are still trying to determine why younger people are being diagnosed in more significant numbers. Some experts point to risk factors, which include obesity, physical inactivity, and smoking, as a possible explanation for the increase.
“We don’t know for sure why we are seeing earlier onset and death from colon cancer,” Dr. Yeo told SurvivorNet.
“It is likely a combination of factors, including diet and genetics as well as access to care and some environmental factors,” Dr. Yeo added.
A new study published in the peer-reviewed medical journal JAMA Network examined colorectal cancer screening rates between 2016 and 2023. Researchers conducting the study analyzed more than 7.8 million colorectal cancer screenings conducted at more than 1,350 hospitals throughout the United States.
A point of note from the study was that the rate of colorectal cancer screenings appeared to correlate with guideline changes from the U.S. Preventive Services Task Force (USPSTF) and the American Cancer Society (ACS) for people at average risk to begin screening at age 45.
- CRC screenings among adults aged 45–49 increased nearly tenfold, from 2.9% to 17.8% of all screenings between 2016 and 2023.
- Monthly screening volume for this age group rose 955%, compared to a 46% increase among adults aged 50–75.
- The surge reflects rapid guideline adoption in hospital settings and early uptake even before the USPSTF changes.
The findings from the study highlight the impact of hospitals following recommended screening guidelines for their patients. It’s important to note that the study does not account for at-home colorectal screenings.
What Treatment Options Exist for Colon Cancer?
“There are a lot of advances being made in colorectal cancer,” Dr. Yeo previously told SurvivorNet.
Colon cancer treatment is more targeted, meaning doctors often test for specific changes or genetic mutations that cause cancer growth.
Biomarkers are key to tailoring specific treatments. Biomarkers are molecular patterns becoming more commonly used in colon cancer diagnosis, prognosis, and management. According to the National Cancer Institute, a biomarker is “a biological molecule found in blood, other body fluids, or tissues that is a sign of a normal or abnormal process, or a condition or disease,” such as cancer.
“In colon cancer, we’re starting to look more and more at people’s biomarkers, so we’re starting to take the cancers, sequence them, understand where the different mutations are to figure out whether or not someone has a normal gene here or an abnormal gene,” Dr. Yeo explained.
“Those are the areas that people want to be able to target a little bit more. We’re getting close to more of what we would call precision medicine, meaning we can start looking at people’s genetic mutations and think about how they might respond to different drugs.”
There are different types of biomarkers, including DNA, proteins, and genetic mutations found in blood, tumor tissue, or other body fluids. The biomarkers most commonly used in colon cancer management are:
Genetic mutations within the tumor, such as MMR/MSI, KRAS, BRAF, and HER2
Bloodstream carcinoembryonic antigen (CEA)
CEA is a protein produced by most tumor cells (but not all) and can be picked up in the bloodstream. High CEA levels do not establish a colon cancer diagnosis. However, higher CEA levels correlate with a worse prognosis and potential metastasis. Carcinoembryonic antigen is important for post-treatment follow-up to ensure the cancer hasn’t returned. Be sure to check with your doctor before treatment starts to ensure a CEA blood sample has been obtained.
More on Treating Colon Cancer
Surgery and chemotherapy are common approaches to colorectal cancer.
Some examples of Food and Drug Administration (FDA) approved chemotherapy drug treatments include:
- FOLFOX: leucovorin, 5-FU, and oxaliplatin (Eloxatin)
- FOLFIRI: leucovorin, 5-FU, and irinotecan (Camptosar)
- CAPEOX or CAPOX: capecitabine (Xeloda) and oxaliplatin
- FOLFOXIRI: leucovorin, 5-FU, oxaliplatin, and irinotecan
- Trifluridine and tipiracil (Lonsurf)
WATCH: Understanding Your Options with Metastatic Colon Cancer
Among metastatic colon cancer patients, multiple treatment options exist, including surgical and non-surgical options.
One treatment option includes an oral treatment called Fruquintinib, which is a targeted therapy for adults who have metastatic colorectal cancer and have tried other treatments. Results from a trial published last year showed the drug improved overall survival and progression-free survival, which measures the amount of time before the cancer returns or spreads. It works by blocking the growth of blood vessels, which increases tumor growth.
Once you get to the metastatic setting, many patients “just run out of options,” Jennifer Elliott, head of solid tumors at Takeda, explained to SurvivorNet at the ASCO Annual Meeting. So it was critically important for Takeda to do this deal to in-license fruquintinib. We hope to give patients another option.”
Fruquintinib has been approved in China since 2018 and was originally developed by the Chinese biopharmaceutical company HUTCHMED. Takeda Oncology acquired the exclusive worldwide license for the drug outside of mainland China, Hong Kong, and Macau in January 2023.
Questions to Ask Your Doctor
If you are facing a colon cancer diagnosis, here are some questions you may ask your doctor.
- What are my treatment options based on my diagnosis?
- If I’m worried about managing the costs of cancer care, who can help me?
- What support services are available to me? To my family?
- Could this treatment affect my sex life? If so, how and for how long?
- What are the risks and possible side effects of trea
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