Screening For Colon Cancer
- Actress Kirstie Alley passed away from colon cancer at age 71 on December 5, 2022. Now, after the one year anniversary of her death, we’re reminded of the “incredible life” she lived and the importance of screening for this type of disease.
- Colon cancer, or colorectal cancer, affects your large intestine (colon) or the end of your intestine (rectum). It is highly treatable especially if caught early with screening.
- A colonoscopy is a procedure doctors use to screen for colon cancer by looking inside your colon. Experts recommend screening begin at age 45; however, if you are at higher risk screening may begin earlier. It’s best to discuss your risk of colon cancer and screening time with your doctor.
- The American Gastrointestinal Association lowered the recommended initial age for a colorectal screening from 50 to 45.
- Dr. Heather Yeo, a colorectal surgeon and surgical oncologist at Weill Cornell Medicine and New York-Presbyterian, previously told SurvivorNet, “Colon cancer is considered a silent and deadly killer. What happens is people often don’t know that they have colon cancer. They don’t have any symptoms. That’s why we screen for colon cancer in the United States.”
- Colon cancer symptoms will most notably impact your bowel habits. If you notice a change in your bowel habits or changes in your stool, talk to your doctor. Other symptoms can be harder to pinpoint, such as abdominal pain and unintentional weight loss.
Alley’s passing serves as a reminder to women and men of all ages to be aware of the importance of regular screening, which can help detect the disease early on, making it easier to treat. Some types of screening can also find and remove pre-cancerous growths called polyps before they turn into cancer.
Read MoreView this post on Instagram
The mom of two became a household name with a starring role opposite Ted Danson in the NBC hit sitcom “Cheers,” a show about the antics of a cast of regulars at a Boston bar, where Alley played Rebecca Howe alongside Ted Danson’s Sam Malone. Her performance led to her winning an Emmy in 1991, and she was honored with a second Emmy just two years later for playing the title role in the CBS TV movie “David’s Mother.”
Alley also starred in the NBC comedy “Veronica’s Closet,” between 1997 and 2000, playing the role of a fashion mogul. She also appeared alongside John Travolta the 1989 hit film “Look Who’s Talking,” which gave her a huge career boost and spawned two sequels.
More recently, Alley also appeared on several reality shows, including “Dancing with the Stars” and “The Masked Singer.” She also had a recurring role on Ryan Murphy’s “Scream Queens.”
In the wake of Alley’s passing, her daughter and son shared a heartfelt post on the actress’s Instagram page, writing, “We are sad to inform you that our incredible, fierce and loving mother has passed away after a battle with cancer, only recently discovered.
“She was surrounded by her closest family and fought with great strength, leaving us with a certainty of her never-ending joy of living and whatever adventures lie ahead. As iconic as she was on screen, she was an even more amazing mother and grandmother.”
Expert Resources On Colon Cancer
- 5 Possible Signs of Colon Cancer; Don’t Be Afraid to Look in the Toilet!
- Anxiety Around Colon Cancer Diagnosis
- Biomarkers in Colon Cancer: Understanding KRAS, BRAF, and HER2
- Can a Blood Test Screen for Colon Cancer? Guardant Health Chief Medical Officer Shares Promising Update
- Colon Cancer Diagnosis: What Happens After the Colonoscopy
- Colon Cancer Screening is Extremely Important; Guidelines Now Say to Start at Age 45 if There Is No Family History
- Choosing the Right Surgery for Your Colon Cancer While Avoiding Marketing Gimmicks
- Colon Cancer Screening Options And Genetics: Myth Busting With Dr. Heather Yeo
They continued, “We are grateful to the incredible team of doctors and nurses at the Moffitt Cancer Center for their care. Our mother’s zest and passion for life, her children, grandchildren and her many animals, not to mention her eternal joy of creating, were unparalleled and leave us inspired to live life to the fullest just as she did.
“We thank you for your love and prayers and ask that you respect our privacy at this difficult time. With love always, True and Lillie Parker.”
Now, her daughter Lillie and her son William are selling some of their mom’s personal items in her memory, in a sale dubbed, “Property from The Collection of The Late Kirstie Alley.”
In a statement made to People this month, the Parker siblings said, “Our mom collected so many fun and unique things over her incredible life. We want to share some of them with others in the hopes of spreading her love of decorating.”
According to People, the sale will be organized by Those Two Girls Estate Sales and will take place three parts via an online bidding platform known as Live Auctioneers. The first part of the sale, including items from Alley’s three homes (Maine, California, and Florida) will begin on Dec. 21 and will end on Jan. 7.
Colon Cancer: A Silent Killer
Dr. Heather Yeo, a colorectal surgeon and surgical oncologist at Weill Cornell Medicine and New York-Presbyterian, previously told SurvivorNet, “Colon cancer is considered a silent and deadly killer.
“What happens is people often don’t know that they have colon cancer. They don’t have any symptoms. That’s why we screen for colon cancer in the United States.”
The Rate of Colon Cancer is Increasing in Those Under 50
“You should be screened for colon cancer, even if you have no family history. Once you have your initial screening colonoscopy, if there are no polyps and you have no high-risk factors, usually once every 10 years is fine,” she advises.
“Colon cancer is a slowly progressing cancer. If you have any family history of colon cancer, you should be screened about 10 years before your family member had colon cancer. So if you have a family member that was 53, you should be screened at 43.”
Colon Cancer Appearing More in Younger People
Although the average age people are diagnosed with colon cancer is 68 for men and 72 for women, according to the American Cancer Society, 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 the proportion of cases in people younger than 55 years old 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.
Researchers are still trying to determine why younger people are being diagnosed in greater 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. Heather Yeo, a surgical oncologist who specializes in colorectal cancers at Weill Cornell Medicine, 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.
Screening for Colon Cancer
Luckily, most colon cancers can be prevented through routine screenings. Colon cancer screenings usually involve a colonoscopy, in which a long thin tube attached to a camera is used to examine the colon and rectum.
The advantage of a colonoscopy is that your doctor can remove any polyps found during the test before they turn into cancer. If no polyps are discovered, the next screening won’t be needed for about 10 years.
Dr. Paul Oberstein Explains Common Colon Cancer Symptoms
A colonoscopy isn’t the only colon cancer screening test. There are other options, including stool tests that detect blood or DNA, and flexible sigmoidoscopy, which checks only the lower third of your colon.
Ask your doctor whether any of these tests would be good additions to a colonoscopy, based on your risks and/or personal preferences.
RELATED: Can the Stuff in My Gut Cause Cancer? There May Be A Link to Colon Cancer
“We know that colon cancers can be prevented when polyps are found early,” Dr. Yeo added. “Lowering the screening age helps somewhat with this, but access to care is a real problem.”
The American Gastrointestinal Association lowered the recommended initial age for a colorectal screening from 50 to 45.
“The fact that we have now reduced the screening age to 45 is a huge step,” Michael Sapienza, CEO of Colorectal Cancer Alliance, told SurvivorNet in an earlier conversation.
“It will allow us to potentially screen 15 million more eligible Americans a year and will certainly save lives. I also think what it’ll do is bring much-needed attention that even if you’re younger than 45 you should be paying more attention. I think that’s also a really important message.”
Cancer Research Legend Urges Patients to Get Multiple Opinions
What Increases Your Risk for Developing Colon Cancer?
For some people, certain risk factors can influence their risk of getting colon cancer. They include the following:
- Are older. About 90% of cases are in people aged 50 or older, according to the U.S. Centers for Disease Control & Prevention (CDC). Yet it is possible to get this cancer earlier in life.
- Have inflammatory bowel disease. Crohn’s disease or ulcerative colitis can, over time, cause cells in your intestines to turn cancerous.
- Have a family history of this cancer. Just under one-third of people who get colon cancer have family members with the disease.
- Have a gene mutation. About 5% of colorectal cancers are caused by an inherited genetic mutation that causes syndromes such as familial adenomatous polyposis (FAP) or hereditary nonpolyposis colorectal cancer (Lynch syndrome).
- Don’t exercise very often. Staying active can lower your risk.
- Eat a diet that’s high in meat. Regularly eating red meats like burgers and steaks, and processed meats such as hot dogs and bacon might put you at higher risk. Eating more fruits, vegetables, and whole grains instead might lower your risk.
- You are overweight or obese. Having too much weight increases your risk of both getting colon cancer and dying from it.
- Drink a lot of alcohol. Limiting alcohol to one drink daily for women and two drinks daily for men could help lower your risk.
- Use tobacco. Long-term smokers are more likely to get this cancer than nonsmokers.
Keeping Up With Recommended Screenings
As a part of routine care, people who have had colitis for eight years or more may get a colonoscopy to screen for colon cancer every one to three years, depending on their individual level of inflammation.
In the general population, guidelines recommend colon cancer screening once every ten years starting at age 45. Follow up screenings sooner than ten years are based on whether you have any abnormalities.
Dr. Heather Yeo Breaks Down Different Ways to Screen for Colon Cancer
Doctors use colonoscopies to check for abnormal growths (polyps) in the colon that can be cancerous or develop into cancer. People with colitis tend to develop a different kind of polyp than other people do, and these polyps are more likely to contain atypical or pre-cancerous cells.
“So those polyps are one step closer to developing into cancer, whereas a lot of the polyps we find in the general population are benign,” Dr. Limketkai said.
Crohn’s disease, however, is a little bit different. Because this condition can affect any part of the GI tract, Crohn’s disease only raises risk for colon cancer if the inflammation is in the colon, which varies from one person to the next.
Does inflammation cause any other types of cancer? Dr. Stephen Freedland explains.
“If it spares the colon, then we don’t have to do all the surveillance that we do in colitis,” Dr. Limketkai explained. “Of course, you may need to have colonoscopies for other reasons, and while you’re doing that, you’re getting a screening anyway.”
When it comes to inflammatory bowel disease, the major risk factor for colon cancer is untreated disease. Treatment, which may include a combination of medication, dietary changes and routine endoscopies, keeps inflammation under control. Sticking to that treatment can help keep colon cancer risk to a minimum, too.
Treating Colon Cancer at Stages One, Two and Three
When it comes to treatment for colon cancer at stages one, two and three, there is the potential for a curative effect with surgical resection.
Colon Cancer Stages One, Two and Three
“As long as it hasn’t spread outside of the local area, it’s still considered a curable colon cancer,” Dr. Yeo told SurvivorNet.
According to Dr. Yeo, all patients with stage one to three colon cancers undergo surgery “if they’re healthy enough to tolerate it.” But there’s more nuance to the possibility of additional treatment for stages two and three.
“Stage 2 a little bit more in between,” she said. “It really depends on kind of the depth of the tumor into the colon wall and the risk that it has to spread.
If a stage two colon cancer has “bad features” identified by a pathology report, chemotherapy might be the right move.
“For example, if when they look at the pathology slides under the microscope, if they see that it’s involving some of the vessels nearby, then that is a higher risk factor,” she explained. “And then, those patients might be more likely to benefit from chemotherapy.”
Stage three colon cancers have spread to the lymph nodes. So, these patients “at least need a conversation of chemotherapy,” according to Dr. Yeo.
“For our patients with 3 or higher, they all need chemotherapy,” Dr. Yeo said.
Treatment Advances
Meanwhile, a new promising treatment for late stage colorectal cancer may soon be available for patients in need of options. The Food And Drug Administration (FDA) is currently reviewing the drug fruquintinib, an oral treatment by Takeda Oncology.
Fruquintinib is a targeted therapy for adults who have metastatic colorectal cancer and have tried other treatments. Results from a trial published in June showed the drug improved overall survival and progression-free survival, which is a measurement of the amount of time before the cancer comes back or spreads.
New Hope For Advanced Colorectal Patients: Drug Fruquintinib Shows Improved Overall Survival
When found early, colorectal cancer has a great prognosis. If detected before it spreads, 90% of those diagnosed have a 5-year survival. That is why so much emphasis is put into screening. But for those who are in a later stage, the prognosis is grim and there has been very little progress in treatment development.
Once you get to the metastatic setting, many patients “they 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 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.
Fruquintinib is an oral drug that inhibits angiogenesis, meaning it blocks the growth of blood vessels that increase tumor growth. It was investigated in two phase three trials for metastatic colorectal cancer.
“Both trials were robust large placebo controlled trials, and they both showed an overall survival advantage,” Elliott told SurvivorNet.
According to the study published in June, patients who received fruquintinib plus best supportive care (BSC) experienced 7.4 months of overall survival, compared to those who received a placebo plus BSC, who experienced 4.8 months of overall survival. And patients who received fruquintinib experienced 3.7 months of progression-free survival, over those who received placebo, who experienced 1.8 months of progression-free survival.
“I think what’s unique about fruquintinib is its manageable safety profile, as well as the fact that it didn’t decrease the quality of life of patients on the trial — which is really important in this late stage of disease,” Elliott told SurvivorNet.
The drug was granted Priority Review by the FDA and assigned a Prescription Drug User Fee Act (PDUFA) goal date of November 30, 2023. A marketing authorization application for the drug in Europe has also been validated.
Contributing: SurvivorNet Staff
Learn more about SurvivorNet's rigorous medical review process.