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Colorectal Cancer: Preventable and Treatable

Dr. Deirdre Hart

While colorectal cancer is the third leading cause of cancer-related death in men and in women, but the second most common cause of cancer deaths when men and women are combined it is most important to know that it is preventable and highly treatable if detected early.  

Dr. Deirdre Hart, colon and rectal surgeon with Lincoln Surgical Associates, Ltd. and on staff at HSHS St. Elizabeth’s Hospital, said there are risk factors people should be aware of when it comes to colorectal cancer including genetics, family history, excessive alcohol and tobacco use and increasing age. 

“Part of the problem with colon and rectal cancer is you tend to be asymptomatic until you reach the later stages and have problems with obstruction or being blocked up or bleeding,” Hart said. Hart works on the entire colon and also performs colonoscopy procedures. 

Hart shared some signs and symptoms that may represent colorectal cancer are changes in bowel habits, changes in stool frequency or stool size, bloody stool, fatigue or unexplained weight loss.

“The guidelines for screening have recently changed,” Hart said. “It’s now recommended you undergo screening at the age of 45, which is different than age 50 that everybody is used to.” According to Hart, if you have a first degree relative (parents or siblings) that has had colon cancer, it is recommended that you start screening at age 40 or 10 years before that person was diagnosed.  “If you had a family member diagnosed at age 40, you would want to start at age 30.” 

Hart said while there are several methods of colon screening, “the gold standard is colonoscopy.”

“The goal with a colonoscopy is to find polyps before they become cancer,” she said. “Most colon cancer starts as polyps and over several years change into colon cancer.” There is a spectrum of different types of polyps and they can change into colon cancer at different rates depending on the type.

“If we do take out polyps during a colonoscopy, we let the pathologist look at them and that helps determine when you need your next colonoscopy,” Hart said. If polyps are too big to be taken out during a colonoscopy, it could mean that a section of the colon would be removed during a separate surgical procedure. 

“For most colon cancer, once we have a diagnosis, we do imaging studies to make sure it hasn’t spread outside the colon,” she said. “If it hasn’t, the primary treatment is surgery. For rectal cancer, sometimes we recommend chemotherapy and radiation before surgery, depending on the imaging findings.” 

“Generally, people aren’t great at screening for colon cancer,” Hart said. “A significant portion of the population does not get a screening in any form at the recommended intervals. We are finding cancer at a later stage because they were not worked up until they had problems.” 

Hart said over the past several years, colon cancer incidences have actually decreased, but screening is still not taking place as much as it needs to. 

“I think it’s up to both the general population and the medical community to work together to help increase the screenings that we do,” Hart said. 

Colorectal Cancer Awareness month is observed nationally every March to challenge assumptions and misconceptions about colorectal cancer by dispelling myths, raising awareness, and connecting people across the country with information and support. 

“I think there are a lot of people that put it off and don’t want to be screened because they don’t feel like they have any symptoms,” she said. “That’s why I think it’s important for people to know that we want you to get screened when you’re not having any problems to prevent you from having problems.”

Hart said individuals with no polyps or family history of colon cancer may receive a colonoscopy every 10 years, but that interval can be shortened after discussion between a patient and their doctor. 

“In the older population, the incidences are going down and screenings play into that,” she said. “In the younger age group, we are seeing an increase of colon and rectal cancers and I think that does have to do with diet and environmental factors.” 

Hart said herself and gastroenterologists at St. Elizabeth’s are working to try and screen as many people as possible, and she encourages an open dialogue between patients and physicians about scheduling a colonoscopy. 

To further educate the general public, Dr. Hart is speaking on colorectal cancer risk factors, signs and symptoms, plus current screening methods and treatment on Thursday, March 28 from 11:30 a.m. to 12:30 p.m. in St. Elizabeth’s boardroom. Seating is limited and RSVP’s are required. To register, email stemarketing@HSHS.org.