By Joel Hall
Colorectal cancer is the second leading cause of cancer-related death in the United States.
The problem is exacerbated, according to Dr. Stephen Cohen, a colon and rectal surgeon at Southern Regional Medical Center, because too many people wait until they need surgery to do something about it.
March is National Colorectal Cancer Awareness Month and the hospital is encouraging anyone over 50 years of age to have a regular colonoscopy. The hospital is also using medical advances that enable those who need colon or rectal surgery to have it done safely, and with less risk of complications.
"If you wait for symptoms, bowel bleeding, obstruction, it's going to be too late," said Cohen. "We can decrease the amount of cancer deaths if more people over 50, who are asymptomatic, come in for regular colon screenings."
According to the American Cancer Society, about 148,000 people were diagnosed with colorectal cancer in 2008 and about 50,000 people died of the disease. It is estimated by the U.S. Centers for Disease Control and Prevention that 60 percent of colorectal cancer deaths could have been prevented with regular screenings.
Cohen said there are many misconceptions about colonoscopy that deter people from having the procedure done, even though early detection of pre-cancerous polyps is crucial in avoiding the development of cancer.
"People are scared," he said. "The common misconception is that a colonoscopy is painful. It's an easy procedure. You do it in your sleep, and when you wake up, it's done.
"For every 100 colonoscopies in men and women, I will find three cancers and 17 pre-cancerous polyps," Cohen said. He added that the rate of colorectal cancer diagnosis in women is slightly higher than it is in men (51 percent in women, versus 49 percent in men) and that race is not a factor in developing the disease.
He recommended that people over 50 years of age without polyps get a colonoscopy every 10 years, and that people with polyps get a colonoscopy every five years.
According to Cohen, once cancer occurs in the colon (large intestine) or the rectum, the only method of treatment is surgery to remove the portion of the large intestine infected with cancer. The hospital, however, has been using a new technology to re-attach the intestines, that is safer than using staples, which is currently is the industry standard, he said.
The Compression Anastomosis Ring, a U.S. Food and Drug Administration approved device made by Niti Surgical Solutions, uses pressure to seal the two ends of the intestine back together. Cohen, one of the earliest adopters of the technology, said using the ring eliminates the potential problems that come with using a staple gun, including bleeding, bowl constriction, and leakage.
"The major problem when you remove a piece of bowel is [to] keep it together," he said. "With a hole in the bowel [as a result of a staple], there is often an inflammatory response. A few years ago, I started using compression. I've looked at it with the scope [after surgery], and it's much better because it's natural healing."
Cohen said that doctors still have no idea what causes polyps or colorectal cancer, but said in countries where people have less sedentary lifestyles and receive 25-30 grams of fiber in their diets a day, the incidence of colorectal cancer is less. He said most Americans get about 8-12 grams of fiber daily.
"The lack of fiber, and a high-fat diet, leads to higher records of colorectal cancer," he said. "There is a lot of epidemiology that points to it. That's why you should add fiber to your diet."
For more information, visit www.atlantacolon.com.