Y o u r C o u n t y C r u s a d e A g a in s t C a n c e r

COLORECTAL CANCER

Let’s Get Talking . . .

( colorectal cancer )  It can be “embarrassing” to talk about colorectal cancer  DON’T DIE FROM EMBARRASSMENT  Colorectal Cancer CAN Be Prevented

S o ,

L e t s G e t T a l k i n g . . .

Colorectal Cancer Overview  Where & What is the Colon?

 What is Colon Cancer?

 Why the Concern?

 Who’s at Risk?

 What Can be Done?

– Prevention – Screening – Treatment  Where to Get More Information

Where is the Colon ?

What does it do?

As part of the digestive system the colon: – Stores mainly non-absorbed food, fiber and water – Re-absorbs nearly all the water – Moves solid waste to the rectum where it is eliminated by defecation

What is cancer?

 Cancer is the uncontrolled growth and spread of abnormal cells.

 It includes 100’s of different diseases, usually classed by the part of the body where it is first found.

How does colorectal cancer develop?

 Most colorectal cancers begin as polyps, or tiny abnormal growths on the inside walls of the colon or rectum.

 Polyps vary in size, from tiny to a few centimeters.

 Some polyps become cancerous after several years and should be removed to prevent development of colorectal cancer.

X-Ray of Colon and Polyps

Why the Concern?

 4 th leading cause of cancer-related death in world  2 nd leading in US – Why a difference between world and US ?

– Stay tuned  2 nd leading in Missouri  2 nd leading in YOUR County

Who Is At Risk of Developing Colorectal Cancer?

 Men

AND

Women are at

similar risk

 Risk increases with age –  90% occurs in people aged 50 +  85% of people with colorectal cancer had

NO

medical history related to colorectal cancer.

What are Risks for Developing Colorectal Cancer?

 Poor Diet – high amount of fats – high amount of red meat – high temperature cooking of red meats – low amount of vegetables – high alcohol consumption – low water consumption

What are Risks for Developing Colorectal Cancer?

 Physical inactivity

Why the Difference Between World and U.S. Rates?

 Colorectal Cancer has been Called a “Cancer of Economically Developed Countries” – Diet is different – Physical activity is different

Ways to Reduce Your Risk  Regular moderate exercise  Healthy diet  Proper weight  Avoid smoking  Limit alcohol use  GET REGULAR SCREENING

Ways to Reduce Your Risk Healthy Diet “Five-A-Day” is  vegetables / day 5 servings of fruits & This can reduce your risk for a number of diseases, including some types of cancer, such as colorectal cancer

Ways to Reduce Your Risk  Physical activity recommendations: – For 30 minutes (can be three 10 -minute segments) – At least 5 times per week – At the pace of brisk walking

Other possible risk reducers  Aspirin  Non-steroidal anti-inflammatories  Calcium  Vitamin D

Screening is KEY !

 American Cancer Society estimates for the impact of colorectal cancer in 1999: – 129,400 cases diagnosed in the U.S.

– 56,000 deaths in the U.S.

– 1,300 deaths in Missouri  At least 1/3 of deaths could be reduced with widespread adoption of screening.

Don’t wait...

 Colorectal cancer can develop with

few

or

no

symptoms at first.

 Screening can lead to reductions in the number of deaths: – FOBT: 33% – Flexible sigmoidoscopy: 70% – Colonoscopy: 80%

How does screening save lives?

 Prevention – By finding polyps in the colon and removing them

before

they become cancerous  Early detection – Finding cancer

early

works best when treatment

Who should be screened for colorectal cancer?

 EVERYONE aged 50 and older: – Women and men – All races and ethnicities  May be younger than 50 for those with a family history of colorectal cancer or colorectal polyps (talk to your doctor!)

Why don’t some people get screened?

 Don’t think they are at risk for colorectal cancer  Embarrassed to ask their doctor  Think it will hurt  Don’t realize that screening is covered by their insurance plans, including Medicare

The screening tests  Fecal Occult Blood Test (FOBT)  Flexible Sigmoidoscopy  Colonoscopy  Double Contrast Barium Enema

Fecal Occult Blood Test (FOBT)  Looks for hidden (occult) blood in the stools  Stool sample is collected at home  Test preparation will likely include dietary and medicinal restrictions (check test kit instructions)

Example of One Type of FOBT

Positive test results may be due to:  Colorectal cancer or polyps.

 Failure to follow pre-test dietary and medicinal restrictions.

 Other bowel disorders which could cause bleeding (though not always a lower GI source): – colitis - diverticulitis - hemorrhoids, among others  Follow-up is IMPORTANT- your physician will usually recommend a full colon exam using colonoscopy or barium enema.

Fecal Occult Blood Test  Annual screening can lead to 33% reduction in deaths  Annual FOBT test is worth the effort !!!

Flexible sigmoidoscopy  Uses a flexible lighted tube to examine the inside of the lower part of the colon (sigmoid).

 The slender tube allows for discovery of polyps.

 Polyps can be removed during sigmoidoscopy or by a follow-up colonoscopy.

Flexible Sigmoidoscopy  Regular screening can lead to 70% reduction in deaths Regular Flexible Sigmoidoscopy is worth the effort !!!

Colonoscopy  Uses a flexible lighted tube to examine the inside of the entire colon  The slender tube allows for removal of polyps and tissue for biopsy

Colonoscopy  Regular screening can lead to 80% reduction in death Regular Colonoscopy is worth the effort !!!

Double Contrast Barium Enema  Radio-opaque liquid with barium put into colon  Barium coats lining of colon and rectum  Allows organs and any signs of disease to show more clearly on x-rays

Double Contrast Barium Enema  Regular screening can lead to 80% reduction in deaths Regular Barium Enema is worth the effort !!!

American Cancer Society recommendations for screening  For adults aged 50+ with no family history of colon cancer or polyps: – Annual FOBT

PLUS

– Flexible sigmoidoscopy every 5 years

- - OR - -

– Total colonic exam • Colonoscopy every 10 years; or • Double-contrast barium enema every 5-10 years

Treatment  More than 90% of people whose colorectal cancer is treated early survive at least 5 years after their diagnosis  Only 8% of people who are diagnosed in later stages survive past 5 years

THIS IS WHY SCREENING IS SO IMPORTANT !!!

Remember

… Lifestyle risk reducers: Healthy food choices Physical activity Maintain a healthy weight Avoid smoking Plus screening tests...

FOBT

and

*** Colonoscopy

or

Sigmoidoscopy *** Double contrast barium enema

Combine to save lives!

Where Can You Get Screening?

Talk to your health care professional

Where Can You Get More Info?

 American Cancer Society 33 East Broadway, Suite 100 Columbia MO 65203 573-443-1496 800-429-7753 [email protected]

www.cancer.org

 Toll-free National Phone 1-800/ACS-2345

Where Can You Get More Info?

 Missouri Department of Health & Senior Services Bureau of Cancer Control P.O. Box 570 920 Wildwood Jefferson City MO 65102 ph 573/522-2841 fax 573/522-2899 e-mail [email protected]

Presented in Cooperation of Your County Community Council of the American Cancer Society .

Missouri Department of Health & Senior Services Bureau of Cancer Control

Special thanks to the U.S. Centers for Disease Control & Prevention