The exact causes of colon and rectal cancer are not known. However, studies have shown that certain factors are linked to an increased chance of developing this disease. These factors include:

• Age: Most people who develop colorectal cancer are over 50.
• Polyps: These are abnormal growths that protrude from the inner wall of the colon or rectum. They are fairly common in people over 50, but most are benign (harmless).
• Personal History: Anyone with a history or colorectal cancer is at increased risk of having it recur.
• Family History: Close relatives (sibling, parent, child) of someone who has had colorectal cancer are somewhat more at risk to develop this type of cancer.
• Diet: Some evidence suggests that a low intake of fruits and vegetables and a high intake of red and processed meats may be associated with increased risk of developing colorectal cancer.
• Exercise: Some evidence suggest that people who exercise regularly may be at lower risk for developing colorectal cancer, while those who do not may have increased risk.
• Smoking: There is mounting evidence that smoking, particularly over a long period of time, increases the risk of developing colorectal cancer.

Age and your heath history can affect the risk of developing cancers. Risk factors include:

• Age 50 or older
• Family history of colon or rectal cancer
• Personal history of colon, rectal ovarian, endometrial, or breast cancer
• History of colon polyp

Common symptoms include:

• Changes in bowel habits - constipation, diarrhea, or the feeling that the bowel is not completely empty
• Blood - bright red or very dark - in the stool (solid waste)
• Stools that are narrower than usual
• Abdominal discomfort - frequent gas, bloating, cramps
• Weight loss for unknown reasons
• Constant tiredness
• Vomiting
• Mucous in the stool

The majority of these cancers do not become symptomatic until they get larger. By the time these cancers become symptomatic, they can cause problems such as blockage of the colon. That's why screening is so important. The earlier these cancers are detected, the better the chances are to cure them.

A physical exam and history are useful for demonstrating general signs of health, including indicating signs of disease, such as lumps or anything else that seems unusual. A history of the patient's health habits and past illnesses and treatments are also helpful.

Fecal occult blood test is used to check the stool for evidence of blood that can only be seen using a microscope. Small stool samples are placed on special cards and returned to a laboratory for testing.

Digital rectal exam is done by the doctor using a lubricated, gloved finger inserted into the rectum to feel for anything abnormal.

Barium enema is a series of x-rays of the lower intestinal tract. A liquid containing barium is inserted into the rectum, which coats the lower intestinal tract. X-rays are then taken.

Flexible sigmoidoscopy is a procedure that enables the physician to observe the rectum and lower part of the colon, called the sigmoid or descending colon, for polyps, abnormalities, or cancer. A sigmoidoscope (lighted tube) is inserted through the rectum into the sigmoid colon. Polyps or samples of tissues may be taken for biopsy. A biopsy is the removal of cells or tissues to be viewed under a microscope for evidence of cancer. However, flexible sigmoidoscopy is not adequate to detect polyps or cancer in the upper two-thirds of the colon - the ascending and transverse colon.

Colonoscopy is the procedure to look inside the rectum and colon for polyps, abnormalities, or cancer. A colonoscope (thin lighted tube) is inserted through the rectum and into the colon. Polyps or samples of tissues may be taken for biopsy. This procedure allows the physician to examine all the sections of the colon.

Virtual colonoscopy is a procedure that uses a series of x-rays called computed tomography to make a series of pictures of the colon. The computer puts the pictures together taken and creates detailed images to help detect polyps or any abnormalities in the colon.

For most people screening should begin at age 50. With proper screening, it is estimated that colon and rectal cancer can be reduced by as much as 95%. The American Cancer Society recommends that some people be screened using a different schedule because of their personal history or family history. Talk with your physician about your history and what colorectal cancer screening schedule is best for you.

Depending on the stage of the disease, whether the cancer has recurred, and the patient's general health, these cancers are treated with surgery, chemotherapy, and radiation. If the cancer is confined just to the colon, it is highly curable through surgery. The surgeon may remove the cancer using one of the following types of surgery:

• Local Excision: If the cancer is found at a very early stage, the surgeon may remove it without cutting through the abdominal wall, a procedure known as local excision. If the cancer is found in a polyp (a growth on the surface of the colon), the operation is called a polypectomy.
• Resection: If the cancer is larger, the surgeon will remove the cancer and a small amount of healthy tissue around it along with surrounding lymph nodes and then sew the bowel back together. The lymph nodes are examined under a microscope to see if they contain cancer.
• Resection and colostomy: If the two ends of the colon are not able to be sewn together, the surgeon creates an opening to the outside of the body (stoma) through which waste can pass. This procedure, called a colostomy, may be temporary and needed only until the colon has healed. At that point, the colostomy can be reversed. However, if the entire lower colon has to be removed, the colostomy may be permanent.

Some patients may be given chemotherapy or radiation therapy after the operation even if the surgeon removes all the cancer that he or she sees at the time of the operation. These treatments are to kill any cancer cells that may be left.

Chemotherapy is a cancer treatment that uses x-rays or other types or radiation to kill cancer cells. Radiation therapy is used in two ways. One way, called external radiation, sends radiation toward the cancer from a machine that is located outside the body. The other, called internal radiation, uses a radioactive substance inside a wire, needle, catheter (flexible tube), or seed, which is a small radioactive pellet placed in or near the cancer.

Most colorectal tumors occur in areas where the tumor can be removed and the bowel put back together. When that occurs, patients can have normal bowel functioning and bowel movement. Over 95% of patients have colon or rectal cancer can have their colons put back together and experience normal bowel functioning.

Two types of surgery are open and laparoscopic to remove tumors and lymph nodes. The advantages of laparoscopic surgery (also called Minimally Invasive Surgery - MIS) include less pain, a shorter stay in the hospital, and quicker recovery time. You will need to discuss these options with your doctor since not everyone is a candidate for laparoscopic surgery.

You can take steps to lower your overall risk for cancer occurring. Being active, exercising, and maintaining a diet high in fruits and vegetables can lower your risk. One research study demonstrated that a high intake of red and processed meat over a long period of time is associated with an increased risk for a certain type of colon cancer. Research suggests that up to 35 percent of cancers are related to poor diet. Consult with your physician before you begin an exercise program, especially if you have not engaged in those types of activities for a long period of time.