Colon Cancer: What You Should Know

WMCHealth experts weigh in on prevention screening and warning signs of this prevalent disease.

By Laurie Yarnell
As seen in the December 2020 Issue of Advancing Care.

The shocking death of Black Panther actor Chadwick Boseman was a stark reminder that colon cancer can strike at any age. At age 43, the seemingly healthy actor succumbed four years after diagnosis.

Incidence rates among African Americans, like Boseman, are higher than for Caucasians, while colorectal cancer (cancer of the colon or rectum) is the third -leading cause of cancer-related deaths in the country, according to the Centers for Disease Control and Prevention.

Here, three physicians from the Westchester Medical Center Health Network (WMCHealth) share some key information about colon cancer.

Prevention

“Regular screening, beginning at age 45, is the key to preventing the disease,” says Rajkumar Jeganathan, MD, a Colorectal Surgeon at Ramapo Valley Surgical Associates, a member of the Bon Secours Medical Group, part of WMCHealth, in Suffern.

“Regular screening, beginning at age 45, is the key to preventing the disease.”
— Rajkumar Jeganathan, MD

For those with a family history in a first-degree relative, screening “should begin 10 years prior to the age that their relative was diagnosed,” adds Edward Lebovics, MD, Chief of Gastroenterology at Westchester Medical Center, the flagship of WMCHealth. Other factors thought to help, says Dr. Jeganathan, are “exercising regularly, maintaining a normal body weight, eating a low-fat, high-fiber diet, avoiding smoking, and drinking alcohol only in moderation.”

Screening & Testing

There are a variety of screenings and testing to detect colon cancer. One includes the fecal immunochemical test (FIT) that tests for hidden human blood in the stool. Another stool test detects certain DNA markers and blood in the stool. If either of these return positive, the patient must have a colonoscopy.

Newer testing includes the CT colonography, also known as virtual colonoscopy, which uses low-dose-radiation CT scanning to obtain an interior view of the colon. As with the stool tests above, if polyps are found, a follow-up colonoscopy takes place.

Additional testing options include the flexible sigmoidoscopy, which uses a thin, flexible tube to evaluate the colon.
Finally, the colonoscopy is a procedure which looks at the entire colon and requires preparation and sedation.

Considered the gold standard in testing, a colonoscopy offers greater accuracy, as well as a treatment benefit. “It is not a diagnostic test but a therapeutic one, in that polyps can be removed during the exam,” explains Kevin Dodd, Medical Director of Gastroenterology, Health Alliance Hospital in Kingston.

Adds Dr. Lebovics: “The overwhelming majority of colon cancer emerges from premalignant polyps, so it is obviously advantageous to detect these lesions before they become cancerous.”

Consult with your physician to determine which test is most appropriate for you.


Warning Signs

According to Dr. Jeganathan, there are several symptoms that should trigger a visit to your physician. These include: blood in your stool; feeling that your bowels do not empty completely; ongoing diarrhea or constipation; unexplained weight loss, abdominal pain, or fatigue; a change in bowel habits; and narrower stools than usual.


Please call your Primary Care Physician or Gastroenterologist to find out which colon cancer screening is right for you.