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The prevention, early diagnosis and treatment of colon cancer

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Posted at 3:24 PM, Feb 27, 2020
and last updated 2020-03-02 16:52:38-05

Colorectal Cancer or colon cancer is the third most common cancer diagnosed in both men and women, according to the American Cancer Society.

The American Cancer Society says that the lifetime risk of developing this type of cancer is: about 1 in 23 for men and 1 in 25 for women. Because of this, there is a lot of research into different types of treatment as well as preventative measures.

Dr. Mahsa Mohebtash, Medical Director of the MedStar Franklin Square Cancer Center, Loch Raven Campus and chief of medical oncology and hematology said that there has been a lot of research as of late into the role of immunotherapy in colorectal cancer.

Immunotherapy is the use of medicines to help a person's own immune system better recognize and destroy cancer cells. However, Mohebtash said while colorectal cancer is not very responsive to immunotherapy, there is a subtype of the cancer that does respond. The percentage however of that subtype ranges from three to five percent, so it's not something that can be offered to the majority of their patients.

“There are still studies going on on how we can modify immunotherapy in a way that more patients could benefit from it," Mohebtash explained. "The other exciting area which is going on right now is checking for circulating tumor DNA in the blood, Peripheral blood."

This is for people who have early stage colon cancer and have gotten chemotherapy to see if they have minimal residual disease.

"However, its not routinely done right now," Mohebtash said. "This is something that we need more data to see if it should be widely used or not. So there are lots of studies going on in that area.”

As for the role of antiangiogenesis, Mohebtash says this is mainly for those with stage 4 cancer.

"Thats mainly when we try to starve the tumor of blood, because the tumor continues to make new blood vessels, so antigiogenesis blocks that," Mohebtash explained. "So this has been going on for a long time in combination with chemotherapy or as maintenance."

As for symptoms to look for, Mohebtash says the warning sign symptoms are weight loss, blood in the stool, bright red blood, dark blood or dark stool. Changes in bowel habits can be a symptom as well. Cramps, pressure or difficulty deficating can be signs, but Mohebtash says you really do not like to diagnose cancer at that stage, because usually those symptoms can be indicative of a higher stag of cancer.

"They want to diagnose it before at the very early stage and even better at a precancerous stage," Mohebtash said. "So the benefit of screening colonoscopy is not just that it can diagnose early stage colon cancer, but also it can identify adenomas which are specific kind of polyps that can turn into colon cancer over the course of 7 to 10 years."

Mohebtash explained that at that point, the gastroenterologist can remove those polyps, basically killing the cancer before it even becomes cancer. This is why it is extremely important for people to get screenings done regularly.

While family history or symptoms mentioned earlier would be indicative of a good idea to get a screening early, Mohebtash said the age for the average population to get checked is 50 years old.

"In 2018 American Cancer Society changed the starting age as age 45 and its because colon cancer is becoming unfortunately more and more diagnosed in younger population," Mohebtash said. "But the other societies have not changed their recommendations yet, like The United States Preventive Services Task Force, its still 50 years."

The topic of a diet has been controversial, Mohebtash explained, but doctors recommend a healthy diet that includes high fiber, low fat and low carbohydrates.

However, Mohebtash says there's conflicting data on how diet plays a role in the formation of colon cancer.

"There is some data supporting that, some data saying no there's not much information about that, so we still recommend a healthy diet for many other reasons."

But the single most important thing you can do to prevent it? Mohebtash says that's to get a colonoscopy.

This can often be a scary thing, but there are alternatives to the actual screening itself, including tests and kits that can be done in your own home.

For more information, click here.