March is National Colorectal Cancer Awareness Month, and physicians like Morton Kahlenberg, M.D., of the Health Science Center, are spreading the word: If you are over 50 (or younger if you have certain risk factors), make a deposit in the bank account of your health by getting screened.
Screening is performed in patients who do not have complaints or symptoms related to their colon and rectum. If symptoms such as bleeding do occur, don’t ignore them or think they are harmless, says Dr. Kahlenberg, chief of the division of surgical oncology in the Health Science Center’s department of surgery, and physician with the University Health System, the Cancer Therapy and Research Center, the South Texas Veterans Health Care System and CHRISTUS Santa Rosa Health Care.
“Colorectal cancer is a serious health issue, yet compliance with screening guidelines is not nearly as widespread as it is for breast, prostate and cervical cancer,” Dr. Kahlenberg says. “People don’t like the preparation for colonoscopy and are concerned about the procedure itself, but we do have medicines to minimize the discomfort. Screening is an investment in your health. If we see a polyp and remove it, we are taking away something that over the years can otherwise develop into a cancer and threaten one’s life. If your colonoscopy is normal, then you do not need another procedure for 10 years.”
Do you have a first-degree relative (parent, sibling, child) who has been diagnosed with colorectal cancer? If so, consult with your doctor to discuss this. If there is a history in the family of several individuals having colon cancer, then you may have a condition such as familial adenomatous polyposis (FAP) or hereditary nonpolyposis colon cancer (HNPCC) that makes you more susceptible to the disease. African Americans appear to be at greater risk for the disease, and everyone’s risk increases with age. “Ethnicity appears to play a role in risk and presentation, both in San Antonio and regionally,” Dr. Kahlenberg says.
All colon cancers come from the lining of the colon. That is why a colonoscopy looks at the lining, which is made up of epithelial cells. Like hair and fingernails, this type of cell undergoes rapid turnover, with cells sloughing off and being replaced by other cells. “We believe cells that turn over rapidly tend to be more vulnerable to genetic errors that accumulate over time and can result in cancer development,” Dr. Kahlenberg says. “That’s why addressing the problem with early screening and intervention, including surgery if necessary, is so important.”
The colon, or large intestine, is 3-4 feet long. The rectum is 6-8 inches long. Conditions affecting the rectum include cancer, hemorrhoids and abscesses.
It is estimated that nearly 150,000 people will be diagnosed with colorectal cancer this year, and more than 55,000 will die of its effects. Yet, colorectal cancer is very preventable, which remains Dr. Kahlenberg’s goal and message. “If you are at risk because of age or another factor, make an appointment today to get checked,” he says. “Make that investment in your health.”