The polyp is a small growth in the colonic wall that is often found when we do colonoscopies for routine screening. When we remove them and look under the microscope, they appear to be these precancerous lesions that, if not removed, can eventually develop into a cancerous lesion or malignancy. Therefore, that is a very good reason for us to undergo this clinical colonoscopy that are recommended on a routine basis.
Colon cancer is a malignancy of the large bowel and/or the colon. It can develop in different parts of the large bowel and it often starts in the glands and grows and it can involve the right side of the colon, the left side, the transverse colon, as well as the rectum.
The colon is part of our digestive system or the digestive tract and is actually the large bowel that connects the small bowel to the rectum and the anus. It is where a lot of the absorption of nutrients takes place and it is also, unfortunately, one of the most common sites of cancer that we see both in the United States and worldwide.
Colon cancer survival really depends on the stage of the colon cancer and how early we find the cancer. Obviously, the earlier the stage, the better the survival. For example, for stage one colon cancer patients, surgery alone can be curative in most patients over 90%. With stage two disease, again we have very high cure rates with surgery alone and sometimes we do offer some chemotherapy afterwards depending on what we find on pathology. For stage three patients, we always offer chemotherapy after surgery and we can raise the cure rates from about 50 to 60% with surgery alone, up to about 80, 85% with surgery combined with some form of chemotherapy after surgery. Stage four patients - we don't really discuss cure because it's hard to cure a patient with stage four cancer. Sometimes, we shoot for that, but again, often, all we can do to stabilize patients and keep them in remission. When I was in training, survival for stage four patients was about six to nine months life expectancy. These days, we talk about a few years life expectancy because of all of the nutritional options that you have available. I've seen patients that have survived four or five years or even longer and some have gone into remission for many years.
Most colon cancer develops without any family history in the individual. All of us need to be vigilant about the risk of colon cancer. Young people can also get colon cancer without a family history. In fact, over the last few years or decade, we have noticed an increased incidence of colon cancer in younger people under 50 and specifically in their 30s and 40s with advanced stage colon cancer. The exact reason for this is really not clear. We believe it's something about an environmental factor - either with diet or activity level - but still yet to be determined. So we may actually think about lowering the age of doing a screening colonoscopy for people less than 50 but that still has not been decided.
Colon cancer is one of the more common types of cancers in the United States. In people over the age of 50, the incidence has been slowly decreasing over time. However, in people younger than 50, for some reason, the incidence has been increasing recently and the patients have especially been presenting with stage four disease. Recently, we have many more new options for patients with colon cancer for stage four disease, which has helped to increase the lifespan of such patients, including immune therapy for some patients that qualify for this treatment. In addition, we know that physical activity can be very helpful in terms of prevention of colon cancer prior to being diagnosed, as well as once you have colon cancer, we know that physical activity can help to respond better to treatment and to prevent recurrences. Diet can also be very helpful for prevention with a low fat and low animal protein diet, in addition to one daily aspirin, as well as calcium and vitamin D supplementation.
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