Colon and Rectal Cancer
Cancer of the Colon remains the most common cancer affecting both men and women. More than 95,000 new cases of colon cancer are diagnosed each year in the United States.
While the cause of colon cancer is not yet known, experts agree that there is a relationship between benign colon polyps and cancer. Polyps are either flat or grape-like collections of slightly abnormal colon tissue. When polyps first appear in the colon they are small and usually cause no symptoms. As they enlarge they may cause either hidden (occult ) blood to appear in the stool or may bleed, causing bright red blood to appear on or in the stool. When polyps grow to an inch or more in diameter the chances of degenerating into a cancer increase. While it must be stressed that small cancers may remain completely asymptomatic, as they continue to grow they can also present with bleeding, pain, weight loss and intestinal blockage.
Polyps can usually be diagnosed and treated non-surgically when they are small and before they degenerate into cancers. The American Cancer Society recommends that people over fifty years of age undergo screening based upon predetermined risk (https://www.cancer.org/cancer/colon-rectal-cancer/detection-diagnosis-staging/acs-recommendations.html). People with a family history of cancer or with a tendency to develop polyps may require more frequent examinations and colonoscopy .
The treatment for colon cancer usually involves removing the portion of the colon that is diseased. Operations are usually performed via a minimally invasive approach (laparoscopic or robotic), but in rare instances advanced cancer or history of previous abdominal surgery may necessitate and open approach . Blood tests are usually performed and a CAT scan is frequently obtained before surgery in order to appropriately “stage” the cancer. Intestinal continuity can almost always be reestablished and colostomy is rarely needed. Advanced stage cancers are sometimes treated with chemotherapy after surgery.
The causes of rectal cancer and the symptoms that result from it are similar to that of colon cancer. It has a prevalence of approximately 40,000 cases per year in the United States
The Rectum is the last six inches of the large intestine and is located just above the anus. Because of its proximity to the anal sphincter muscles special surgical expertise along with advanced fellowship training is required in order to prevent serious complications that can result from surgery.
Cancers in the top 1/3 of the rectum can invariably be removed and intestinal continuity can be restored through an abdominal operation similar to the procedures performed for colon cancer. Early stage cancers of the bottom 1/3 of the rectum can frequently be removed by an operation performed through the anus, avoiding major surgery. More advanced cancers of the lowest part of the rectum usually require removal and creation of a permanent colostomy . Modern surgical techniques also permit the removal of most mid-rectal cancers without the need for permanent colostomy.
MRI examination of the rectum is frequently performed pre-operatively in order to determine its stage. Radiation and chemotherapy are sometimes used pre- and /or post-operatively in to improve the results of treatment.
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Established in 1924 by Ellen Browning Scripps, Scripps Memorial Hospital La Jolla has been one of Southern California’s premier medical centers for more than 80 years. Scripps Memorial Hospital La Jolla offers a wide range of clinical, surgical and specialty services. It is consistently recognized for quality patient care and is the first in San Diego to be designated a Magnet Hospital by the American Nursing Association for excellence in patient care.
San Diego Colon and Rectal Surgeons
9834 Genesee Avenue
La Jolla, California 92037