Understanding Colon Cancer

Understanding Colon Cancer

Understanding Colon Cancer

Understanding Colon Cancer


For decades, while other cancers grabbed the headlines, colorectal cancer was quietly ignored. The lifetime risk of colorectal cancer in the general population is 2.5 to 5 percent. This means that twenty-five to fifty out of one thousand people will be stricken by this disease. Although data show that in America colorectal cancer incidence and mortality have been waning in recent decades, cancers of the colon and rectum still cause approximately 56,000 deaths annually. About 140,000 new cases are diagnosed each year.

It is plainly evident that colon cancer constitutes a large portion of all new cancer cases, a little more than 10 percent. It is the fourth most frequent type.

For the lay reader wishing to know more about this disease that has become more prominent in public attention, Understanding Colon Cancer gives concise information and explanation. It covers fundamental knowledge about occurrence, carcinogenesis, genetics, diagnosis, staging, prognosis, and treatment, as well as forecasting the kinds of diagnostic tests and treatments that may be developed.

It reviews demographics, high-risk conditions, the sequence from bowel polyps to cancer, polyposis syndromes predisposing people to colorectal cancer, and the genetics of the disease. Discussed in full detail are the warning signs of the disease and the tests used for screening and diagnosis (fecal occult blood test, barium enema, sigmoidoscopy, and colonoscopy). The stages of the disease are examined, along with theories of how colon cancer spreads.

Two chapters focus on treatments, including surgery and chemotherapy. An entire chapter devoted to early detection and prevention discusses standard ap-proaches, as well as such new or emerging strategies as vitamins, drugs, and genetic screening.

What lies in the future for diagnostic testing and therapy? Understanding Colon Cancer concludes with discussion that forecasts the potential of genetic screening and treatment, of "virtual colonoscopy," and of new chemotherapeutic drugs, vaccines, and monoclonal antibodies.

Richard Adrouny has a private practice in Los Gatos, California, and serves as the director of medical oncology at the Community Hospital of Los Gatos-Saratoga. He is a clinical assistant professor of medicine at Stanford University School of Medicine and has been published in such periodicals as the New England Journal of Medicine, American Journal of Medicine, and Annals of Internal Medicine.


Audrey Hepburn. Ronald Reagan. “Tip” O'Neill. Eric Davis. Darryl Strawberry. Charles Schulz. Jay Monahan. Vince Lombardi. All of these famous people, and hundreds of thousands of ordinary people, have had it. “It, ” of course, is colorectal cancer.

Colorectal cancer is a significant health problem in the United States and the rest of the western world. It is the third most common cause of cancer worldwide. In the United States, it is the second most common cause of cancer in both men and women. However, the public is not as well acquainted with this disease as it should be. While colorectal cancer has been quietly ignored for decades, other cancers, including cancer of the lung, breast, ovary, and prostate, have been grabbing headlines for years. However, the image of colon cancer languishing in medical awareness purgatory is slowly beginning to change.

The public is becoming aware of the value of screening for this disease. While breast cancer can be detected early by mammography and prostate cancer by PSA (prostate specific antigen) blood testing, colon cancer can be detected in its premalignant or asymptomatic stages when prevention or cure is possible. (Note: in this book, the terms colon, colorectal, large bowel, and large intestine are used interchangeably, although when the discussion concerns distinct regions of the large intestine, the colon is distinguished from the rectum.)

The advent of fiberoptic endoscopy in recent decades has reformed our way of thinking about the disease and has provided unprecedented intelligence about its natural history. Colorectal cancer can be viewed as a disease confined to a geometrically and anatomically distinct plane of tissue that is readily accessible to direct examination. Therefore, prospects for elimination of the disease exist in a not too . . .

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