140,000 people are diagnosed with colorectal cancer in the
United States each year. It is the third most common cancer
and No. 2 cause of cancer-related deaths among men and women.
Colorectal surgeon Heidi Nelson, M.D., chair of surgery at
Mayo Clinic, shares five things to know about colorectal
Early detection through screening is really important to
increase survival odds. The survival rate is roughly 90
percent when it is caught early, Nelson says. There are now
multiple screening options, including colonoscopies, a stool
DNA test called Cologuard, a virtual colonoscopy using a CT
scan and more.
to insurance and Medicare coverage of screening and the
availability of more screening options, colorectal cancer is
more often being caught earlier," Nelson says.
patients with colorectal cancer will require an operation to
remove cancerous tissue, but there is a big difference between
colon cancer surgery and rectal cancer surgery.
cancer surgery is typically a fairly straightforward,
minimally invasive procedure," Nelson says. "Roughly
1 foot of the colon is removed, and in those cases, patients
can usually eat normally and have normal bowel movements after
surgery. The implications of rectal cancer are quite
cancer surgery can also be performed with minimally invasive
procedures, but there are often long-term changes in bowel
function that must be considered.
example, some patients will resume normal bowel emptying after
rectal cancer surgery, some may require more frequent bowel
emptying or have less control over emptying, and others, fewer
than 40 percent, will need a stoma. A stoma is an opening
created in the abdomen to allow waste to leave the body. A bag
is worn outside the stoma to collect stool; it can be
temporary or permanent.
vast majority of patients, once they come to understand the
importance of it, they adapt to it, and they can live normal
lives with a high quality of life as well," she says.
"About 3 million patients in the United States have
stomas," Nelson says.
Clinic, patients are encouraged to get up and start moving and
to eat normally soon after surgery to help speed their
recoveries. Walking more and stopping smoking before surgery
are also important, Nelson says.
Young adults can get colorectal cancer. It is most common in
people in their 60s, but younger people, and though it is
rare, children, can get it. Colorectal cancer in young people
tends to be hereditary. For older people, environmental or
lifestyle factors such as diet, obesity and smoking often play
Precision medicine: The Mayo Clinic biobank is helping
researchers look for genes responsible for hereditary
colorectal cancer, which could vary family by family, Nelson
not ‘one size fits all,’" she says. "There are
multiple ways genes can cause cancer in families, and there
could be different ways in each family."
those genes could help identify people who should be screened
for colorectal cancer at younger ages and may also lead to new
Microbiome: Mayo Clinic researchers are studying the microbes
in the gut to try to determine if they are creating
metabolites leading to colorectal cancer.
know that human papillomavirus and helicobacter pylori cause
cancer, so are there bacteria or viruses in the gut that might
actually cause cancer? I think there’s a lot to be learned
by looking specifically at the environment in the gut,"
says Nelson, director of the Mayo Clinic Center for
Individualized Medicine’s microbiome program and the Fred C.
Andersen Professor at Mayo Clinic.
disclosure: Ahlquist and Mayo Clinic have a financial interest
in Cologuard, the commercial name for a stool DNA test
co-developed by Ahlquist and Exact Sciences, the company based
in Madison, Wis., that manufactures and distributes Cologuard.
Neither Mayo Clinic nor Ahlquist receives royalties for
Cologuard tests ordered for Mayo patients by Mayo physicians.