The National Institute of Health says that there is no single cause for colon cancer. Nearly all colon cancers begin as non-cancerous (benign) polyps, which slowly develop into cancer. What makes this cancer type insidious is that many cases have no symptoms. Thus, being proactive in gathering information and scheduling regular screenings may be key factors in catching the disease at its earliest stages. 

For early diagnosis, The Philippine Cancer Society recommends those at risk to have colorectal cancer screening starting the age of 50, especially those with:

o        A strong family history (i.e. in a close relative younger than 60 or two close relatives of any age) of colorectal cancer have a higher risk of developing the disease than those with no family history.

o        A long history of inflammatory bowel disease such as Crohn's disease or ulcerative colitis

o        Those with familial adenomatous polyposis (FAP)

Other factors such as physical inactivity and a high-fat, low-fiber diet may also increase the chances of developing colorectal cancer. The disease is traditionally associated with a high-fat, low-fiber diet and consumption of red meat. However, some studies found that the risk does not drop if you switch to a high-fiber diet, so the cause of the link is not yet clear.

With proper screening, colon cancer can be detected BEFORE symptoms develop, when it is most curable.

During a screening exam, the doctor will perform a physical exam and press on your belly area. The physical exam rarely shows any problems, although the doctor may feel a mass in the abdomen. A rectal exam may reveal a mass in patients with rectal cancer, but not colon cancer. Imaging tests to diagnose colon cancer include Colonoscopy and Sigmoidoscopy. A fecal occult blood test (FOBT) may detect small amounts of blood in the stool, which could suggest colon cancer. However, this test is often negative in patients with colon cancer. For this reason, a FOBT must be done along with colonoscopy or sigmoidoscopy. It is also important to note that a positive FOBT doesn't necessarily mean you have cancer.

Stages and Treatment Options

If your doctor learns that you do have colorectal cancer, more tests will be done to see if the cancer has spread. This is called staging.

• Stage 0: Very early cancer on the innermost layer of the intestine
  • Stage 0 colon cancer may be treated by removing the cancer cells, often during a colonoscopy.
• Stage I: Cancer is in the inner layers of the colon
  • For stages I, II, and III cancer, more extensive surgery is needed to remove the part of the colon that is cancerous.
• Stage II: Cancer has spread through the muscle wall of the colon
  • There is some debate as to whether patients with stage II colon cancer should receive chemotherapy after surgery. You should discuss this with your oncologist
• Stage III: Cancer has spread to the lymph nodes

o        Almost all patients with stage III colon cancer should receive chemotherapy after surgery for approximately 6 - 8 months. The chemotherapy drug 5-fluorouracil has been shown to increase the chance of a cure in certain patients.

o        Although radiation therapy is occasionally used in patients with colon cancer, it is usually used in combination with chemotherapy for patients with stage III rectal cancer

• Stage IV: Cancer that has spread to other organs
  • Chemotherapy is also used to treat patients with stage IV colon cancer. Irinotecan, oxaliplatin, and 5-fluorouracil are the three most commonly used drugs. In addition, monoclonal antibodies, including cetuximab (Erbitux), panitumumab (Vectibix), and bevacizumab (Avastin) have been used alone or in combination with chemotherapy. You may receive just one type, or a combination of the drugs. Capecitabine is a chemotherapy drug taken by mouth, and is similar to 5-fluorouracil.
  • For patients with stage IV disease that has spread to the liver, various treatments directed specifically at the liver can be used. This may include:

·         Burning the cancer (ablation)

·         Cutting out the cancer

·         Delivering chemotherapy or radiation directly into the liver

·         Freezing the cancer (cryotherapy)

The Good News on Colorectal Cancer

Colorectal cancer is, in almost all cases, a treatable disease if caught early. How well you do depends on many things, including the stage of the cancer.

In general, when treated at an early stage, the vast majority of patients survive at least 5 years after their diagnosis—called the 5-year survival rate. However, the 5-year survival rate drops considerably once the cancer has spread.

If the colon cancer does not come back (recur) within 5 years, it is considered cured. Stage I, II, and III cancers are considered potentially curable.

And because of increased awareness on the disease and more available information, the rate of colorectal cancer incidence has dropped in the last 15 years. More and more people are also being proactive in scheduling cancer screenings, while the medical field continues to research on therapies that are more effective in treating the disease.