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Published on April 02, 2020

4 myths and facts about colorectal cancer

Colorectal Cancer

Note: Due to the ongoing COVID-19 emergency, elective colonoscopies are not currently offered within Cape Cod Healthcare. Please schedule your colonoscopy when elective procedures resume.

This year, an estimated 104,610 adults in the U.S will be diagnosed with colon cancer and 43,340 will be diagnosed with rectal cancer, according to the American Society of Clinical Oncology.

As last month was Colorectal Cancer Awareness month, we checked in with Peter S. Hopewood, MD, FACS, a surgeon based at Cape Cod Surgeons in Falmouth, to clarify some myths and facts about the third leading cause of cancer death among men and women in the U.S.

Myth: “I don't know anyone with colorectal cancer, so I don’t think it affects many people.”

“People get a false sense of security if they don’t know anybody who’s had colon cancer or if no one in their family’s had colon cancer. But you can develop colon cancer with no known risk factors, said Dr. Hopewood.

“If we could do universal colon cancer screening, we could make colon cancer a disease of the past, because we can remove polyps before they become malignant. If you don’t have any symptoms, polyps can take a few years or 10 years to cause trouble. Then all of a sudden you get some cramps, some diarrhea, a little bit of blood in the bowels, and you're behind the eight ball, because by then you've got partial blockage. A lot of colon cancers show up when patients come into the emergency room with intestinal symptoms that they thought may have been the flu or gas.

“Because screenings are starting to make an impact, we have fewer people developing colon cancer. The screenings let us take out polyps before they become malignant. We're hoping that for our grandchildren, colon cancer will be very, very rare.”

Myth: Colorectal cancer only affects people over the age of 50.

“Not true,” he said. “What we’re seeing now is that there's a younger group of people who are developing colon cancer in their 40s, sometimes even in their 30s. Some of this can be genetics, but some of it may be related to obesity or lifestyle. A lot of it’s probably related to diet – processed meats, low roughage, not eating enough fiber.

“The cancers that are showing up in younger people, under the age of 50, seem to be more distal, down in the rectal area. Some people might think they’re having hemorrhoids or a little bit of bleeding. Instead, it’s a rectal cancer.

“Some of the newer screening recommendations say people need to start having screening done at age 45.”

Myth: A colonoscopy is very painful and very unpleasant.

“The worse part about a colonoscopy is the preparation,” said Dr. Hopewood. “The ‘clean out’ laxative drink doesn’t taste so great. It tastes like bad lemonade. But it’s important to get an excellent clean-out because we need to have good visualization of the inside of the colon.

“The colon looks like the inside of a vacuum cleaner hose. You need to wash it out so we can see anything hanging on the walls. Some of the polyps in there might be only half an inch in size. If you have any poop on the sides of the wall, we might miss a polyp.

“The prep is unpleasant, but it’s not painful. You get some diarrhea and maybe some cramps. The procedure itself should be painless. Sometimes they give you a little bit of IV sedation during the procedure, so you’ll need a ride home. A lot of people have a colonoscopy done with no sedation and are able to get back to work the same day.”

Myth: There’s nothing I can do to prevent colorectal cancer.

“First of all, you can prevent colorectal cancer if you get a colonoscopy and they pull out any polyps. As polyps get bigger, once they get over an inch in size, the chances of malignancy start to increase significantly. If you get them out small, when they’re benign, you're fine.

“There are also lifestyle choices to reduce your risk. Avoid processed foods, which have preservatives that we think are not good for you. Weight control and exercising are important, as is not eating a lot of red meat.

“If you have a family member who has had colon cancer, like a parent or a sibling, you should start your colon cancer screening in your early 40s, rather than wait until your 50s,” said Dr. Hopewood.