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HOME | Hereditary Colorectal Cancer Screening
How is Hereditary Colon Cancer Diagnosed? - Screening
Warning signs may be present in some cases : rectal bleeding; crampy abdominal pain or discomfort; persistent change in bowel habit (constipation or diarrhoea); or unexplained weight loss. However, often there are NO OBVIOUS SYMPTOMS. Knowing your family history can be your most important clue. A bowel lesion such as a polyp or cancer may only be diagnosed on one of the following tests. How often these examinations are done depends on your age and your family pattern of colon cancer. However, it is always best to screen for the disease PRIOR to any signs developing.
Flexible Sigmoidoscopy - The insertion of a short flexible fibreoptic tube to examine about 60 cm or 2 feet of the lower bowel (rectum and sigmoid colon). A pair of forceps may be passed through the scope to remove bowel tissue for examination under the microscope. This test can be done as outpatient. No sedation is required. However, not all of the colon is assessed.
Air-Contrast Barium Enema - An X-ray to outline the entire large bowel with BARIUM, a chalk-like substance. Unless the colon is completely empty after taking a specific bowel preparation, lesions may be missed. Biopsy is not possible during this procedure.
Colonoscopy - The passage of a long flexible fibreoptic tube into the whole length of the large bowel, about 1.5 meters or 5 feet. Biopsy of bowel tissue or removal of small polyps can be carried out at the same time. Careful bowel preparation is required.
Sedation is given for this examination which may be done as a day-patient or in-patient in the hospital. It is a more uncomfortable but more complete procedure in highlighting the entire colon. Colonoscopy is the screening procedure of choice for hereditary colon cancer.
How is Hereditary Colon Cancer Treated?
There are three main ways to treat cancer of the large bowel : surgery, radiation therapy, and chemotherapy.
SURGERY
This is the most effective form of treatment. Depending on the size of the tumor and its location in the large bowel, one of the following operations may be recommended :
Colectomy and Ileorectal Anastomosis - The removal of the large bowel or COLON and joining of the last part of the small intestine or ILEUM to the rectum. This is the recommended treatment for hereditary colon cancer.
Right or Left Hemicolectomy - The removal of half of the large intestine and reconnection of the healthy remainder.
Colostomy - The creation of an opening or STOMA in the abdomen for the elimination of body wastes using an external appliance. If the tumor is blocking the bowel, either a temporary or a permanent colostomy may be created after the tumor is removed. If it is temporary, a second operation will be needed to close the stoma once the bowel has healed and normal bowel function can be restored. An ENTEROSTOMAL THERAPIST is a nurse specially trained to teach a patient how to care for his or her own colostomy. It is important to remember that having a colostomy does not mean that you cannot resume your activities or lifestyle. This procedure is required less frequently now thanks to more modern surgical techniques.
Depending on your unique circumstances, including the site of the tumor, your surgeon will explain the different treatment options suitable for you and will help you in deciding on the type of operation needed.
One of the ways cancer can METASTASIZE or spread through the body is through the LYMPH SYSTEM. During your operation, the surgeon will remove lymph nodes to look for any cancer cells. Sometimes, more treatment will be needed, either before or after your surgery.
RADIATION THERAPY
The use of high-energy rays to stop cancer cells from growing and increasing. This may be done preoperatively to shrink the tumor or postoperatively to remove any remaining cancer cells. Radiation may be particularly helpful for a cancer of the rectum. Should you require radiation, you can have this done as an outpatient. Your doctor will discuss the possible side effects of radiation and what you can do with the support of the medical team looking after you.
CHEMOTHERAPY
The use of oral or injected drugs to treat cancer. The drugs travel through the bloodstream to almost every area of the body. Chemotherapy may be suggested after your operation or radiation therapy for any cancer cells which are left. This is most commonly done in cycles with a resting period in-between. Sometimes, chemotherapy is started in the hospital, then continued on an outpatient basis or at home. Chemotherapy has been suggested for some forms of colonic or rectal cancers. Since your appetite may be affected, the dietitian will help you work out ways to ensure good nutrition during this period.
Why is Screening Important?
The only way to find out whether you are at risk for hereditary colon cancer is to take preventive steps. This, in turn, will allow you to have the appropriate screening test to meet your needs, based on your age and your family history of cancer. Research has allowed the identification of the genes responsible for hereditary colon cancer. Genetic testing is feasible to identify the diseased gene in a family. This usually starts from testing family members who have already developed cancers. Result of molecular genetic testing will further assist in defining your cancer risk so that the most appropriate screening plan can be devised for you.
Where is Help Available?
Contact the Hereditary Gastrointestinal Cancer Registry based at Queen Mary Hospital to learn more about your family cancer pattern. A family tree will be developed so that you can understand your own risk and that of your first-degree relatives. The Registry can provide more information concerning current treatment and research on hereditary colon cancer. Patients can be referred through the Registry for treatment in specialist centres when required. Support is offered through the Registry so that you can participate more fully in your health care and that of your family. Cancer prevention is effective but it will not happen without you. Start today.
If we can be of assistance, please feel free to contact us.
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