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FAQ - Colon Cancer and Polyps

What is the colon and what does it do?

  • The colon is about six feet long and is the part of the body's digestive system. It moves waste material from the small intestine to the rectum.

  • Together the colon and the rectum make up the large intestine also known as the bowel.picture colon polyps

  • The small intestine absorbs most of the nutrients from what you eat and then passes on the leftover waste to the colon. The colon absorbs water from the waste. What is left is called stool (feces or poop). When you have a bowel movement, the stool leaves the rectum through the anus.
  • Small growths (polyps) can develop inside the colon and rectum. You can have these growths for a long time with no symptoms. Polyps can turn into cancer if they are not removed.

If the polyp is removed, does that mean I am cured?

  • If a polyp is completely removed, it will not usually grow back. Villous polyps are usually harder to remove completely as they are often flat in shape and closer to the colon wall.

  • If a polyp contains cancer, a cure will depend on how far the cancer has advanced and how close the cancer is to the cut portion of the polyp. Follow-up with colonoscopy is usually required to ensure complete removal. Sometimes surgery is required to ensure that all the cancer is removed.

Is it possible to have colon or rectal cancer without having polyps?

  • Colon cancer can occur without polyps but it is less common. Individuals with inflammatory bowel disease (IBD), such as chronic ulcerative colitis and Crohn's disease are at increased risk for developing colon cancer without polyps.

  • The risk of colon cancer increases with the length of time a person has IBD, as well as how much of the colon (bowel) is affected by the IBD.

Does Irritable Bowel Syndrome (IBS) or Inflammatory Bowel Disease (IBD) increase your risk of colon cancer?

  • Irritable Bowel Syndrome (IBS), not to be confused with Inflammatory Bowel Disease, is a condition caused by the muscles in the colon wall. IBS is characterized by alternating bouts of diarrhea and constipation, abdominal cramping, bloating, and frequent bowel movements shortly after eating. IBS is diagnosed by first eliminating the possibility of more serious causes of these symptoms. Although IBS may be distressing, it does not increase your risk of colon cancer.

  • Inflammatory Bowel Disease (IBD) may put you at an increased risk of colon cancer. IBD is a general term to describe conditions that cause the colon and rectum to become inflamed. There are 2 characteristic patterns of inflammation, one called ulcerative colitis and the other named Crohn's disease. For more information about IBD, click here. If you have IBD, do not do the home screening test. You may need to have a colonoscopy instead. Talk to your health care provider.

Do hemorrhoids cause colon cancer?

No. Hemorrhoids, or piles, are one of the most common and nagging disorders. By themselves, hemorrhoids are rarely serious, but they can be extremely troublesome. In some instances, they may mask a more serious disorder, such as colon or rectal cancer. Therefore, hemorrhoids require proper diagnosis and treatment by a physician.

Can people under 50 years of age get colon cancer?

Yes, but people under 50 do not usually get colon cancer. In Manitoba, 94% of newly diagnosed colon cancer occurs in people over the age of 50. However, there are hereditary syndromes in which cancer can develop in young people. The first is Familial Adenomatous Polyposis (FAP). The other is hereditary non-polyposis colorectal cancer (HNPCC). Persons with a strong family history of colon cancer may have other unidentified genetic factors which contribute to the development of colon cancer. If you know someone in your family who has either FAP or HNPCC, talk to your doctor or nurse as you may be at increased risk.

What is Familial Adenomatous Polyposis (FAP)?

This disease is associated with a gene mutation. People with FAP develop hundreds to thousands of precancerous polyps in the colon. Unless the colon is removed, almost all of these people will eventually get colorectal cancer. The polyps usually develop in the mid-teens, but they have been found in children as young as eight. For families with FAP, there is a genetic test available to screen for the gene mutation. Screening can begin early and surgery to remove the colon can be planned. If you know someone in your family who has either FAP or HNPCC, talk to your doctor as you may be at increased risk.

What is hereditary non-polyposis colorectal cancer (HNPCC)?

In this syndrome, cancers also develop from polyps but not in the hundreds as in FAP. The cancers usually develop in middle age (late 30's-mid 40's). In addition to colon cancer, there may also be an increased risk of cancers of the stomach, breast, urinary tract and uterus. Genetic testing may also be helpful in determining whether someone has HNPCC. If you know someone in your family who has either FAP or HNPCC, talk to your doctor or nurse as you may be at increased risk.

I am under 50 years of age. Can I develop colon cancer if I do not have FAP or HNPCC?

  • It is possible, although colon cancer is not common before 50 years of age.

Other environmental and genetic factors may contribute to the development of colon cancer at an earlier age.

 

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