Nikki Sommer, a nurse with Key West Surgical Group, joined Good Morning Keys on Keys Talk 96.9/102.5FM this morning for Medical Matters.
Colorectal cancer is a big topic nowadays, but most colorectal cancers do not start as cancer right away.
Sommer explained, “They usually begin with small growths on the inside of the colon called polyps. Over time, sometimes years, certain types of polyps can turn into cancer. That is why early detection is everything. There are different types of polyps. I do want to mention that colon cancer is one of the most common cancers in both men and women, but it’s also one of the most preventable.”
What are the three different types of polyps?
Sommer said, “These are the three most common, I guess you would say, two most common that you see often is normally when, if you have your colonoscopy, you’re told you have polyps, you’re most likely going to have one of these two. Adenomas. It’s adenomatosis. So if you are told you have an adenoma, that is the most important polyp that you need to watch. Adenomas are considered pre cancerous. That doesn’t mean they’re cancer, like it says colon cancer, doesn’t start out as cancer, it turns into cancer. So this is the polyp that if it’s left in your colon, or if you don’t get screened routinely, can turn into cancer. So most colorectal cancers start from this type of polyp. That’s why it’s important to get your screening. If you have a polyp, get it removed, get sent to the pathologist, and then you know if you need to have another colonoscopy in three years or five years. So this type of polyp, if you have it, you will come back in three years to get screened again.”
Hyperplastic polyps is another type.
Sommer said, “They’re usually small and lower risk. However, these can grow very large. Again, Dr Smith has removed some really big, large hyper plastic polyps because somebody hasn’t been screened ever, and they go for like, their first colonoscopy in their 60s, and they’re having trouble going to the bathroom, and it’s a very large, hyper plastic polyp, most commonly found in the lower colon. Very rarely turn into cancer, but doctors will document them, watch for pattern, size, number and location matter. So again, they can grow and cause problems too. In other words, like you can have issues with going to the bathroom, and it’s because these polyps are there, causing a problem, but not the typical one that causes cancer.”
The third one is Sessile Serrated Polyps.,
Sommer said, “This one is not talked about as much, but it is also very important. Sessile serrated polyps can lie flat against the colon while making them harder to see. Some of these do carry a high cancer risk, especially if they’re large or on the right side of the colon. This is one reason why colonoscopy and proper follow up is essential. These can be missed, and then if you don’t get your routine screening like you should be, can turn into a problem. So, not much, not as common as the other two, but they are there, and you need to be aware, especially if you know you have polyps. So you know you have a family history of polyps, it’s important to know what type of polyps you have, or your family has had in the past.”
Who is at higher risk for colorectal cancer?
Sommer said, “Anyone can develop colorectal cancer. There are certain risk factors – age over 45. They changed the screening to 45 or older. More younger people are being diagnosed with colon cancer. So it was 50. It is now 45 family. History of colorectal cancer or polyps. So if you have a family member, immediate family member, that has had colon cancer under the age of 45, most likely, you need to start screening earlier. If you have a history of inflammatory bowel diseases like ulcerative colitis, you need to make sure you get screened. You are at higher risk for colon cancer. A diet high in red or processed meats increases your risk of colon cancer. So does smoking, heavy alcohol use and obesity.”
What are some of the symptoms to watch for?
Sommer said, “It’s usually silent. You can have a few of these symptoms, so blood in stool, and that usually means, if it is cancer, it’s advancing, because that means the polyp is either emitting some blood, vascular, or it’s invading into the colon. Change in bowel habits, if you’re having an increase of diarrhea or constipation, and that’s something that’s new for you, you need to pay attention to that and talk to your provider. Unexplained weight loss. If you are losing weight and you are not trying to, that is a definite reason. It’s not just colon cancer. It could be any cancer. Or something could be going on. You need to check with your primary care provider or a doctor right away. Any type of abdominal discomfort or bloating, get it checked out. Don’t let it go on for months and months and months and fatigue from anemia. So sometimes you have blood loss, even like a micro blood loss. You may not see blood in your stool, but you’re feeling really tired and fatigued. So regardless, these are all things that you need to have checked out. Doesn’t necessarily mean colon cancer. Could mean something else is going on, but it also can be related to colon cancer. So any of those symptoms, make sure you see a doctor.”
Putting off the screening really isn’t a good idea.
Sommer said, “It allows the providers to see the colon and what’s going on in there. Also, if there’s other things going on, sometimes you can have bleeding and you might have some type of new inflammatory bowel disease, microscopic colitis is another one. So if you’re having an issue, definitely have a colonoscopy, and then the provider can see what’s going on. It’s the only way that you’re going to see a polyp. There’s really no other way to detect if you have a polyp or not, other than having a camera up your rectum. Once you have the colonoscopy, the polyps will be removed. Again, it’s prevention and early detection, and it’s all in one test. I know it’s a little uncomfortable, the prep is really the worst part. I’ve had one. It wasn’t the worst day of my life, it wasn’t the best day of my life, but peace of mind after you have the colonoscopy. That’s the best part.”
What are the treatments?
Sommer said, “Depending on the type of cancer, how big the polyp is, whether they think it’s large and it’s invaded, like into the wall of the colon, which can go into the muscle, all those things can be decided. Surgery is usually recommended to remove that part of the colon. Sometimes you may need chemotherapy and sometimes you may need radiation, depending on the location of where the cancer is.”
What are the takeaways?
Sommer said, “Colorectal cancer often starts as a polyp, and remember, not all polyps are cancerous when they’re first found. So getting them out prevents that from turning into cancer. Some polyps can become cancer and some don’t. Screening finds problems before symptoms appear, and that is true like when we talk about all the different types of screening, that’s why we do screening to find it before the symptoms appear. And colonoscopy can prevent cancer, not just detect it.”
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