Colorectal cancer
with Marshall Levine, MD
Is weakness a symptom of colorectal cancer?
Colorectal cancer is the fourth leading cause of cancer mortality in the United States. “Colorectal cancer is a malignancy which arises from the inside lining of the large intestine,” says Dr. Marshall Levine, Medical Oncologist at GBMC.
This malignancy may be discovered in some instances before it becomes symptomatic, but it may also be present with symptoms of bleeding, change of bowel habits, new onset of constipation or a change of the caliber (size) of stools. Some patients may present with weakness and fatigue caused by anemia from slow and chronic gastrointestinal bleeding.
Factors that influence colorectal cancer are:
- Being age 50 or older
- Eating a diet high in red meat or animal fats
- Having a personal or family history of gastrointestinal polyps, Crohn’s disease or ulcerative colitis
- Having a personal or family history of colorectal, uterine, ovarian or breast cancer
Although the exact cause is unknown, colorectal cancer is highly preventable through routine screening. It’s highly important to diagnose the disease early, before it spreads.
There are two methods of screening for colorectal cancer in the earliest stages: the fecal occult blood test and colonoscopy. The first test involves checking a stool sample for evidence of intestinal bleeding. The latter test is an examination of the inside of the large intestine through a scope of the inside lining of the large intestine.
Colonoscopy should be scheduled periodically for persons over the age of fifty, but the frequency of the exam depends on the individual’s risk for developing colorectal cancer. Colonoscopy may allow detection of tumors at a very early stage, even before they become symptomatic and have a chance to spread. If a colonoscopy is entirely negative and there is no history to indicate a high risk of developing colorectal cancer, the frequency of the exam may be only once every five to ten years.
Treatment options vary from person to person. For early stages, surgery is the primary treatment. Less invasive types of surgery, using laparoscopy are often associated with quicker recovery times. In some more advanced cases, radiation and chemotherapy may be used to shrink the tumor prior to surgery to improve the overall outcome. “Some patients who would otherwise require a colostomy sometimes have the rectum preserved if they received chemo-radiation before surgery,” says Dr. Levine.
A colostomy is a surgical procedure, which creates an artificial opening to the colon through the abdominal wall and is becoming less necessary as colorectal cancer treatments advance.
Some of the most dramatic advances in treatment have been developed for patients with the most advanced stages of colorectal cancer. “The result is that many patients who ten years ago would have an average survival expectancy of six to eight months now live twenty-four to twenty-six months, a tripling of the life expectancy,” says Dr. Levine. “Moreover, many of the new therapies are much less toxic and interfere less with the quality of lives of patients.”
Targeted therapies have been developed. Their job is to attack and inhibit the spread of cancer cells, induce cancer cells to die at an earlier stage in their life, and prevent the development of a needed blood supply to cancer cells. These “targeted therapies” tend to be much less toxic than standard chemotherapeutic agents and frequently cause only an acne-like rash or a modest rise of blood pressure.
“This is an exciting time for those who treat colorectal cancer,” says Dr. Levine. Nevertheless, making a diagnosis at an early stage remains an important feature of successful treatment. Patients are urged to follow-up with their physicians at regular intervals for screening and other diagnostic reasons.
