HJBR Mar/Apr 2021

HEALTHCARE JOURNAL OF BATON ROUGE I  MAR / APR 2021 51 Nathan Hite, MD Colorectal Surgeon Mary Bird Perkins – Our Lady of the Lake Cancer Center yps or cancers with a high rate of accuracy. We are also able to perform specialized CT scans, which can evaluate for large polyps or masses within the colon. It is important to note than any abnormality found on one of these tests will need to be followed by a formal colonoscopy. The general age to start screening for colorectal cancer is no later than 50 years of age; some societies have changed their recommendations to 45. If you have a family history of colon or rectal cancer, a strong family history of colon polyps, inflammatory bowel disease (ulcerative colitis or Crohn’s disease) or a genetic syn- drome, then you may need earlier screen- ing. It is best to ask your doctor to see which age is appropriate to start screening. Anyone with warning signs such as bleed- ing, a change in bowel habits, or severe abdominal pain should also be screened regardless of age. STAGING/TREATMENT Colon and rectal cancers can be treat- ed in a variety of ways. When someone is diagnosed with a colon or rectal cancer, the first step in treatment is to perform a staging workup. This usually consists of a variety of imaging studies (CAT scans or sometimes an MRI) as well as lab work. The purpose of the imaging is to deter- mine how much the cancer has grown lo- cally as well as to evaluate for any spread of cancer cells. The lab work will measure special values called tumor markers, which can suggest prognosis. We can also follow these labs during treatment. If a cancer has spread to a separate location in the body, we refer to that as a colon or rectal cancer with metastatic disease. Metastatic disease remains a challenging entity to treat; fortu- nately, there are many options (both surgi- cal and nonsurgical) available to help any patient maintain a good quality of life. Cancers in the colon are usually treat- ed with some form of surgical resection. Depending on the pathology found, some patients require additional treatment in the form of chemotherapy. Patients with colon cancer are followed extremely closely af- ter their initial treatment. Close follow up ensures that patients progress both phys- ically and emotionally. It is also critical to surveil patients to monitor for any recur- rence of disease. Rectal cancers are also considered for surgical treatment. If a cancer has been caught early in its development, the patient may be a candidate to avoid a major col- orectal resection. The tumor will still need to be removed, but it can be excised locally from the rectal tissue (instead of remov- ing the entire rectum). These patients are carefully selected, and not everyone is an SCREENING There are a variety of ways that a per- son can undergo screening for colorectal cancer. These methods range from stool tests to endoscopies to special imaging studies. One of the most common meth- ods to screen a person for colorectal can- cer is called a colonoscopy. During this procedure, your doctor will pass a lighted endoscope though the entire colon. The colon is insufflated with air to allow for the detection of polyps or lesions. If any suspicious area is found, it is at minimum biopsied and usually removed completely. While this does require a patient to con- sume a bowel prep, it remains an extreme- ly effective way to both detect and prevent colorectal cancer. As with any procedure, there are risks associated with the proce- dure. Abdominal discomfort and cramp- ing are the most common post procedure issues. The most serious complication is a small tear in the colon, but the incidence of this happening is extremely low. Most clinicians would agree that the benefits of undergoing colonoscopy far outweigh the risks in most situations. Newer developments in colorectal can- cer screening include specialized stool tests as well as special imaging. While stool tests initially only tested for blood, newer tests can detect abnormal DNA shed from pol-