Colon Cancer (Colorectal)

Are You at Risk?

Both men and women are at risk for developing colon cancer. Understanding your risk is an important element in how you and your doctor schedule your screenings.

• Level 1: You do not have a family member who has had colorectal cancer or adenomatous polyps. Or you have a family member who had colorectal cancer or a polyp but the affected family member is not your parent, sister, brother or child.
• Level 2: You have a parent, sister, brother or child who had colon or rectal cancer after the age of 50 or a polyp after age 60.
• Level 3: You have a parent, sister, brother or child who had colon or rectal cancer before age 50 or a polyp before age 60. Or you have two close relatives (parent, sister, brother, child) who had colon or rectal cancer after the age of 50 and/or an adenomatous polyp at any age.
• Level 4: You have an even stronger family history. For example, your father and his sister both had colorectal cancer before age 50.

Colon Cancer Screening

Colonoscopy performance and colon cancer and colon polyp detection rates are dependent upon a complete and well-visualized exam along the entire length of the colon. Research led by Jefferson physicians has produced new FDA-approved commercial preps and other innovations such as:

• A liberalized diet to allow patients to eat the day prior
• Split dosing
• New "same-day prep" to make colonoscopy a one-day procedure.

We study the safety of commonly used over-the-counter preparations and new formulations to improve the proportion of excellent preps. These endeavors have led to improved clinical outcomes and greater patient satisfaction. We are a founding member of the ASGE/AGA national endoscopy program, dedicated to setting and monitoring performance guidelines for safe and effective colon cancer screening.

Additionally, assessing the risk of hereditary colorectal cancer and understanding lifestyle and treatment options are complex issues for you, your family and your physician to consider. Jefferson's Clinical Cancer Genetics Service is among the most comprehensive in the Delaware Valley, with experts who are dedicated to identifying and managing individuals with a known or suspected inherited predisposition to cancer. Evaluation is available to any individual who is concerned about a family history of cancer or a personal history of early-onset cancer.

State-of-the-art treatments

Previously, the standard treatment of colon cancer often involved the surgical removal of all or part of the colon. This necessitated a colostomy, which is a surgical procedure that creates an opening through the wall of the abdomen to provide a new path for waste material to leave the body.

In recent years, Jefferson physicians have been national leaders  in developing more advanced and less drastic treatment alternatives for colon cancer patients for whom colostomy had been their only option. Our surgeons have successfully used preoperative radiation therapy and innovative surgical techniques to help retain the natural function of the muscles that control bowel movements, thereby dramatically reducing the need for colostomy.

If you have colorectal cancer, physicians of the Jefferson Colon and Rectal Cancer Center are experienced in performing minimally invasive laparoscopic surgery, which can reduce postsurgery pain, scarring, hospital stays and recovery time. A program utilizing high-dose preoperative radiation and sophisticated sphincter-preservation surgical techniques has been in place since 1976 and continues to offer new promise for patients with rectal cancer.

Among the state-of-the-art colorectal cancer treatments our physicians are using is an innovative technique called interstitial chemotherapy, which entails the insertion of chemotherapy-soaked wafers directly into the cavity left after the removal of cancerous tissue.

Patients with high risk for colon cancer are treated with a multidisciplinary team approach. This group includes patients with chronic inflammatory bowel disease being screened for dysplasia, a family history of colorectal cancer and inherited colon cancer syndromes such as familial adematous polyposis (FAP), hereditary nonpolyposis colon cancer (HNPCC) and Peutz-Jeghers syndrome. These patients need intensive screening for multiple neoplasms in addition to colorectal cancer.