March is Colorectal Cancer Awareness Month

Anthony M. Vernava, M.D.
Board Certified Colorectal Surgeon

Many of us can be hesitant to discuss the details of our bowels, nevertheless entertain the prospect of a colonoscopy. With colorectal cancer being the third leading cause of cancer deaths in the United States, any reluctance needs to be set aside in discussing symptoms and colon screenings with your doctor. “Patients should not allow embarrassment to keep them from preventing cancer,” says Anthony M. Vernava, M.D., Board Certified Colorectal Surgeon at Physicians Regional Medical Group. “It can be preventable and successfully treated as the vast majority of colorectal cancers develop from a precursor lesion called polyps that can be removed.” 1The American Cancer Society predicts more than 50,000 deaths from colorectal cancer and estimates 97,220 new cases of colon cancer and 43,030 new cases of rectal cancer in 2018. These statistics alone are enough to stress the importance of an early screening.

The most common and effective screening method is a colonoscopy which lets a doctor closely see the inside of the entire colon and rectum using a four-foot long, flexible tube about the thickness of a finger with a camera and a source of light at its tip. A colonoscopy can both identify any polyps present and remove them if necessary. “It is the only screening test that can both diagnose and treat the problem,” says Dr. Vernava. Less invasive screening methods include a CT Colography or a Cologuard® test kit. With Cologuard®, a patient collects a stool sample in the privacy of their own home and then mails the sample to the lab where the test is performed to identify any colon cancers. If the test is negative, then there is a very low chance of a cancer being present. If the test is positive, then the patient needs a colonoscopy for further evaluation. A CT Colography is a virtual colonoscopy that is very good at identifying polyps or tumors greater than 1 centimeter, but Dr. Vernava expresses caution with this type of screening. ”The patient is exposed to a high dose of radiation in order to perform the test and because of that, I recommend either colonoscopy or Cologuard® in most patients.”

Colorectal cancer symptoms are typically non-specific and might not fully display right away, so any subtle symptoms involving the colon must be taken seriously. According to the American Cancer Society, symptoms can include one or more of the following:

• A change in bowel habits, such as diarrhea, constipation, or narrowing of the stool, that lasts for more than a few days
• A feeling that you need to have a bowel movement that is not relieved by having one
• Rectal bleeding with bright red blood
• Blood in the stool, which may make the stool look dark
• Cramping or abdominal (belly) pain
• Weakness and fatigue
• Unintended weight loss

Dr. Vernava points out that all of these symptoms should be discussed with your healthcare provider and a determination should be made about whether any diagnostic evaluation such as a colonoscopy should be done.

If colorectal cancer is found, surgical removal remains the primary treatment for the vast majority of cases. Fortunately, there have been dramatic changes in operation over the last 25 years making minimally invasive surgery the standard of care. The introduction of robotic surgery for management of colorectal cancer coupled with enhanced recovery programs has further improved patient outcomes, and has helped to reduce hospital stay allowing the patient to return to normal activity sooner.

While there is no exact known cause of colorectal cancer, there are preventative measures that may lower the risk of development. These include:
1) Undergoing routine screenings. For patients at average risk, screening begins at age 50 and usually involves a colonoscopy.
2) Consuming a diet low in animal fat and high in vegetables and fiber.
3) Maintaining an ideal body weight and lose excess body fat.
4) Taking part in daily physical activity and exercise.

Talk to your doctor about the screening methods that are right for you. Also encourage loved ones and friends over the age of 50 to get their screening tests. As part of Colorectal Cancer Awareness Month, you can help spread the word and be a part of the national promotion to help save lives from this deadly disease.

Dr. Vernava’s office is located at Physicians Regional – Pine Ridge, 6101 Pine Ridge Rd, Naples. For more information or to schedule an appointment, please call (239) 348-4221, or visit PhysiciansRegionalMedicalGroup.com.

1 https://www.cancer.org/cancer/colon-rectal-cancer/detection-diagnosis-
staging/signs-and-symptoms.html