Colorectal Cancer

Frequently Asked Questions About Colorectal Cancer

This text has been adapted from the Oncology Interactive Education Series. Click here for a demo of this unique and innovation series.

1. What is colorectal cancer?
2. Why do people get colorectal cancer?
3. How common is colorectal cancer?
4. Can colorectal cancer be cured?
5. What are polyps?
6. What is the relationship between polyps and colorectal cancer?
7. What is the relationship between family history and colorectal cancer?
8. Are my children at risk?
9. What should I ask my health care team?

1. What is colorectal cancer?
Colorectal cancer is the uncontrolled growth of cells in the colon or rectum. Since cancer cells do not have the ability to regulate their own growth, they have the ability to spread. If colorectal cancer is not treated, the cancer cells can invade local tissues and eventually spread to distant organs (metastasis).

2. Why do people get colorectal cancer?
No one knows what specifically causes cells in the colon to become cancerous. However, it has been established that poor diet and genetics can affect your chances of developing the disease.

3. How common is colorectal cancer?
In the United States and Canada, approximately 56 out of every 100,000 men and 39 out of every 100,00 women will develop colorectal cancer.

4. Can colorectal cancer be cured?
There is about a 90% chance that colorectal cancer can be cured if it is diagnosed early. However, there is only about a 10% chance of cure for advanced-stage disease. Screening is important for this disease, because it increases the chances that the cancer is detected early.

5. What are polyps?
Polyps are benign growths that can occur on the inner lining of your colon or rectum. There is little or no way of knowing if you have a polyp or polyps in your bowel unless a doctor screens you. The polyps most commonly associated with colorectal cancer are known as adenomatous polyps.

6. What is the relationship between polyps and colorectal cancer?
Having polyps does not mean that you have cancer. However, polyps may become cancerous if they are left untreated for a long period of time.

Only a small portion of polyps ever becomes cancerous. Most colorectal cancers arise from a specific type of polyps, called adenomatous polyps, on the inner lining (mucosa) of the colon or rectum. As a polyp increases in size, it can eventually become a malignant tumour and, therefore, can grow quickly. This process takes years to occur, so there is sufficient time to remove the polyps surgically before the onset of cancer. Polyps occur more frequently with age. Screening is very important for adults over fifty, so that polyps or small tumours can be discovered and removed.

7. What is the relationship between family history and colorectal cancer?
There is definitely a relationship between the risk of colon cancer and one’s family history. Generally, the more close relatives you have with colorectal cancer, the greater your chance is of developing the disease. However, it is important to remember that everyone is at some risk, and that the majority of colorectal cancer patients have no family history of the disease.

There are also two very rare genetic conditions that have a 50% chance of being passed from generation to generation if there is one affected parent. These conditions make up only about 2% to 4% of all colorectal cancer cases. They are known as familial adenomatous polyposis (FAP) and hereditary non-polyposis colorectal cancer (HNPCC).

8. Are my children at risk?
If you and other members of your family have had colorectal cancer, the chance of one of your children developing the disease may be slightly greater than that of a child with no family history. However, if you are the only member of your family with the disease, then your child’s chances are not increased. If your doctor determines that your children are at significantly greater risk, they will likely be recommended for a screening program. Remember, screening can actually prevent the disease from ever developing.

9. What should I ask my health care team?
You should ask your health care team whatever questions are necessary to make you feel comfortable with what is happening to you during the course of your diagnosis, staging, treatment and follow-up.

Here are some examples of questions you may wish to ask your health care team:

1. What is the stage of my tumour and how big is it?
2. How does the stage of the tumour affect my prognosis?
3. What will the surgery to remove my tumour involve?
4. Will I need an ostomy? If so, will it be temporary or permanent?
5. What other treatments will I receive? When will I be receiving them?
6. What side effects can I expect from my treatments?
7. Will there be any restrictions to my diet?
8. Should I be referred to a dietician?
9. Should anyone in my family be screened for colorectal cancer?
10. If there is an emergency, which doctor on my treatment team should I call?
11. Where can I find more information about colorectal cancer?
12. Is there anyone who I can talk to about how the disease is affecting me?

This text has been adapted from the Oncology Interactive™ Education Series. Each title in this series contains between 15 and 20 hours of interactive, graphically rich and comprehensive content for patients, their families and health care professionals. You can use this series at any one of the Resource Centres at Princess Margaret Hospital, borrow a copy from the PMH Patient and Family Library or purchase your own personal copy from http://www.OncologyInteractive.com.