Colorectal Cancer: Answers from Surgeon Sandy Fang

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Colorectal cancer (cancer of the colon and rectum) is the second leading cause of cancer death in the United States, claiming the lives of approximately 56,000 people each year. Learn more about prevention, screening and treatment options with expert answers from Johns Hopkins colorectal surgeon Sandy Fang.

How can I prevent colorectal cancer?

Colorectal cancer occurs when the cells that line the colon become abnormal, most often through the growth of a polyp. These polyps, if left untreated, can transform into cancer.

Early detection is vital to the prevention of colorectal cancer, and screening should be a part of routine care. A colonoscopy is able to detect and remove any polyps, preventing something more serious from developing in the future.

Can diet affect my colorectal cancer risk?

What you eat can influence your risk. Whenever possible, try to limit the amount of processed or red meats you consume. An occasional burger or strip of bacon isn’t the end of the world, but research has found that certain chemicals and preservatives in these meats can contribute to colorectal cancer — especially if eaten often.

Instead, fill your plate with fruits, vegetables, fish and whole grains. These foods can reduce your risk of developing cancer.

What symptoms should I look out for?

Unfortunately, there typically aren’t any symptoms until the disease progresses. If they do appear, symptoms can include:

  • Blood in the stool, which may not be visible to the naked eye
  • Anemia
  • Abdominal discomfort
  • Nausea and vomiting
  • Pelvic pain
  • Weight loss
  • Change in bowel habits (e.g., unusual diarrhea and/or constipation , thinner-appearing stool)

If my doctor finds something during my colonoscopy, how can surgery help?

Surgery is often the first line of treatment against colorectal cancer.

If the cancer is caught early enough, patients can often be treated with surgery alone — without having to undergo radiation or chemotherapy. That’s why it’s so important to talk to your doctor about colorectal cancer screening.

Another advantage of surgery is that, if needed, doctors can deliver radiation during the operation. This makes it easier to target the cancer and keep radiation away from other parts of your body.

What types of minimally invasive options are available for colon cancer?

There are several options to provide patients with better outcomes and easier recoveries:

  • Laparoscopic : With this approach, a tiny camera and surgical tools are inserted through small incisions to remove the cancer.
  • Robotic : Robotic instruments offer more degrees of freedom so that a surgeon is able to operate with ease. With laparoscopy, the instruments are straight and may limit access to certain structures. Both robotic and laparoscopic incisions are minimally invasive techniques.
  • Transanal Minimally Invasive Surgery : This technique allows surgeons to operate through the anus to remove large, noncancerous rectal tumors and, in a select number of cases, early rectal cancers.

Depending on how far the cancer has spread, your surgeon may need to remove certain parts of your digestive tract, including the anus and rectum. If you fit into that category, groundbreaking reconstructive methods are available to optimize your quality of life following the procedure.

Dung Le, MD

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