Wednesday, March 3rd 2010, 4:00 AM
The specialist: Dr. Randolph Steinhagen on colorectal cancer
As chief of Mount Sinai Medical Center‘s Division of Colon and Rectal Surgery, Steinhagen treats patients who suffer from disorders like colorectal cancer and inflammatory bowel disease (IBD). He has been at Mount Sinai for more than 30 years.
Who’s at risk
Colorectal cancer is a malignancy that arises at the end of the intestinal tract in the colon or rectum. “By definition, cancer has the ability to break off from the region where it arose and spread to other parts of the body,” says Steinhagen. “Colorectal cancers frequently spread to the liver.”
About 150,000 cases of colorectal cancer are diagnosed in the U.S. each year, making it one of the most common cancers in this country. “Overall, it’s the second most common cancer after lung cancer,” says Steinhagen. “It’s responsible for 40,000 to 50,000 deaths a year.”
It’s so prevalent that doctors recommend universal screening, usually starting at age 50. while there are risk factors for colorectal cancer, Steinhagen stresses that “the small answer is – everyone is at risk of colorectal cancer.” Men and women are equally affected, and your risk goes up with age. You’re considered at high risk if you have IBD or a family history of colorectal cancer or any syndrome associated with polyps.
Doctors believe that all colorectal cancers start out as benign polyps. “These polyps can be seen and removed in colonoscopy, thus preventing colorectal cancer,” says Steinhagen. “That’s why we push for people to go for colonoscopy.” Because of this link between benign polyps and cancer, you’re considered at higher risk if you have a parent who has had polyps removed.
Signs and symptoms
Most colorectal cancers give no warning signs until they are well advanced. “At the earliest stages, when it’s just a benign polyp or even early cancer, there are no symptoms,” says Steinhagen. “That’s why it’s vital for people to go for colonoscopy even if they’re asymptomatic.” for most other types of cancer, screening tests hope to catch cancers early, but colonoscopy really identifies polyps for removal before they become cancerous. “In colorectal cancer, we can use screening for prevention,” says Steinhagen. “There aren’t too many other situations where we can prevent the disease this well.”
Most doctors recommend that patients with no risk factors start getting colonoscopies at age 50. if no polyps are detected, the test can be repeated every 10 years. “If you find polyps or another abnormality, it is done more often, depending on what is found,” says Steinhagen.
Doctors recommend universal screening due to prevalence of colorectal cancer