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Doctors' Answers to "Frequently Asked Questions" - Colorectal Cancer

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Colorectal Cancer [posted 8/11/98]
Question: It is known that nearly all colorectal cancers emanate from adenomatous polyps. It is generally agreed that a low fat/high fiber diet may deter the formation of polyps. It is known what substances may contribute to or help prevent colorectal cancer. If 3-5 yearly colonoscopies are conducted, what is the value of avoiding the cancer "causers" (e.g. beer, red meat, pickled and preserved foods) and pursuing the cancer "preventers" (e.g., selenium, inositol, aspirin)?

Answer: The prevention rate of colon cancer varies with the screening method. Most patients do not have colonoscopies every 3-5 years unless they are at high family risk or have documented preexisting polyps. Most of the dietary changes that you mention also have other health benefits. I think it is beneficial to follow this diet for several reasons, colon cancer being only a minor issue. Cholesterol and coronary disease are a much bigger issue.

Colorectal Cancer
Question: I have had blood in my stool on two different occasions in the past year. I am only 30 years old, and have only university supplied health insurance. My family doesn't have a history of colorectal cancer. Is there any explanation besides colon cancer for rectal bleeding? Do I need a specialist to examine me? As you might guess, I am very scared of the prospect of cancer. But I do understand that early diagnosis leads to the best prognosis. I would greatly appreciate any and all the advice you can provide me with.

Answer: There are many causes of blood in one's stool. The most common cause under 35 or 40 is bleeding from hemorrhoids. This should produce bright, red blood-usually on toilet tissue as well as in the stool. However, persistent bleeding needs to be checked. This does not need a specialist if your physician is comfortable using an anoscope and/or a flexible sigmoidoscope. While cancer is a possibility-it is uncommon(with no family history). Commnon causes not related to hemorrhoids would include colitis, and congenital lesions called arteriolar-venous malformations. These are reasonably common in young patients and need to be diagnosed early due to the different treatment strategies and courses of each.
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