The colon and rectum are parts of the body’s gastrointestinal system, also called the digestive tract.
After food is digested in the stomach and nutrients are absorbed in the small intestine, the remaining material moves down into the lower large intestine (colon) where water and nutrients are absorbed.
The lower parts of the digestive tract include the rectum and anus, through which stool (solid waste) travels as it passes from the body.
Possible signs of cancer of the colon and/or rectum include a change in bowel habits or blood in the stool.
These and other symptoms may be caused by colon and/or rectum cancer.
Stephen Sentovich, MD is here to discuss Colon Cancer and how early screening can save lives.
Selected Podcast
Colon Cancer: Why Screening Absolutely Saves Lives
Featured Speaker:
Stephen Sentovich, MD
Stephen M. Sentovich, M.D., M.B.A.,is a clinical professor in the Department of Surgery with extensive experience in the surgical treatment and management of colon and rectal cancers. He joined City of Hope from the Boston University Medical Center where he served as chief of colon and rectal surgery and co-director of its Center of Digestive Disorders. Concurrently, he was an associate professor of surgery at Boston’s University School of Medicine, and also served as the associate chair of clinical operations within the Department of Surgery. Transcription:
Colon Cancer: Why Screening Absolutely Saves Lives
Melanie Cole (Host): Sometimes, hereditary or genetic factors can increase your risk for cancer. City of Hope’s Cancer Screening and Prevention Program is designed to help you understand more about your personal cancer risks, and armed with this knowledge, you can learn how to minimize your risk and stop cancer from developing. My guest today is Dr. Stephen Sentovich. He’s a clinical professor of surgery and staff surgeon at City of Hope. Welcome to the show, Dr. Sentovich. Tell us a little bit about colon cancer and how screening absolutely can save your life.
Dr. Stephen Sentovich (Guest): Colon cancer is a very common cancer. The lifetime risk for both men and women is somewhere around five percent. Consequently, it is recommended that patients undergo screening for colon cancer.
Melanie: What does the screening entail? As women, we get our mammograms, but when people hear screening for colon cancer, Dr. Sentovich, right away they make a face and they’re scared, and really, this screening is, in my opinion, a piece of cake. It’s just the prep that’s not great. Tell us about the screening itself.
Dr. Sentovich: Well, I agree with you. The prep is the worst part of the screening. The essential screening cast is a colonoscopy that’s recommended for patients who are at average risk, starting at age 50 and every 10 years after that. The prep itself is necessary in order to clean your colon of the stools so that we can see any polyps or cancers that might be in the colon.
Melanie: The prep. Let’s start there. It’s a lot of liquid. You feel a little thick to your stomach. Your stomach looks like you just swallowed a bowling ball. That prep is really important. You need a good, clear picture. Is there a prep out there or is one being developed that is less in full volume that people can use or is this just really what gives you the best picture?
Dr. Sentovich: There are low-volume preps as well as high-volume preps. Not all the patients are candidates for the low-volume prep, but most patients are. Many patients who have the low-volume preps prefer the low-volume prep over the high-volume prep. You still have to go to the bathroom a lot and that’s important to clear your colon.
Melanie: It is, and you get that nice, clean picture. Now, the colonoscopy itself, Dr. Sentovich, people get in there, you’re talking to them, whatever, and they say, “When are you gonna start?” You say, “We’re already done.” Tell us a little bit about how quick and absolutely easy this procedure is.
Dr. Sentovich: The procedure itself takes anywhere from 15 minutes to 30 minutes in general. We give patients sedation during the procedure and that’s the reason why they may not remember much of the procedure. Some patients will feel a little gassy, either during the procedure or afterwards. Patients just pass that gas out and feel better.
Melanie: What are you looking for? What is a polyp and if you find polyps, does that mean you’re at risk for colon cancer?
Dr. Sentovich: A polyp is a growth in the colon. They’re relatively easy to identify with colonoscopy. The advantage of colonoscopy is that it can also remove that polyp at the exact same time and get rid of it. Most polyps are benign, but if they are left to grow, they could turn into colon cancer.
Melanie: Most polyps are benign, but what if your doctor tells you that you have a pre-cancerous polyp, would that mean that that one, if left in there, would turn into cancer? And if it’s taken out, do you have to get markers? Is a pre-cancerous polyp the same as if you had a little tiny bit of colon cancer?
Dr. Sentovich: No. Pre-cancerous polyps, if they are removed completely at the time of colonoscopy, present no risk to you because you just do not have cancer. It’s not the same as having cancer.
Melanie: Okay, so what do you do then if someone has a pre-cancerous polyp? You take it out, you send it for biopsy, whatever, and then what? We get those lovely pictures, Dr. Sentovich, where we get to see our colon. Why do docs give us our pictures?
Dr. Sentovich: Just to emphasize the importance of screening and that you made a difference in your life by having that polyp removed. Because you have a polyp though, that means that you may be polyp former and then you would need follow-up colonoscopies, perhaps a little sooner than every 10 years, perhaps every five years, to make sure that all polyps that grow in the interval time are dealt with.
Melanie: Since this is a test that you recommend and it can save a life, when is our first colonoscopy, and then afterward, how often do we have them?
Dr. Sentovich: The first colonoscopy is usually recommended at age 50 and then every 10 years after that. If there is a family history, that could move up anywhere from age 40 to even in the 20s or 30s, depending on how strong the family history is, and then every five or 10 years if there is a strong family history.
Melanie: Now if someone, God forbid, does have a colonoscopy and you say, “We’ve found colon cancer in there,” then is this one of those cancers that people need to be really afraid of? What are the treatments going on and the research going on at City of Hope now?
Dr. Sentovich: Colon cancer is very treatable, even when it’s in its worst stage, Stage IV. There is surgery, which is the primary treatment for colon cancer, but there is also excellent chemotherapy and radiation therapy that is used in combination with surgery to cure many patients.
Melanie: Okay, so what are the outcomes and what’s on the horizon for colon cancer? What’s really exciting in research?
Dr. Sentovich: I think what’s really exciting in research is that now we can do these colon cancer operations with minimally invasive techniques, including laparoscopic and robotic techniques. We can use new chemotherapeutic agents so that patients who have Stage IV disease can actually live, not only live with their disease but get cured from their disease.
Melanie: In just the last minute, tell patients and people listening why they should get their colonoscopy and come to City of Hope for their prevention and screening information.
Dr. Sentovich: Colon cancer is a very common cancer. Screening is recommended. Colonoscopy saves lives. It’s been shown in many studies that colonoscopy can save lives and can actually prevent cancer when you remove polyps before they turn into cancer.
Melanie: Thank you so much. You are listening to City of Hope Radio. For more information, you can go to cityofhope.org. That’s cityofhope.org. This is Melanie Cole. Thanks so much for listening.
Colon Cancer: Why Screening Absolutely Saves Lives
Melanie Cole (Host): Sometimes, hereditary or genetic factors can increase your risk for cancer. City of Hope’s Cancer Screening and Prevention Program is designed to help you understand more about your personal cancer risks, and armed with this knowledge, you can learn how to minimize your risk and stop cancer from developing. My guest today is Dr. Stephen Sentovich. He’s a clinical professor of surgery and staff surgeon at City of Hope. Welcome to the show, Dr. Sentovich. Tell us a little bit about colon cancer and how screening absolutely can save your life.
Dr. Stephen Sentovich (Guest): Colon cancer is a very common cancer. The lifetime risk for both men and women is somewhere around five percent. Consequently, it is recommended that patients undergo screening for colon cancer.
Melanie: What does the screening entail? As women, we get our mammograms, but when people hear screening for colon cancer, Dr. Sentovich, right away they make a face and they’re scared, and really, this screening is, in my opinion, a piece of cake. It’s just the prep that’s not great. Tell us about the screening itself.
Dr. Sentovich: Well, I agree with you. The prep is the worst part of the screening. The essential screening cast is a colonoscopy that’s recommended for patients who are at average risk, starting at age 50 and every 10 years after that. The prep itself is necessary in order to clean your colon of the stools so that we can see any polyps or cancers that might be in the colon.
Melanie: The prep. Let’s start there. It’s a lot of liquid. You feel a little thick to your stomach. Your stomach looks like you just swallowed a bowling ball. That prep is really important. You need a good, clear picture. Is there a prep out there or is one being developed that is less in full volume that people can use or is this just really what gives you the best picture?
Dr. Sentovich: There are low-volume preps as well as high-volume preps. Not all the patients are candidates for the low-volume prep, but most patients are. Many patients who have the low-volume preps prefer the low-volume prep over the high-volume prep. You still have to go to the bathroom a lot and that’s important to clear your colon.
Melanie: It is, and you get that nice, clean picture. Now, the colonoscopy itself, Dr. Sentovich, people get in there, you’re talking to them, whatever, and they say, “When are you gonna start?” You say, “We’re already done.” Tell us a little bit about how quick and absolutely easy this procedure is.
Dr. Sentovich: The procedure itself takes anywhere from 15 minutes to 30 minutes in general. We give patients sedation during the procedure and that’s the reason why they may not remember much of the procedure. Some patients will feel a little gassy, either during the procedure or afterwards. Patients just pass that gas out and feel better.
Melanie: What are you looking for? What is a polyp and if you find polyps, does that mean you’re at risk for colon cancer?
Dr. Sentovich: A polyp is a growth in the colon. They’re relatively easy to identify with colonoscopy. The advantage of colonoscopy is that it can also remove that polyp at the exact same time and get rid of it. Most polyps are benign, but if they are left to grow, they could turn into colon cancer.
Melanie: Most polyps are benign, but what if your doctor tells you that you have a pre-cancerous polyp, would that mean that that one, if left in there, would turn into cancer? And if it’s taken out, do you have to get markers? Is a pre-cancerous polyp the same as if you had a little tiny bit of colon cancer?
Dr. Sentovich: No. Pre-cancerous polyps, if they are removed completely at the time of colonoscopy, present no risk to you because you just do not have cancer. It’s not the same as having cancer.
Melanie: Okay, so what do you do then if someone has a pre-cancerous polyp? You take it out, you send it for biopsy, whatever, and then what? We get those lovely pictures, Dr. Sentovich, where we get to see our colon. Why do docs give us our pictures?
Dr. Sentovich: Just to emphasize the importance of screening and that you made a difference in your life by having that polyp removed. Because you have a polyp though, that means that you may be polyp former and then you would need follow-up colonoscopies, perhaps a little sooner than every 10 years, perhaps every five years, to make sure that all polyps that grow in the interval time are dealt with.
Melanie: Since this is a test that you recommend and it can save a life, when is our first colonoscopy, and then afterward, how often do we have them?
Dr. Sentovich: The first colonoscopy is usually recommended at age 50 and then every 10 years after that. If there is a family history, that could move up anywhere from age 40 to even in the 20s or 30s, depending on how strong the family history is, and then every five or 10 years if there is a strong family history.
Melanie: Now if someone, God forbid, does have a colonoscopy and you say, “We’ve found colon cancer in there,” then is this one of those cancers that people need to be really afraid of? What are the treatments going on and the research going on at City of Hope now?
Dr. Sentovich: Colon cancer is very treatable, even when it’s in its worst stage, Stage IV. There is surgery, which is the primary treatment for colon cancer, but there is also excellent chemotherapy and radiation therapy that is used in combination with surgery to cure many patients.
Melanie: Okay, so what are the outcomes and what’s on the horizon for colon cancer? What’s really exciting in research?
Dr. Sentovich: I think what’s really exciting in research is that now we can do these colon cancer operations with minimally invasive techniques, including laparoscopic and robotic techniques. We can use new chemotherapeutic agents so that patients who have Stage IV disease can actually live, not only live with their disease but get cured from their disease.
Melanie: In just the last minute, tell patients and people listening why they should get their colonoscopy and come to City of Hope for their prevention and screening information.
Dr. Sentovich: Colon cancer is a very common cancer. Screening is recommended. Colonoscopy saves lives. It’s been shown in many studies that colonoscopy can save lives and can actually prevent cancer when you remove polyps before they turn into cancer.
Melanie: Thank you so much. You are listening to City of Hope Radio. For more information, you can go to cityofhope.org. That’s cityofhope.org. This is Melanie Cole. Thanks so much for listening.