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While new cases of colorectal cancer have been declining among adults over 50, rates are on the rise among younger adults. The reasons for the increase among adults under 50 aren’t known, but research shows that the disease is largely preventable through screening for adults of any age.

Colorectal cancer is the third most common cancer diagnosed in the United States. It starts as a polyp, or an abnormal growth, in the large intestine, which over time may become cancerous and potentially spread to other parts of the body.

More than 140,000 adults are diagnosed with the disease each year. When adults get screened for colorectal cancer, it can be detected early at a stage when treatment is most likely to be successful. In some cases, it can be prevented through the detection and removal of precancerous polyps.

 

If you’re age 45 or older, you should start getting screened for colorectal cancer. If you have a family history of colorectal cancer, talk to your doctor about when you should start screening and how often you should be screened.

Several types of tests can be used. No matter which test you choose, the most important thing is to get tested.

Tests include:

  • Colonoscopy. This is the “gold standard” preferred method for colorectal cancer screening. The doctor uses a flexible, lighted tube called a colonoscope to look in the rectum and the entire colon. Samples of tissue may be collected for examination, or polyps may be removed. This test should be done every 10 years.
  • Stool-based tests: These tests check the stool (feces) for signs of cancer. These tests are less invasive and easier to have done, but they need to be done more often.

In addition to screening, other steps you can take to lower your risk of colorectal cancer include:

  • Follow a healthy diet. Avoid eating a lot of processed meats such as hot dogs, bacon and some lunch meats. Instead, eat plenty of fruits, vegetables and whole grains.
  • Quit smoking. Chemicals in cigarettes have been shown to increase the risk of colorectal cancer.
  • Exercise. Being inactive increases the risk of colorectal cancer. Government guidelines recommend that every week adults should get at least 150 minutes of moderate-intensity activity (such as cycling, swimming or gardening) and two days of muscle-strengthening activities (such as lifting weights or push-ups).
  • Reduce your alcohol intake. Excessive drinking (such as 14 or more drinks per week) can increase the risk of developing early-onset colorectal cancer. Federal guidelines recommend limiting your intake to no more than one drink per day for women and no more than two drinks per day for men.
  • Try to keep a healthy weight (having a body mass index under 25 decreases the risk of early-onset colorectal cancer).

Treatment for Colorectal Cancer

If a screening test finds colorectal cancer, and it has not spread beyond the colon, treatment will involve surgery. Patients at Montefiore Nyack Hospital are generally treated for colorectal cancer with minimally invasive techniques. “This means smaller incisions, faster recovery, with less pain and less need for opioid painkillers,” said Ziad N. Kronfol, M.D., a colorectal surgeon with Highland Surgical Associates and Montefiore Nyack Hospital.

 

The da Vinci Surgery System

Many colorectal procedures at Montefiore Nyack are done using the da Vinci surgery system, which uses robotic arms and instruments that have a wider range of motion than humans do. This results in less pain for the patient and a shorter time for recuperation.

The da Vinci system has four robotic arms instead of a surgeon’s two arms. The da Vinci robotic surgery system has multiple joints that maneuver better than a hand, wrist and fingers. The surgeon can produce finer movements with more accuracy. The system also gives the surgeon a three-dimensional view which is magnified 10 times.

 

The surgery is minimally invasive, meaning the surgeon makes small cuts, and uses thin long surgical instruments and a laparoscope (a telescope). This is a thin tube with a light and a camera lens. The robotic surgical instruments are inserted through the cuts. Sitting at the console, the surgeon uses the controls to perform the surgery.

“The surgeon has greater control and visualization, allowing us to operate with greater precision,” Dr. Kronfol said. “Before we used minimally invasive surgery, colorectal surgery patients often had to be in the hospital for at least a week.”

Now, with smaller incisions and less pain, patients return home faster, often in one to three days, with minimal discomfort. “In addition to a shorter hospital stay, patients have less blood loss, a quicker return to bowel function, and a fast return to their regular diet,” Dr. Kronfol said.