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Colorectal Cancer Awareness Month shines light on need for early screening

Colorectal cancer
Classification and external resources

Diagram of the lower gastrointestinal tract
ICD-O:M8140/3 (95% of cases)
eMedicinemed/413 med/1994ped/3037
Colorectal cancer, commonly known as bowel cancer, is a cancer from uncontrolled cell growth in the colon, rectum, or appendix. Symptoms typically include rectal bleeding and anemia which are sometimes associated with weight loss and changes in bowel habits.
Most colorectal cancer occurs due to lifestyle and increasing age with only a minority of cases associated with underlying genetic disorders. It typically starts in the lining of the bowel and if left untreated, can grow into the muscle layers underneath, and then through the bowel wall. Screening is effective at decreasing the chance of dying from colorectal cancer and is recommended starting at the age of 50 and continuing until a person is 75 years old. Localized bowel cancer is usually diagnosed through sigmoidoscopy or colonoscopy.
Cancers that are confined within the wall of the colon are often curable with surgery while cancer that has spread widely around the body is usually not curable and management then focuses on extending the person's life via chemotherapy and improving quality of life. Colorectal cancer is the fourth most commonly diagnosed cancer in the world, but it is more common in developed countries.[1] Around 60% of cases were diagnosed in the developed world.[1] It is estimated that worldwide, in 2008, 1.23 million new cases of colorectal cancer were clinically diagnosed, and that it killed 608,000 people.[1]

When John Hobart first found out he had colon cancer, he was supposed to be asleep.

“I was on the table [after my colonoscopy], and they had just put me in a recovery room,” Hobart said.  “I was supposed to be out still, but I could overhear a doctor talking about my cancer and how they were going to tell me.”

Hobart said he was “dumbfounded. It really doesn’t register at first.”

A nurse later confirmed what Hobart already knew – the doctors had found a large cancerous tumor in Hobart’s lower colon.  While the diagnosis was definitely not what Hobart wanted to hear, part of him wasn’t surprised.  Coming from a family that rarely went to the doctor, Hobart had waited until the last second to get screened.

“I had a feeling that it probably was going to be cancer because my mother died of cancer,” Hobart said.  “Nobody in my family ever went to the doctor, which was such a mistake.  You literally had to be on the ground to go to the doctor.  But thank goodness I went – a couple more months, and I’d have been dead.”

March is National Colorectal Cancer Awareness Month, and Hobart is sharing his story in hopes that people will realize the importance of getting screened.  Currently, colon cancer is the second leading cause of cancer-related deaths, with approximately 150,000 new cases diagnosed in the United States each year.

After getting over the shock of his diagnosis and understanding his chances, Hobart set out to find the right oncologist to help treat his cancer.  He came across Dr. Brett Ruffo, a board-certified colorectal surgeon at Peconic Bay Medical Center in Riverhead, N.Y.  Ruffo easily related to Hobart, having lost his own father from colon cancer because he had waited too long.

“He was a stubborn Italian and was told never to go to the doctor,” Ruffo said.  “By the time he went it was too late.  He had a very miserable course – a terrible metastatic disease that spread to his liver, lung, and brain actually.”
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