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Q&A: Colorectal Cancer

1. What is the difference between colon cancer and rectal cancer?Colon and rectal cancers are actually very similar - but the difference lies in what part of the large intestine the cancer affects. The colon and rectum make up a long, muscular tube that most people know as the large intestine. The first part of the large intestine is the colon and at the end of it is the rectum.

Cancers in the colon and rectum usually grow slowly and may start as benign polyps. These polyps are found during a colonoscopy, and early removal of polyps may prevent it from becoming cancer. Over 95 percent of colon and rectal cancers start in the cells that line the inside of the large intestine.

Cancer of the colon and/or rectum is the third leading cause of cancer in men and the fourth leading cause of cancer in women worldwide.

2. Who is at risk for colorectal cancer? There are several risk factors for developing cancer of the colon and/or rectum including:

  • Age- people aged 50 and over should be screened, with frequency depending on medical history;
  • Medical history- a personal history of polyps or colorectal cancer increases your risk;
  • Family history- a family history of colon cancer also raises your risk of developing the disease;
  • Inherited syndromes- certain syndromes such as Familial Adenosis Polyposis (FAP) also increase your chances of developing colorectal cancer;
  • Ethnicity- Studies have shown higher incidence of colorectal cancer in African-Americans and Ashkenazi Jews;
  • Diet & lifestyle- diets high in red meat and overcooked foods, smoking, obesity, heavy alcohol consumption are all risk factors;
  • Overall health- underlying conditions like type 2 diabetes can increase your chances of developing colon and/or rectal cancer.
3. What is the treatment and survival rate for rectal cancer?Surgery is usually the most common treatment for stages I, II and III rectal cancer - although radiation and chemotherapy will often be given before surgery to try and shrink the tumor and kill off cancerous cells in affected tissue.

There are several types of surgery for rectal cancer. Stage IV rectal cancer is treated primarily with chemotherapy and palliative surgery, if necessary. Palliative surgery provides a treatment that will relieve a problem (such as a bowel obstruction) but does not lead to a cure. In the case of obstruction, a colostomy surgery would be performed.

4. What does it mean to have a permanent colostomy bag?Colostomy is a surgical procedure that brings a portion of the large intestine (colon) through the abdominal wall. Waste (stools) moving through the colon drain into a bag that is attached to the abdomen. It is done when the cancer is removed from the rectum or to bypass an obstruction caused by colon cancer.

Contrary to people's perception, having a colostomy bag is hygienic and can be very discreet because the bag can be well-hidden under clothing.

For some patients suffering from rectal cancer, colostomy surgery may be part of a curative treatment, while for others, it may be relief for an incurable situation. But either way - patients who are candidates for this procedure often see significant improvements in their quality of life.

5. What do you think about the trend of patients trying to treat themselves with herbal remedies?I think that including alternative treatments with conventional medicine can be very beneficial to patients as long as it's under the guidance of a medical doctor who supports this course of treatment and monitors a patient's progress and overall health. I certainly don't think that alternative treatments should replace conventional therapy and patients need to be careful because there are a lot of scams out there that may or may not be harmful, and can take a financial toll.

6. What are some of the reasons a person might seek alternative treatment? One of the most effective uses of alternative medicine in cancer patients is to alleviate pain associated medical treatment. For example, acupuncture has been proven to help with pain and other negative side effects like nausea brought on by chemotherapy or surgery. Certain types of relaxation therapy can relieve anxiety associated with a course of conventional treatment. And there are some natural herbs that aid in calming nausea or vomiting - which are often side effects of chemotherapy.

So for patients who want to use alternative medicine to alleviate negative side effects of medical treatment or to enhance the healing effects of conventional therapy - physician-monitored alternative treatments can help. But again, there is no evidence to support alternative therapies being used in place of conventional medicine - whereas we have a wealth of evidence supporting the effects of chemotherapy, radiation and surgery in the treatment of cancer.

8. What advice do you have for people thinking of skipping out on medical treatment and trying alternative therapies for cancer? Often when people are initially diagnosed with cancer, they often don't feel sick (especially if the cancer is caught early) so a lot of times, the thought of going through medical treatment seems beyond the realm of comprehension.

There are no regulations for alternative treatments, and in most cases, no proof they work. If doctors give a medication and patients have severe negative side effects - that medication is studied and pulled from the market. But with a lot of these herbal remedies, there is no proof that these treatments work. Each patient is different and each situation is different. So what a patient really needs to consider when they talk to their doctor about their diagnosis, is how much they really want to risk.

It comes down to what your current treatment options are, and their effect on your quality - and ultimately quantity - of life.

Dr. Cynara Coomer is an assistant professor of surgery specializing in breast health and breast cancer surgery at Mount Sinai Medical Center in New York City. She is a FOX News Health contributor providing medical expertise on a variety of topics in cancer research with a focus on women's health, breast diseases and tips for healthy breasts at any age.