Walter Reed National Military Medical Center, BETHESDA, Md  –   It’s often what you don’t feel that can hurt you. Colorectal cancer is one of those diseases that can develop quietly, without warning signs—until a routine screening changes the course of a life.

“Colorectal cancer is important because the disease can often be asymptomatic or showing no symptoms,” explains U.S. Army Lt. Col. (Dr.) Mary O’Donnell, chief of colon and rectal surgery at Walter Reed National Military Medical Center.

Colorectal cancer (CRC) begins when cells in the large intestine start growing or dividing abnormally. If left untreated, the cancer can spread into the wall of the colon and even beyond to lymph nodes or other organs.

“Colorectal cancer (CRC) occurs when those cells in the large intestine begin to grow or divide abnormally, invade into the wall of the colon, and sometimes lymph nodes or other organs. CRC is often discovered on a colonoscopy, whether done for symptoms or as a screening exam, recommended for everyone at age 45,” O’Donnell adds.

Walter Reed treats a range of conditions involving the colon and rectum, including cancers, inflammatory bowel disease (such as Crohn’s and ulcerative colitis), diverticulitis, hereditary polyposis syndromes, ostomy complications, fecal incontinence, pilonidal disease, and complex anorectal issues like fissures, recurrent fistula, hemorrhoids, and condyloma.

To screen, diagnose, and treat these issues, Walter Reed offers a variety of services, including laparoscopic, robotic, and open surgical techniques; sphincter-sparing rectal cancer surgery; transanal minimally invasive surgery (TAMIS); the LIFT (ligation of intersphincteric fistula tract) procedure; hemorrhoid treatment options such as fiber counseling, banding, doppler-guided ligation, and hemorrhoidectomy; fissure treatments like counseling, botox injections, and lateral internal sphincterotomy; sacral nerve stimulator implantation; and diagnostic and therapeutic colonoscopy, proctoscopy, and anoscopy.

“Small, early colon cancers can be treated by a gastroenterologist through advanced colonoscopy techniques,” O’Donnell continues. “The majority of colon cancers are treated through surgical removal of a portion of the colon and its associated lymph nodes. This is performed by surgeons, like me, who specialize in intestinal surgery. Walter Reed has two colon and rectal surgeons and a dozen general surgeons who perform these types of surgeries.”

“Chemotherapy can be necessary in addition to surgery based upon the stage of the cancer,” O’Donnell adds. “Radiation and chemotherapy are often used to treat rectal cancers prior to surgery. All of these services, wound ostomy care nursing, and nutritionists and behavior health specialists in cancer-patient care are available at [Walter Reed]. The Murtha Cancer Center is nationally recognized by the American College of Surgeons and has been designated by the Assistant Secretary of Defense for Health Affairs as the Department of Defense Cancer Center of Excellence.”

National statistics underscore the need for awareness and early detection. Every year, more than 100,000 new cases of colon cancer and over 46,000 cases of rectal cancer are diagnosed in the United States. But there’s good news.

According to the American Cancer Society, “the rate of people being diagnosed with colon and rectal cancer each year has dropped overall since the mid-1980s, mainly because more people are getting screened and changing their lifestyle-related risk factors.”

O’Donnell explains that the risk factors for colorectal cancer include “increasing age (greater than 45 years of age), family history of colorectal cancer or colon polyps, and diets high in animal fat and low in calcium, folate and fiber.”

Her advice is clear: “Eat plenty of fruits and vegetables and avoid smoking and excessive alcohol use. It’s recommended that adults eat 25 to 35 grams of fiber daily.”

Although colorectal cancer is often symptom-free, some people may experience signs.

It can present in some people with the following indications, “but not limited to, blood in the stool, weight loss, changes in stool habits or caliber, diarrhea, constipation or feeling that the bowel does not empty completely, fatigue, anemia, abdominal pain or bloating, nausea and vomiting,” added O’Donnell.

That’s where screening makes the most significant difference.

“Screening exams, like colonoscopy, are the best way to detect these cancers early or before polyps can become cancer. Colonoscopy also allows your doctor to remove polyps, which if left in place, may grow into cancer. All beneficiaries in our military health care system have access to this screening exam at age 45 or earlier if prescribed by your doctor. It is important to talk to your doctor about any symptoms you are having concerning for CRC or if you have a family history of CRC or colon polyps,” O’Donnell explains.

“Luckily, much of colorectal cancer is preventable through screening exams like colonoscopy and sigmoidoscopy [which can] remove pre-cancerous polyps before they can grow into cancer.”