Title: Prevent Cancer Super Colon™
Howard Hochster, MD
Professor of Medicine, NYU Cancer Institute
“This is the colon, what it looks like from the view of a colonoscopy, or to the
gastroenterologist. The colon is basically a hollow tube; they have abnormal folds,
which you kind of see reproduced here on this model. And I’d like to show you what
happens to the colon when it becomes diseased and eventually becomes colon cancer.
So, this is normal-appearing colon, and you can see it’s nice and pink, there are
folds, it all looks smooth—that’s what colon is like normally. OK, sometimes when
we have areas of inflammation in the colon, it looks like this, where there’s kind
of markings and inflammation, kind of like sores on the colon and that’s an inflammatory
bowel disease. That’s not cancer. It doesn’t lead to cancer.
What we’re more concerned about though is when you begin to develop polyps. So these
are colon polyps. This is what happens when the colon lining cells start to undergo
biological changes that give them growth and they continue to grow in an abnormal
way. So instead of being nice smooth cells, they begin to form little areas that
pop out of the colon and they’re either flat or they’re on a little stalk, and it’s
like a little tree that is popping off of the colon. This can be removed at the
time of a colonoscopy, the polyps. The polyps are on their way to becoming cancer,
but they’re not yet malignant. So when the gastroenterologist removes this at, during
the colonoscopy, at this stage you prevent cancer. You will never get cancer if
the polyps are removed at the stage when they’re still polyps. And these usually
don’t cause symptoms, that’s why we need to do screening colonoscopy because you
would never know that you have these kinds of polyps.
But if we let them go and they continue to grow, they undergo more biological changes
and become much more aggressive, and it turns into a colon cancer. So this is a
representation of the colon cancer. It’s now much bigger, it looks a little different,
it’s growing more into the lumen, into the passageway of the colon, and this is
an early stage colon cancer. This cannot be removed by the gastroenterologist by
colonoscopy. To treat this, we need to do surgery. However, even if you have surgery
for an early stage of colon cancer this is curable most of the time—usually with
surgery alone and sometimes with some additional therapy. But colon cancer at this
stage is still very curable. We sometimes find these because people have bleeding.
These are very fragile tissue and they get rubbed off, and then they start to bleed
a little bit, and people go to see their doctor when this stage of colon cancer
happens.
This is to represent a more advanced colon cancer cell, so what eventually happens
is that if we don’t treat the colon cancer, we let the polyps go, we let the cancer
go, people really don’t have much in the way of symptoms, and then one day, they
start having bleeding, whatever, or a bowel blockage, we find that colon cancer
has eroded completely through the wall, which you can’t see from the inside, but
you can see it more if you would look from the outside as a surgeon and sometimes
spreads to other organs, and that’s advanced colon cancer. We can prevent this.
This can be prevented by undergoing a screening colonoscopy. Every person starting
at age 50 should speak to your physician and undergo a screening colonoscopy.”