En español | For the past 30 years, Jeffrey Milsom, chief of colon and rectal surgery at New York-Presbyterian/Weill Cornell Medical Center, has often been the bearer of bad news. Colorectal cancer is the second leading cause of cancer deaths in the U.S. and the third most common cancer in both men and women. About 135,000 Americans are newly diagnosed, and more than 50,000 people die, each year. But innovations in screening, diagnosis and treatment have revolutionized the field, and deaths from the disease have steadily declined.
"Just 10 years ago, when someone came in with stage 4 cancer, their survival was measured in months," Milsom says. "Now many of those patients can live for years."
Here is Milsom's take on all the latest developments, including top ways to prevent the disease.
Screening is key
Almost all of us develop precancerous polyps as we get older, and, in fact, there is a pretty big window of opportunity — several years — to get a polyp removed and be cured. Unfortunately, people don't seek treatment early; about 22 million of those ages 50 to 75 who should be screened are not.
An all-liquid diet might not be necessary
A colonoscopy is the best way to detect polyps, but the prep is a major impediment. A study that came out recently found that people who ate small amounts of low-residue foods the day before — eggs, white bread, white rice, chicken breast — tolerated the test better than those who followed a clear-liquid diet. I'm all in favor of making the prep easier for people.
Don't wait to see your physician
Most symptoms of colon cancer are nonspecific: You might have a tummy ache or lose your appetite or feel bloated. Or you might be anemic. At any age, don't ignore this. If something persists for more than a week or two, seek medical advice.
Develop less invasive surgery
The standard of care for colon cancer is surgery to remove the tumor, plus chemotherapy and radiation, if needed. Fortunately, our research group is developing sophisticated tools that will lower the risks and costs dramatically, even make these surgeries outpatient therapy in the next five to 10 years.
Could a bionic colon work? Our dream solution is to put a monitoring device inside your intestine that can tell us when you're losing blood or developing abnormal cells in your colon.
Practice an ounce of prevention
I tell my patients to minimize their intake of red meat—less than a serving a week—and to eat a diet rich in fiber and omega-3 fatty acids. I take 2,000 IU of vitamin D a day and a low-dose aspirin; both can reduce your cancer risk.