Frequently Asked Questions

Dr. James C. Hobley, Assistant Professor at the Penn State University of Medicine, shares some of his patients most frequently asked questions. Read below to find out more.

• What causes a polyp to form?
  One theory is that polyps form because of damage to chromosomes which in turn allow the tissue associated with them to grow uncontrolled, hence forming polyps or growths.
• How can you prevent polyps from forming?
  There have been studies, some of which have been surrounded in controversy, which have looked into some common medications as possible means to preventing polyp formation. There have also been some studies which suggest diets high in fiber lead to less polyp formation. None of these studies have been scientifically proven.
• Exactly what is a "precancerous" polyp?
  A precancerous polyp is any polyp that has not yet progressed on to have cancer cells within it. These polyps have the potential of becoming cancerous if left in place.
• If the polyp is removed does that mean I am cured?
  Removal of the polyp during a colonoscopy effectively "cures" a person from that individual polyp's chances of becoming malignant (or cancerous).
• Can polyps "fall off" or take care of themselves without having them removed?
  Polyps don't typically "fall off" or "take care of themselves." They require a trained professional to remove them.
• What foods or what diet should I follow to prevent colorectal cancer from occurring?
  A high fiber, low fat diet, enriched with roughage and devoid of processed food is an ideal diet that may help in colorectal cancer prevention.
• Can flax seed or green tea prevent colorectal cancer?
  Green tea has antioxidant properties that have been shown to reduce the formation of cancers. There are no controlled studies involving tea, however, there have been observational studies that show a benefit. Flax seed has no particular relation to the prevention of colon cancer.
• Does fiber play a protective role in colorectal cancer?
  Fiber does show a protective role in the prevention of colon cancer. This is also why the western diet, which is low in fiber is considered a contributory factor in colon cancer's prevalence in the U.S.
• Does food intolerance or lactose intolerance increase your risk for colon or rectal cancer?
  Generally, food or lactose intolerance has no true relationship to developing colon cancer.
• What are early symptoms of this type of cancer?
  Symptoms are varied but a general list may include: fatigue, weakness, shortness of breath, change in bowel habits, narrow stools, diarrhea or constipation, red or dark blood in stool, weight loss, abdominal pain, cramps, or bloating.
• Is it possible to have colon or rectal cancer without having polyps?
  People with certain types of diseases such as colitis (Crohn's or ulcerative colitis) may develop colon cancer without developing polyps first.
• Is it possible to have blood in your stool, but not have colon cancer?
  Blood in the stool may mean many things without definitely being cancer; however, blood should not be disregarded, as it is a common presenting symptom of colon cancer.
• Are intestinal obstructions an early symptom of colon cancer?
  Intestinal obstructions are generally considered to be a late manifestation of colon cancer.
• What is the best colon cancer screening test?
  The gold standard for screening for colon cancer at the present time is colonoscopy, which is both diagnostic (i.e. finding the polyp) and therapeutic (removing the polyp).
• Does your general practitioner do colorectal screening tests or should gastroenterologists or other experts do them?
  A colonoscopy is usually performed by a gastroenterologist (GI physician) or a surgeon who has trained and been certified in performing this specialized test. There is a society dedicated to endoscopic training and development called the ASGE which has credentialing information. To find an ASGE doctor near you log on to: http://www.crcawareness.com/treatable.asp.
• Is there a correlation between the length of your colon and colon cancer?
  There is no correlation between the length of your colon and your risk of colon cancer.
• Is there a connection between other cancers and colorectal cancer?
  There are other cancers that may suggest an underlying syndrome, which raises the risk of developing colon cancer. These other cancers include: extra colonic cancers such as endometrial, ovarian, small-bowel, transitional cell of the ureter or bladder, and gastric cancer.
• Is Irritable Bowel Syndrome a risk factor for developing colorectal cancer?
  Irritable bowel syndrome is not a known risk for developing colon cancer.
• Can young people get colon cancer? If there is no family history and if the person is under 30, should they be concerned about getting colon cancer?
  Typically, people without a family history of colon cancer in young people or those who do not have a family history of the cancers listed in #17, do not carry any significant risk of developing cancer at that young age.
• Are there any colon cancer differences associated with gender or race?
  Recent studies have found significant disparities in colon cancer in relation to both gender (women are "less likely" than men to be screened) and ethnicity (African Americans are more likely to die from colon cancer). Arch Intern Med 2007; 167 258-264.

Dr. James C. Hobley is an Assistant Professor at the Penn State University College of Medicine and a Fellow in Gastroenterology and Hepatology at the Milton S. Hershey Medical Center. Hobley is a member of the American Medical Association and the American College of Physicians. He has published multiple works on the risks of colon cancer.