What Is Colorectal Cancer - Ask The Pharmacist

Mar 19, 2014
March is colon cancer awareness month. Specialist Pharmacist David Moeckly discusses the symptoms, risk factors and treatment for colon cancer.
  • Cancer

Among cancers that affect both men and women, colorectal cancer is the second leading cause of cancer deaths in the U.S. Every year, about 140,000 Americans are diagnosed with colorectal cancer and more than 50,000 people die from it.

The specialist pharmacists in the Express Scripts Oncology Therapeutic Resource Center® help patients and caregivers understand the condition and manage the complex treatment regimens that come with a cancer diagnosis.

What Is It?

Colorectal cancer consists of two different types of cancer, depending on the location: colon or rectal cancer. The colon comprises the first 6 feet of the large intestine, while the last 6 inches to 8 inches of the large intestine are defined as the rectum.

Symptoms and Risk Factors

Colorectal cancer is often asymptomatic. That means that screening is critically important for people who have the following risk factors:

  • Those over age 50
  • People with a family history of colorectal polyps or colorectal, ovarian, endometrial or breast cancers
  • Individuals with a history of colorectal polyps, ulcerative colitis, Crohn’s disease or Type 2 diabetes
  • Those who have documented history of genetic syndromes such as hereditary nonpolyposis colorectal cancer, Gardner syndrome and familial adenomatous polyposis

Other dietary and lifestyle risks associated with colorectal cancer include:

  • Diet high in red or processed meats
  • Obesity
  • Tobacco use
  • Heavy alcohol consumption
  • Physical inactivity

Express Scripts members can speak to a registered dietician to help minimize their risk for these factors through appropriate lifestyle changes.

Some symptoms may indicate the presence of colorectal cancer and would warrant a call to a physician for further investigation. These include:

  • A change in bowel habits such as diarrhea, constipation, narrowing of the stool or a feeling that the bowel does not empty completely
  • Blood in the stool
  • Cramping or abdominal  pain
  • Weakness and fatigue
  • Weight loss


Common treatment options for colorectal cancer include surgery, radiation and chemotherapy – depending on the extent of the cancer.

Medications used to treat colorectal cancer usually act by attacking any rapidly growing cells in the body, including cancer cells. This can affect fast-growing healthy cells, such as hair cells, cells lining the digestive system and those in the bone marrow, causing side effects such as hair loss, nausea, vomiting and immune system suppression.

Here are a few tips we share with patients undergoing colorectal cancer treatment:

Do Not Self-Adjust: Take the right dose at the right time as prescribed by your doctor. This will help maximize efficacy and minimize side effects. If the side effects are severe, do not change the dosage without consulting the physician.

Eat Right: Several medications used to treat colorectal cancer are associated with diarrhea. Colorectal cancer itself can cause diarrhea. Severe diarrhea, defined by seven or more stools a day, can have serious consequences due to dehydration. For this reason, the doctor should be called immediately if severe diarrhea is an issue. Mild diarrhea can be managed by diet. Food such as oatmeal, bananas and rice can help, while fried, spicy or very sweet foods can promote it. A registered dietician can give more advice about proper diets.

Stay Hydrated: Adequate water intake is important to prevent dehydration and combat some of the medication side effects such as diarrhea.

Maintain Good Oral Hygiene: Painful mouth sores can occur while taking some medications used to treat colorectal cancer. Good oral hygiene aids in the prevention of these mouth sores. Hard bristle brushes can increase abrasion and precipitate sores. Avoid using mouthwashes containing alcohol. Diet changes can help, too. An Express Scripts dietician can recommend a diet that will help prevent mouth sores, including avoiding acidic, spicy or coarse-textured foods.

Be Aware of Hand-Foot Syndrome: Some oncology medications cause a side effect known as hand-foot syndrome. It is characterized by redness, swelling and pain on the palms of the hands or the soles of the feet. Prevention of hand-foot syndrome includes avoiding heat and friction on the hands and feet. We have discussed ways to minimize this in a previous post.

And last but not least, talk to your doctor or pharmacist. They can help devise a plan to change the current therapy regimen, add supportive medications or implement dietary strategies to alleviate side effects.

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