“In Israel there is a 4% increase in the incidence of colorectal cancer in young people under the age of 0). 40 and below, “says Dr. Ido Mizrahi, director of the Rectal Colon and Anus Surgery Service at Hadassah Hospital on Mount Scopus.
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According to Dr. Mizrahi, “Of all the surgeries I performed in the past year, about 10% were under 45 and 25% under 50. In recent years I have operated on many young people who had clear symptoms of colon and rectal cancer, but because they were young, These symptoms were attributed to benign diseases such as hemorrhoids and rupture and therefore did not undergo colonoscopy.
“Delay in diagnosis causes a late diagnosis that can lead to more complex treatment, more difficult recovery and poorer chances of survival. Younger people should be sent for colonoscopy.”
Colon and rectal cancer is the second most common cause of death from all deaths from cancer, but it is also the only cancer that can be detected at an early stage and thus prevent its development or at least improve its chances of cure.
Despite all the red lights, the doctors did not interpret correctly
Roi, 43, from Jerusalem, suffered for a year from severe abdominal pain, accompanied by extreme weight loss and bleeding in the stool. Despite all the warning lights, he was not referred for a colonoscopy to help detect the cancer that had developed in his colon.
His wife, Anat, who accompanied him all the time, says: “A year before he was diagnosed with violent cancer in the colon, he suffered from terrible stomach pains.
Roy was referred for an endoscopic examination of only the upper gastrointestinal tract that showed inflammation in the stomach. Due to this inflammation he was treated with antibiotics which did not help the symptoms from which he suffered. Because he was referred for an endoscopy (esophageal and gastric examination) and not a colonoscopy (examination for the colon) they were unable to diagnose the tumor he was suffering from in the left colon.
“During the year he continued to lose weight and suddenly began to suffer from constipation which only aggravated the abdominal pain,” says his wife. His body could not contain more, we received all the red lights and did not know how to interpret them correctly, neither we nor the doctors we met on the way.
“One morning he woke up with severe abdominal pain and we went to the emergency room at Hadassah Mount Scopus. .
“Fortunately, the tumor did not metastasize to other parts of the body. From that day on, our and our families’ lives changed from one end to the other. The recovery was difficult and included chemotherapy and further surgery to close the stoma and reconnect the gastrointestinal tract. “Our lives would have looked different and his recovery would have been much simpler.”
“Do not relieve symptoms due to young age”
There are clear symptoms that should light a red light, Dr. Mizrahi emphasizes, “Doctors in the community should not relieve symptoms because of the young age of patients and send more patients for colonoscopy tests, it will save many patients’ lives and the lives of entire families.
Common symptoms of colon and rectal cancer include: stool bleeding, changes in bowel habits: increased constipation; New diarrhea; Change in stool diameter; Pain during bowel movement, in addition – abdominal pain; Anemia: A low hemoglobin level in the blood count may indicate (hidden or overt) gastrointestinal bleeding, loss of appetite and involuntary weight loss.
“Colon and rectal cancer are the only tumors that can be detected in a pre-malignant stage (polyp). The polyp can be removed by a simple colonoscopy that has minor risks and thus prevents its development,” emphasizes Dr. Mizrahi.
Treatment for colon cancer is multidisciplinary and initially includes surgical treatment. Most surgeries are performed at Hadassah today with a minimally invasive approach (laparoscopy). This approach allows for easier and faster recovery for the patient without compromising of course the quality of the oncological surgical resection. After receiving the results of the surgical pathology it is determined whether a patient is required to receive complementary chemotherapy treatment.
Rectal cancer treatment is more complex and multidisciplinary. Hadassah has established a center of excellence for this type of cancer. Each case is discussed in a multidisciplinary team meeting that includes experts in the fields of surgery, oncology and radiology.
Dr. Mizrahi adds: “We are currently the only center in Israel that performs innovative surgery with a minimally invasive approach to resection of the rectum without opening the abdomen at all. The operation is performed by a number of surgeons who are experts in the field, under the direction of Prof. Alon Pikarsky, director of the surgical division at Hadassah, with one team operating on laparoscopic access through the abdomen and the other on laparoscopic access through the anus.
“The great advantage of the surgery is the level of surgical accuracy and achieving tumor-free resection boundaries, all while preserving the rectal sphincter even in extremely low tumors. Patients benefit from shorter, more accurate surgery and immeasurably easy recovery compared to standard surgery.”
Dr. Mizrahi concludes: “It should be understood that early detection by colonoscopy is the key to eradicating this disease. A disease that is detected in the early stages has a 80% or higher chance of complete cure. Keep in mind that in the early stages of the disease there are usually no symptoms and hence the American Cancer Society’s recommendation to perform a colonoscopy from the age of 45 for the entire population regardless of symptoms or family history. The test should be passed every 5-7 years. In Israel, the current recommendation is to perform a colonoscopy from the age of 50, and unfortunately there are no guidelines at all for performing screening tests among young people under the age of 50. “