Colorectal Health - Sheila Hodgson, MD

Ask A Doctor
Sheila Hodgson, MD
Colorectal Health


Q: When should I be screened for colorectal cancer?
A: Men and women of average risk should be offered screening beginning at age 50. Risk is based on personal and family history of polyps or cancer and medical history. Screening tests include one of the following: Fecal Occult Blood Testing (FOBT) every year, flexible sigmoidoscopy every five years, combined FOBT every year and flexible sigmoidoscopy every five years, colonoscopy every 10 years, or double contrast barium enema every five years.

Q: When should I have a colonoscopy?
A: You should have a colonoscopy if you have symptoms or signs that suggest the presence of cancer or polyps, if the result of a screening test is positive, or if you are at high risk for colon cancer. High-risk patients include people with a first-degree relative with colon cancer diagnosed before the age of 60. In this group screening should start at age 40 or 10 years before the age that their parent, sibling or child was diagnosed.

Q: What are some signs or symptoms of colon cancer?
A: Possible signs and symptoms of colon cancer include a change in your bowel habits to include constipation, diarrhea, or a change in the caliber of your stools for more than a couple of weeks; any rectal bleeding or blood in your stool—don’t assume the bleeding is from hemorrhoids; unexplained weight loss, fatigue or anemia; and feeling that your bowels are not emptying completely.

Q: What treatments are available for colon and rectal cancers and what are the success rates?
A: For colon cancer treatment usually involves surgery to remove the tumor followed by chemotherapy depending of the stage of the cancer. Chemotherapy is not needed for stage one and stage two disease unless the tumor has pathological or biological markers that suggest a more aggressive cancer. All stage three and stage four cancers receive chemotherapy. Stage four is the most advanced stage—when the tumor has spread to other organs.
Rectal cancer treatment is different in that it may involve chemotherapy and radiation first, followed by surgery, then more chemotherapy based again on the four possible stages of cancer. Studies have shown that giving radiation and chemotherapy before surgery not only decreases the size of the cancer, enabling a better resection, but reduces the risk of local recurrence. Recurrent rectal cancer is not easy to surgically remove because of the location in the pelvis.
Successful treatment depends on several factors that include the stage of the cancer as well as genetic, pathologic and biological markers. Colon and rectal cancers are survivable cancers. The earlier they are found the better the prognosis. This is why everyone should have appropriate screening depending on their risk factors.

Q: What are the differences between colon cancer and rectal cancer?
A: The difference between colon cancer and rectal cancer is location. The rectum is located in the pelvis, a location which allows the option for radiation treatment. Radiation is rarely used before surgery in colon cancer because of the damage it may cause to nearby vital organs.

Q: What can I do to decrease my risk of colon and rectal cancers?
A: Have appropriate screening—most colon and rectal cancers start out as polyps which can be removed before they turn into a cancer. Eat a healthy plant-sourced diet and limit red meats and processed foods. Choose whole grain rather than refined grain. Exercise 30 minutes a day for five or more days a week. Maintain a healthy weight. Avoiding excessive alcohol intake may also lower your risk.
 

Q: How can I avoid getting hemorrhoids?
A: Keep your stools soft so they pass easily. You can do this by eating high fiber foods such as fruits, vegetables and whole grains which add bulk and help to avoid straining. Drink plenty of fluid. Consider fiber supplementation–most people don’t eat the recommended 25-35 grams a day. Don’t strain and go as soon as you feel the urge—if you wait your stools become dry and harder to pass. Don’t sit too long especially on the toilet—don’t read while sitting on the toilet and lastly, exercise.

Q: At what point do hemorrhoids need treatment? What are the treatment options?
A: Hemorrhoids are very common and most of the time can be treated by lifestyle modification. For mild hemorrhoids diet changes and creams or ointments may help to relieve symptoms. Do not use for more than a week unless your doctor recommends that you do so. I prefer rubber band ligation in the office and surgery only if my patients’ symptoms fail to improve.

Bio:
Sheila Hodgson, MD, is the newest general surgeon to join Sierra Surgical Associates in Sonora. Dr. Hodgson is board certified both in general surgery and in colon and rectal surgery. She has a special interest in minimally invasive, laparoscopic procedures to treat colorectal conditions.

Dr. Hodgson comes to Sonora with a wealth of experience ranging from her fellowship training at the University of Southern California to five years practicing at Kaiser Permanente Hospital in Modesto. She also spent four years on active duty with the United States Army as a General Medical Officer and Flight Surgeon, with two years deployed to Korea and Egypt where she provided trauma and primary care for active duty troops and their dependents.

Dr. Hodgson is currently in the US Army Reserves and recently returned from Morocco. Surprisingly, she also has time to enjoy gardening and is busy replanting her garden that suffered from this past unusually wet and cold winter.