A Simple Guide to Colon Cancer

COLON CANCER

Colorectal cancer is one of the commonest cancer among males and females in the world. Colon cancer is cancer that starts in the large intestine (colon) or the rectum (end of the colon). Colorectal cancer can be effectively treated if detected early.

Colorectal cancer occurs when cells from the intestinal wall grow and spread uncotrollably. It may begin as polyps (growths) in the large intestine and rectum. Polyps should be monitored regularly and removed upon detection to prevent them from developing into cancer.

As with most cancers, the risk of developing colorectal cancer increases with age. People at high risk include those with:

a family history of colorectal cancer
a personal history of endometrial, ovarian or breast cancer
a personal history or family history of gastrointestinal polyps
a history of inflammatory bowel disease such as chronic ulcerative colitis or Crohn's disease.
Colorectal polyps
Cancer elsewhere in the body
A family history of colon cancer
Ulcerative colitis
Crohn's disease
Personal history of breast cancer
Certain genetic syndromes also increase the risk of developing colon cancer.

What you eat may play a role in your risk of colon cancer. Colon cancer may be associated with a high-fat, low-fiber diet and red meat. However, some studies found that the risk does not drop if you switch to a high-fiber diet, so the cause of the link is not yet clear.

In its early stages, the cancer usually has no symptoms, which is why regular screening is important to see if it could be present.

The most common symptom of colorectal cancer, especially if it is located in the lower part of the large intestine, is changes in bowel habits. For some, it may be an increase in the number of bowel visits to the toilet, and for others, it may be constipation. Still others may complain of constipation with overflow diarrhoea, i.e., difficulty in passing motion but stools flow out without any control.

Other symptoms include bloody or black stools from bleeding of the tumour (blood appears black on digestion in the intestines), fatigue, appetite and weight loss, abdominal pains, cramps or bloating.
Diarrhea, constipation, or other change in bowel habits
Blood in the stool
Unexplained anemia
Abdominal pain and tenderness in the lower abdomen
Intestinal obstruction
Weight loss with no known reason
Narrow stools
With proper screening, colon cancer can be detected BEFORE the development of symptoms, when it is most curable.

Your doctor will perform a physical exam and press on your belly area. The physical exam rarely shows any problems, although an abdominal mass may be felt in late cases.. A rectal exam may reveal a mass in patients with rectal cancer, but not colon cancer.

People over the age of 50 years are advised to screen for colorectal cancer, even if they have no symptoms. A Faecal Occult Blood Test (FOBT) is recommended once every year. If the results are positive, other tests like a sigmoidoscopy, barium enema and colonoscopy may be required.
A complete blood count may reveal show signs of anemia with low iron levels.

Those who have a high risk of getting colorectal cancer may need to go for screening at a younger age. They should consult a doctor for advice on the recommended screening age and the test which is most appropriate for them.

Surgery is the main treatment. In surgery, the part of the large intestine containing the cancer is removed. In some cases, the two ends of the colon can be rejoined. Sometimes an opening called a stoma has to be left in the abdominal for the removal of waste. This opening may be temporary or permanent.

Radiation Therapy:

Chemotherapy:

Chances of success depend on how soon the cancer was detected, how much the cancer has penetrated the wall of the large intestine, and whether the cancer has spread beyond the colon.

Staging of the Cancer:
If your doctor learns that you do have colorectal cancer, additional tests will be done to see if the cancer has spread. This is called staging.

Stage 0: Very early cancer on the innermost layer of the intestine
Stage I: Cancer is in the inner layers of the colon
Stage II: Cancer has spread through the muscle wall of the colon
Stage III: Cancer has spread to the lymph nodes
Stage IV: Cancer that has spread to other organs
Treatment depends partly on the stage of the cancer. In general, treatments may include:

Chemotherapy medicines to kill cancer cells
Surgery to remove cancer cells
Radiation therapy to destroy cancerous tissue
Stage 0 colon cancer may be treated by removing the cancer cells, often during a colonoscopy. For stages I, II, and III cancer, more extensive surgery is needed to remove the part of the colon that is cancerous. (See: Colon resection.)

There is some debate as to whether patients with stage II colon cancer should receive chemotherapy after surgery. You should discuss this with your oncologist.

Almost all patients with stage III colon cancer should receive chemotherapy after surgery for approximately 6 - 8 months. The chemotherapy drug 5-fluorouracil given has been shown to increase the chance of a cure in certain patients.

Chemotherapy is also used to treat patients with stage IV colon cancer. Irinotecan, oxaliplatin, and 5-fluorouracil are the three most commonly used drugs. You may receive just one type, or a combination of the drugs. Capecitabine is a chemotherapy drug taken by mouth, and is similar to 5-fluroruracil.

For patients with stage IV disease that has spread to the liver, various treatments directed specifically at the liver can be used. This may include cutting out the cancer, burning it (ablation), or freezing it (cryotherapy). Chemotherapy or radiation can sometimes be delivered directly into the liver.

While radiation therapy is occasionally used in patients with colon cancer, it is usually used in combination with chemotherapy for patients with stage III rectal cancer.

How well a patient does depends on many things, including the stage of the cancer. In general, when treated at an early stage, more than 90% of patients survive at least 5 years after their diagnosis. (This is called the 5-year survival rate.) However, only about 39% of colorectal cancer is found at an early stage. The 5-year survival rate drops considerably once the cancer has spread.

If the patient's colon cancer does not come back (recur) within 5 years, it is considered cured. Stage I, II, and III cancers are considered potentially curable. In most cases, stage IV cancer is not curable.

Cancer spreading to other organs or tissues (metastasis)
Recurrence of carcinoma within the colon
Development of a second primary colorectal cancer
Calling your health care provider

Together with regular screening, adopt the following changes to your lifestyle to decrease your risk of developing colorectal cancer:

Maintain a balanced diet low in animal or saturated fat such as butter, coconut oil, ghee and lard. Diets high in total fat, protein, calories and meat, and low in calcium are associated with an increased incidence of colorectal cancer.
Take at least 2 servings of fruits and vegetables each day. Studies have shown that very low intake of fruits and vegetables is associated with an increased risk of colorectal cancer.
Quit smoking. Cigarette smoke contains many chemicals that promote the development of many types of cancers.
Increase physical activity. Physical activity promotes general health and reduces your risk of colorectal cancer. Maintain your BMI within the healthy range of 18.5 to 22.9 (kg/m2).
The death rate for colon cancer has dropped in the last 15 years. This may be due to increased awareness and screening by colonoscopy. Colon cancer can almost always be caught in its earliest and most curable stages by colonoscopy. Almost all men and women age 50 and older should have a colonoscopy. Colonoscopy is almost always painless and most patients are asleep for the entire procedure.


Dietary and lifestyle modifications are important. Some evidence suggests that low-fat and high-fiber diets may reduce your risk of colon cancer.

The U.S. Preventive Services Task Force recommends against taking aspirin or other anti-inflammatory medicines to prevent colon cancer if you have an average risk of the disease -- even if someone in your family has had the condition. Taking more than 300 mg a day of aspirin and similar drugs may cause dangerous gastrointestinal bleeding and heart problems in some people. Although low-dose aspirin may help reduce your risk of other conditions, such as heart disease, it does not lower the rate of colon cancer.




Other types of colon cancer such as lymphoma, carcinoid tumors, melanoma, and sarcomas are rare. In this article, use of the term "colon cancer" refers to colon carcinoma and not these rare types of colon cancer.

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