Patient's Complete Guide to Colon Cancer

Overview of Colon Cancer

Colorectal cancer affects both areas of the colon and rectum and causes uncontrollable growth of cells. It is more likely to occur in people above 50 years old.

Signs and Symptoms of Colon Cancer

Colorectal cancer (anat ka sartan/آنت کا سرطان) is a group of colon and rectum cancer. The tumour starts to grow in the lining of both colon and rectum. These types of  growth are known as polyps. If the polyps are in the colon or rectum area, they are referred to as polyps colon or rectum respectively. Polyps are characterized by a small non-cancerous lump of cells. As they grow, it can turn into cancer over time.

Colorectal cancer has many stages of development, depending on the extent of cancer and size of any tumour. Stages are as follows:

Stage 0:  Also known as carcinoma. It is a very early stage of cancer in which the growth of cells in the inner layer of the colon or rectum.
Stage 1: In this type, cancer spreads in the next tissue layer but does not reach the lymph nodes or any other cancer.
Stage 2: Cancer has expanded to the outer layers of the colon or rectum, but do not spread beyond them.
Stage 3: Cancer affects the outer layer of the colon or rectum to one of the three lymph nodes. But it does not spread to the other areas of the body.
Stage 4:  As stage 3 progresses, colon cancer starts to expand other parts of the body such as the rectum. If the cancer cells accumulate to form a tumour in the rectum area as well then it is known as colorectal cancer. From there, cancer also extends to other parts of the body.

Prevalence of Colon Cancer (Colorectal Cancer)

As per the American cancer society (ACS) statistics, it accounts for 1 in 23 (4.4%) for men and 1 in 25 (4.1%) for women cases of colorectal cancer were reported during their lifetime.
In Pakistan, the overall cases of colorectal cancer are about 64% in the population till 2017.
According to 2009-2015 data, the 5-year average survival rate for all stages of colon cancer is estimated to be 63 % and 67% for rectal cancer.

Types of Colon Cancer

Common signs and symptoms of colon cancer (colorectal) do not appear in the early stages of cancer. As they appear, it depends on the size of cancer and the location of the large intestine. Some of which are as follows:

  • Change in bowel movements, including diarrhoea or constipation
  • Change in the consistency of your stool
  • Rectal bleeding or blood in the stool
  • Persistent abdominal discomforts, such as cramps, gas or pain
  • A feeling that bowel doesn't empty completely
  • Weakness or fatigue
  • Sudden weight loss

Causes of Colon Cancer

There is more than one type of colon cancer according to the type of polyps. Because these types of polyps transform into cancer on the specific areas of the colon or rectum. On the basis of them, it is further sub-categorized into the following forms:

  • Adenocarcinomas- It is the most common type among all. Typically, it forms within the cells that make the mucus in either the colon or rectum.
  • Lymphomas-This is defined as cancer of immune system cells. Generally, it starts in the lymph nodes but can also affect the colon, rectum, or other organs first.
  • Carcinoids- It starts to form hormone-making cells within the large intestine.
  • Sarcomas- It is a cancer of soft tissues of the specific region such as connective tissues of the colon or rectum.
  • Gastrointestinal Stromal Tumours- This type of cancer forms the non-cancerous cells (benign) in the colon area. As they grow, benign cancer changes into malignant cancer. ( tumours mostly develop in the digestive tract but can rarely exist in the colon area).

Risk Factors of Colon Cancer

Almost all colon and rectal cancers start in the form of polyps. Polyps are not cancer, but the growth of cells in the inner wall of the colon.

Following are the most common types of polyps in colon and rectum that cause cancer, if it is left untreated:

  • Hyperplastic and Inflammatory Polyps- These are a non-cancerous type of large-sized polyps formed on the right side of the colon. If it is not removed on time that may result in cancer.
  • Adenomas or Adenomatous Polyps- These are precancerous polyps, which can change into colon or rectal cancer.
  • Genetic Mutations-Due to mutations in the DNA or genetic damage, uncontrolled cell growth has been observed in colorectal cancer.

Colorectal cancer may also form due to the replication of abnormal cells, called dysplasia, in the lining of the colon or rectum.

Prevention

  • People older than 50yrs
  • African-American people are more likely to develop colon cancer.
  • Personal history of colorectal cancer or polyps
  • Inflammatory intestinal conditions such as  ulcerative colitis  and crohn's disease
  • Inherited syndromes that trigger the colon cancer due to gene mutations that pass through generations of the family such as
  • Familial adenomatous polyposis (FAP)
  • Lynch syndrome (also known as hereditary nonpolyposis colorectal cancer HNPCC)
  • Juvenile polyposis syndrome
  • Muir–Torre syndrome, which is a variant of Lynch syndrome
  • MYH associated polyposis
  • Peutz–Jeghers syndrome
  • Turcot syndrome, which is another variant of FAP
  • People who had a family history of colon cancer
  • Eating of Low-fiber and high-fat diets such as red meat and processed meat.
  • Less physical activity in lifestyle
  • Diabetic or insulin resistance people
  • Being obese
  • Smoking
  • Alcohol
  • Radiation therapy for cancer

Complications of Colon Cancer

  • Problems in the bowel movement
  • Cancer returning in colon
  • Development of secondary cancer
  • Cancer spread to other organs and tissues

Diagnosis

In order to minimize the symptoms of colorectal cancer, the following measures should take:

  • Decreasing the amount of red meat you eat
  • Avoid processed meats, such as hot dogs and deli meats
  • Eat more plant-based foods
  • Decrease dietary fat
  • Physical activities on a daily basis
  • Lose weight
  • Quit smoking
  • Reduce alcohol consumption
  • Decrease stress
  • Manage preexisting diabetes

Treatment of Colon Cancer | When to Consult a Doctor

Doctors will do the physical examination to check the swollen mass in organs. After that, they recommend any one of the following tests of polyps or colorectal cancer:

  • Rectal Examination- To check the rectum for growth of the tumour with the help of fingers.
  • Colonoscopy- This is the standard screening test to check the entire colon or rectum whether there are any abnormalities in them. A doctor placed a thin, flexible tube called a colonoscope for examination.
  • Sigmoidoscopy- Another test to check the rectum and the last part of your colon.
  • Biopsy- In this procedure,  a doctor extracts out the affected tissues during a colonoscopy or sigmoidoscopy for testing. This is done with the help of a fine needle. Along with a CT scan or ultrasound locates the area of tissues. Although complications are rare, this test may cause bleeding or discomfort.
  • Stool DNA- This test reveals the specific genes that may cause colon cancer.
  • CT Colonography- This is a special X-ray (also called a virtual colonoscopy) of the entire colon which takes less time and is less invasive than other tests. But if it shows a polyp, then a colonoscopy is required.
  • Barium Enema X-ray- This is a type of X-ray that involves putting dye in the colon. It can find trouble spots that might mean it needs a colonoscopy.
  • Other imaging tests- MRI or ultrasound can give the doctor detailed scans of organs.

Healthcare Providers

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Speciality for Colon Cancer

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