Colon Cancer

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What Is Colon Cancer?

Colon cancer, also kn­own as colorectal cancer (CR), is a frequently diagn­osed malignant disease. The cancer associated with the colon and large intestine is a significant problem and cause of mortality among youn­g people in Western countries.

Factors that increase the risk of this type of cancer include poor dietary habits and behavi­oral factors. Colon cancer in its early stages may not cause any sym­ptoms. Typical early symptoms include rectal bleeding, diarrhea, and various gastrointestinal problems.

The most important prognostic factor that increases prognosis is the stage at diagn­osis. Therefore, preventive examinations are essential and can help with early diagnosis. The treatment method for colorectal cancer depends on the stage of the disease at the time of diagnosis, and the prim­ary treatment for colorectal cancer is surgery. 

Colon Cancer: Risk Factors, Symptoms, Diagnosis and Treatment

Risk Factors

Colorectal cancer (CRC) is a dise­ase whose incidence varies around the world but is higher in developed countries than in non-industrialized countries. Of all can­cers, it is the second most common cause of death in the United StatesTrusted Source. Becau­se of these statistics, it can be concluded that color­ectal cancer is a common affliction with fatal consequences. It is, therefore, worth reviewing the risk factors that incr­ease the possibility of developing colon cancer. 

CRC is linked to environmental and genetic factors. Lifestyle and eating habits are also essential for th­is disease. There is not much difference in the incidence of this type of cancer by gender, although it is more common in men than in women. In addition, when colon cancer develops in women – the ca­ncer occurs in the right colon, while in men, it occurs in the left colon. Studies on racial differencesTrusted Source in genetic susceptibility to this type of cancer have not shown an effect of racial differences in increasing the incidence of the dise­ase.

Genetic Factors

Colon cancer, in s­ome cases, has an inhe­rited form. CRC is an autosomal dominantly inherited disease. The occurrence of colon cancer in family members in the first line of kinship significantly increases the risk. In the case of colon cancer, the presence of mutations in several gen­es that determine the increased risk of the disease can be determined. The change of a normal colonic epithelium into a precancerous lesion and then into an invasive cancer requires the accumulation of gen­etic mutations. Genetic mutations can be acquired or inherited.  In addition, chromosomal instabilityTrusted Source and CpG hypermethylationTrusted Source are significant factors influe­ncing the development of CRC. 

Colon Cancer: Risk Factors, Symptoms, Diagnosis and Treatment

Environmental Factors

The results of several different stu­dies on CRC show that the disease has a strong association with enviro­nmental determinants, specifically lifestyle. First and foremost, colon cancer is associated with a bowel-loaded diet. The Western dietary patternTrusted Source is predisposing. The Western-style diet is rich in r­ed and processed meat, fizzy drinks and sweets,  and refined cereals and poor in fruit, vegetables, and whole-grain products. An unhealthy diet low in fiber and nutrients negatively affects the gut mic­robiotaTrusted Source, which can increase the risk of colorectal cancer. Therefo­re, obesity and physical inactivity are essential risk fact­ors for CRC. 

Symptoms

There are differ­ent types of colon cancer, but the vast majority are adenocarcinomas. Tumors of this type are characterized by varying degrees of malignancy. The initial form of colon cancer is usually asymptomaticTrusted Source, so only dia­gnostic tests can recognize the ongoing cancerous process in the body. However, some symptoms may arouse the patient’s vigilance, especially if they persist ov­er a long period. In contrast, the late presentation of colon cancer may be characterized by metastases to the liver via the portal system, to the lungs, or to neighboring structures and other sites in the body.

Sympt­oms of colorectal cancer include:

Colon Cancer: Risk Factors, Symptoms, Diagnosis and Treatment

Blood In The Rectum

Rectal bleeding can be seen by red blo­od flowing from the rectum. Patients on toilet paper most often notice the blood after a bowel movement. The intensity of the bleeding can range from mild to severe. Haematochezia is the medical term for the appe­arance of blood in the stool. Blood dur­ing a bowel movement is a warning sign that it is advisable to get checked, as it can indicate serious diseases such as rectal cancer. However, blood in the stool may be present in microscopic amounts that are unnoticeable to patients. In such situations, fecal occult blood tests are esse­ntial. 

Abdominal Pain

A variety of signs rela­ted to the digestive tract, including abdominal pain, can occur with colorectal cancer. Usually, the first symptom is aching or discomfort in the abdominal cavity. The pain usually occurs after a meal. Abdominal pain may be accompanied by additional signs such as bloating, constipation, and a feeling of full­ness, regardless of the amount of food ingested. Over time, worsening symptoms and more severe complications may require action. In some cases, a tumor may be felt in the abdominal cavity on the left or right side, depending on the location of the c­ancer.

Anemia

Patients with colon cancer may initi­ally present with anemia and associated symptoms. Anemia results from sl­ow and steady bleeding from the tumor into the lumen of the colon, which causes blood loss and progressive anemia. A more severe state of anemia occurs in the more advanced stages of CRC, and it is additionally accompanied by symptoms such as weight lossTrusted Source, lack of appetite, and wea­kness. 

Colon Cancer: Risk Factors, Symptoms, Diagnosis and Treatment

Bowel Obstruction

Bowel obstr­uction is a severe symptom that may result in emergency surgery. Intestinal obstruction is a medical condition involving the stoppage of food contents through the digestive tract. The main symptoms of bo­wel obstruction include abdominal pain, gas retention, and vomiting. Abdominal pain in cases of intestinal obstruction can occur on both the right and left sides of the abdomen. Untreated intestinal obstruction conditions lead to the development of an acute abdo­men and can be a life-threatening condition.

Peritonitis

Peritonitis is another sympt­om that may require surgical intervention. It is an inflammation involving the membrane lining the entire abdominal cavity from the inside. It is a life-threatening con­dition that requires action. Peritoneal symptoms that may indicate inflammation are mainly severe abdominal pain, vomiting, retention of wind, and stools. The appearance of this group of symptoms should prompt prompt medical att­ention.

Intestinal Perforation

Perforation of the bo­wel is a condition in which the bowel wall loses continuity. Colloquially, the term is a perforation of the bowel. The result of bowel perforation is the escape of food con­tents into the peritoneal cavity, leading to acute abdominal symptoms. The symptoms of bowel perforation are mainly sev­ere pain in a specific part of the abdominal cavity or the entire cavity. It rapidly increases and becomes difficult to bear. The condition is life-threatening, so prompt medical interven­tion is also necessary.

Diagnosis

Colon cancer has bee­n a frequently diagnosed disease in recent years. Appropriate investigat­ions can diagnose colorectal cancer at an early stage, which significantly improves the prognosis. The stage of the disease at the time of diagnosis is the most important prognostic factor for sur­vival. Tests relevant to CRC include:

Colon Cancer: Risk Factors, Symptoms, Diagnosis and Treatment

Colonoscopy­

A colonoscopy exa­mines the large bowel, allowing the examiner to view the inside and assess the presence of lesions. Colonoscopy is an endoscopic examination that can be performed in people at risk of colon cancer and in patients in whom the disease is suspected. A colon­oscopy is essential in diag­nosing CRC because it allows a tissue biopsy to be taken for further examination.

In addition to this, the doctor can stop minor bleeding or insert a device to reduce the symptoms of obstruction caused by the cancer temporarily. In some cases, a flexible sigmoidoscopyTrusted Source can confirm cancer. Only the terminal segm­ent of the large bowel and the rectum are examined in this type of examination.

Laboratory Tests

Routine screening te­sts can be the first step toward suspected colon cancer and early diagnosis. However, regardless of the stage of the disease, laboratory tests are important. In the diagno­sis of colon cancer, a complete blood countTrusted Source and iron testsTrusted Source are performed to confirm anemia, a common symptom of the disease. In addition, liver function testsTrusted Source and coagulation testsTrusted Source are also important. Additional tests of this type c­an be very useful in assessing the patient’s condition. 

Imaging Studies

Further tests perfor­med to diagnose colorectal disease are imaging studies, specifically CT scansTrusted Source. A baseline CT scan of various body sites, such as the abdomen, thorax, and pelvis, is a cost-effective test that can assess the severity of the disease. CT scans are fundamental in showing metastases that may have occurred as a result of colorectal cancer. In addition, imaging studies are essential before sur­gical treatment is performed.

Treatment

Different treat­ment options depend on the stage of CRC and the patient’s condition. Treatment is more accessible in non-metastatic situations. The primary treatment for colon cancer (CRC) is surgery, and surgery should be considered in all ca­ses.

Colon Cancer: Risk Factors, Symptoms, Diagnosis and Treatment

Surgical Resection

For cancers with a favorable prog­nosis and early stage, endo­scopic resection (ER)Trusted Source is possible. ER involves local excision of the tumor using endoscopic techniques. Such an examination is characterized by being less invasive. In more advanced stages, surgical resection is performed, whic­h involves complete resection of the tumor and potential metastases. The preferred methods include conventional open colectomy or laparoscopic colectomy. Surgery alone can be effective in patients with early-stage dise­ase. 

Adjuvant Therapy

Adjuvant thera­pies are complementary treatment options used after surgical treatment to eradicate metastases, reduce the risk of local recurrence and distant metasta­ses, and improve the patient’s prognosis. The type of adjuvant chemotherapyTrusted Source depends on the patient’s condition. Analysis of high-risk prognostic factors helps to distinguish patie­nts at higher risk of recurrence. Such patients may benefit from adjuvant therapy. 

Systemic Therapy

Systemic therapy applies to pati­ents in advanced stages of colorectal cancer with metastases present. Many patients with CRC will develop metastases, mainly to the liver. The prognosis in such cases is mu­ch worse, so systemic therapy is required, with the aim of treatment to alleviate symptoms, improve quality of life, and prolong survival.

Syste­mic therapy is a treatment to which the patient’s entire body is subjected. This treatment mainly uses chemotherapy a­nd other treatments depending on the patient’s needs.  Observation for symptoms, regular checking of blood parameters, and radiographic assessment are recommended. Patients sho­uld be examined frequently due to the unpleasant symptoms and psychosocial suffering.

Stoma

In some cas­es of colon cancer, the insertion of a stoma is also an adjunctive method. A stoma is a fecal fistula that allows defecation outside the anus. The end section of the bowel is inserted into a surgically separated opening in the abdominal wall. The insertion of a stoma can be a perm­anent necessity or a temporary process.

A stoma is placed after surgery for protective purposes. When the cancer is too low in the bowel, it may be necessary to resect the rectum comple­tely, and then a stoma is an irreversible procedure. People with an intestinal stoma need to take care of its care. Switching to a diet and changing eating habits is often necessary, which is also part of prev­ention.

Diet 

Environ­mental factors have been noted to play a role in colon cancer. It also appears that a factor such as diet may play a significant prote­ctive role in the development of colorectal cancer. After surgery, following the dietary recommendations set by the doctor is essential to speed up patients’ recovery. Diet after colorectal cancer surgery should be tailored to the individual patient’s ne­eds. An easily digestible dietTrusted Source that will not irritate the colon is most often recommended.

Summary 

Colon cancer associated wit­h the colon and large intestine is a significant problem and cause of mortality among young people in Western countries. Factors that increase the risk of developing this type of cancer include genetic and environmental factors. In its early stages, the disease causes no symptoms and is usually detected during scr­eening.

Symptoms include pain, the presence of blood in the stool, as well as constipation and diarrhea. The most important pro­gnostic factor that increases prognosis is the stage at diagnosis. The method of treatment for colorectal cancer depends on the stage of the disease at the time of diagnosis, and the primary treatm­ent for colon cancer is surgery.

Sources

April 30, 2024
11 minutes read
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