What is Colorectal Cancer?

Colorectal cancer

or bowel cancer is characterized by its presence in the colon, rectum and the vermiform appendix (tube like structure near the junction of the small and large intestine). It is the third most commonly diagnosed cancer in the world.

This disease affects about 160,000 Americans annually causing about 62,070 deaths each year.The lifetime risk of developing it is 4.6 percent for men and 3.2 percent for women.

This cancer first appears as a small polyp (mushroom like structure of tissue) or tumor on the lining of the large intestine. It could be harmless or benign and without any symptoms.
Left undetected and untreated for a long time, it could lead to cancer. Starting in the large intestinal wall it spreads onto the muscles nearby and then beyond the bowel wall.

What are the causes of colorectal cancer?

  • Family History of the disease

    – The risk of having it increases many times by the fact that there is a family history of the disease. Anyone could be born with faulty genes which are capable of producing cancerous cells later on. A family history of polyps and tumors increases the risk manifold.

  • Polyps and adenomas (Tumors)

    – Having polyps and adenomas untreated for a long time could lead to cancer. A large percentage of colon cancers start with a polyp or tumor.

  • Inflammatory Bowel Disease

    – This ailment is characterized by the abnormal swelling of the colon known as Diverticulum and in extreme cases it is followed with perforation of the colon and a severe infection. Ignored and neglected, chances are high that it will lead to cancer. Ulcerative colitis and Crohn’s disease too are responsible in leading to the disease.

  • Anal-rectal Abscess/Fistula

    – An abscess is an infected pus filled cavity found in the anus or rectum. When the abscess opens up into a tunnel like structure creating a communication between the anal-rectal wall and the outer skin, a fistula appears. It is caused by a bacterial infection of the anal gland. It too contributes to the risk of contracting bowel cancer.

  • Age

    – Age can never be attributed as a cause but reports indicated that the incidence of the disease is mostly in people above 50 years of age. Above 50, one in four people have it.

  • Lifestyle

    – A faulty lifestyle which includes lack of exercise, smoking, alcohol, and untreated obesity could increase the risks of getting it. Lifestyle changes are a major preventive measure against cancer.

  • Diabetes

    – Insulin deficiency and dependency wrecks havoc in the body and increases the risk of cancer. A study reveals that people having diabetes have a 40% higher risk of getting the disease.

  • Diet

    – Poor choices like a low fiber, high in fat kind of diet contributes to constipation and incomplete defecation. Years of such diet choices lead to toxins accumulating in the colon, poor digestion, nutrition and metabolism. Various benign colorectal diseases begin to surface which has a high risk of becoming cancerous later on.

What are the stages of Bowel Cancer?

  • Stage 0 (Pre-cancer Stage)

    – This stage is also known as Carcinoma in situ and is the foremost stage of this ailment. The cancer cells have just appeared in the mucous (innermost protective slippery tissue layer) lining of the colon wall. They have not spread to any neighboring tissue or organ. Removal of these cells eliminates the risk of any subsequent advancement of the disease.

  • Stage I

    – In this stage, cancer may have spread to the mucous lining of the colon. It has permeated into the tissues (submucosa) and the muscles beneath the colon wall.

  • Stage II

    – This stage can be divided into Stage IIA, Stage IIB and Stage IIC which are as follows:

    Stage IIA

    – In this stage the cancer has gone well beyond the muscles to the serosa (a smooth thin layer of cells forming the outermost lining) of the colon wall.

    Stage IIB

    – Cancer has spread throughout the serosa of the colon lining, but has not moved into any neighboring organ or tissues.

    Stage IIC

    – Cancer has spread from the serosa to the neighboring organs and tissues.It is yet to affect the lymph nodes.

  • Stage III

    – This can be divided into StageIIIA, Stage IIIB and Stage IIIC and are as follows:

    Stage IIIA

    – Cancer cells have been formed in not more than 3 nearby lymph nodes or they are found in the tissues close by the lymph nodes(glands which are storehouses of immunity enhancing white blood cells) but not in the cells inside the lymph node.

    Stage IIIB

    – Cancer cells have gone beyond the inner and outer lining of the colorectal wall to at least 4 nearby lymph nodes but not more than 6 of them.

    Stage IIIC

    – The cancer has also now progressed into 7 or more nearby lymph nodes.

  • Stage IVA

    – Cancer has spread to one nearby organ, tissues, lymph node as well as one organ not near the colon like liver, lung, ovary or a far off lymph node.

    Stage IVB

    – Cancer has spread to more than one distant organ or has moved into the walls of the small intestine.
    Stage IV is also known as the Metastatic stage where the cancer has spread into the other organs.

What are the Symptoms of this Disease?

Colon cancer can exist in the body without any symptoms for a long time. Symptoms vary depending on the location of the cancer cells in the organ.
The colon has two sides. The right side is spacious. So tumors go undetected for a long time here and are generally without symptoms. The symptoms from cancer in the right side of the colon are as follows:

  • Persistent Blood loss
  • Anemia or Iron deficiency
  • Fatigue
  • Weakness
  • Loss of appetite
  • Anemia
  • Nausea or Vomiting
  • Shortness of breath

The left side of the organ is more constricted and so developing cancerous tumor would cause the following symptoms:

  • Bowel obstruction
  • Change in bowel habits
  • Constipation
  • Diarrhea
  • Narrowed stools
  • Abdominal pain and cramping
  • Bloating
  • Bright red blood in stools

Management of Cancer in the Colon and Rectum

  • Surgery

    – Removal of the cancerous polyps or lesions in the early stages of cancer is often associated with complete recovery. Advanced stages of the cancer also call for specialized surgery in which the tumor along with a part of the colon is removed and the colon is reconstructed to provide normal functioning. The lymph nodes are also removed when affected.
    In advanced Stage IV cancer, surgery is often done to remove whole or parts of the original tumor to reduce the pain and discomfort in the body.

  • Chemotherapy

    – Chemotherapy is a combination of powerful medicines given through the veins and is often chosen as the primary treatment for this cancer. It is often coupled with the surgical removal of cancer. Chemotherapy could be given before or after surgery. It prevents the cancer from spreading, reduces the tumor size and improves the chances of survival.

  • Radiation Therapy

    – Radiation Therapy is also sometimes used especially when the cancer is in the rectal region. It uses electromagnetic radiation to destroy the cancer cells in the area. However, radiation could lead to side effects like other intestinal problems because it could lead to the destruction of the good bacteria and healthy cells of the intestine.

Prevention of Colorectal cancer

There are some preventive measures, which if followed could decrease the incidence of the disease.

  • Regular Screening

    – Most of the cancers of this region begin with colonic polyps and tumors. A procedure like colonoscopy to determine the health of the colon can be used to look for them and remove them. Further biopsy of these structures can help to rule out cancer.

    Individuals above 50 years of age must go for a colonic screening regularly as the possibility of them getting the cancer is more.

  • Lifestyle Changes

    – Regular exercising and maintaining a healthy body weight is very important. A diet which is rich in green vegetables, fruits and cereals and is full of fiber is advisable. Keeping away from red meat, refined sugar ensures a good nutrition and a healthy body weight thereby decreasing the chances of getting the ailment.

  • Calcium

    – Some reports indicate that a calcium enriched diet and calcium supplements could reduce the incidence of the disease.

  • Vitamin D

    – Vitamin D too has been found to be beneficial in preventing this cancer.

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