Types, Symptoms and Treatments

Colorectal Cancer - Types, Symptoms and Treatments

Cancer that begins in the colon is called colon cancer, and the cancer that begins in the rectum is called rectal cancer. Cancers affecting either of these organs also may be called colorectal cancer. It is a disease which malignant (cancer) cells first form in the tissues of the colon. Colorectal cancer occurs in rectum or the large intestine. This type of cancer occurs when abnormal tissues grow on the inner walls of the colon and rectum. These abnormal tissues commonly present in the form of polyps. Polyps grow as a projection of tissue away from the colon wall, remaining connected to the colon wall of a thin stalk. Their shape is similar that of a mushroom. Polyps are fairly common, especially in older people. The vast majority of polyps are not cancerous. However, some polyps will eventually become cancerous. Unchecked, a cancerous polyp gives rise to a tumor, which grows in size until it penetrates to bowel wall and involves adjacent organs and lymph nodes through the process known as metastasis.

Types

In general, colorectal cancers tend to be slow growing, gradually enlarging and eventually penetrating the bowel wall. When they do spread, it is usually through invasion of nearby lymph nodes. On the right side of the colon near the cecum, cancers usually grow into the space within the colon. They can become large enough to be painful and are likely to cause bleeding. In these cases anemia from chronic blood loss is often the first sign and is why a stool test for occult, or hidden, blood is important.

Most polyps and cancers appear on the left side of the colon. In the left or descending colon, where the channel is narrow, the cancer usually grows around the colon wall and encircles it. Left-sided cancer typically constricts the bowel channel, causing partial blockage.

Symptoms

Symptoms may include:

• Diarrhea, constipation, vomiting, fatigue.
• Going to the toilet more often.
• A feeling that the bowel does not empty properly after a bowel movement.
• Pain and bloating in the abdomen.
• Blood in stools.
• Inexplicable weight loss.
• A lump in the tummy.
• Unexplained iron deficiency in men, or in women after the menopause.

Causes

• Alcohol.
• Polyps.
• Diabetes.
• Age and gender.
• High cholesterol diet.
• Inflammatory Bowel Disease (IBD).
• Genetics.
• Lack of exercise.
• Smoking.
• Obesity.
• Numerous adenomatous polyps develop in the colon, ultimately leading to cancer.
• A family history of this cancer.
• Drug effects.

Diagnosis

A person with colorectal cancer will be diagnosed in following ways:

• It is found on a routine screening test.
• Symptoms lead a person to the doctor, and tests to find the cause of the symptoms reveal colorectal cancer.

Treatments

Treatments may include following options, alone or in combination:

• Surgery - Surgical options include:

1. Bowel resection: This operation involves cutting into the abdomen to reach the area of the colon or rectum that is affected by the cancer. The surgeon cuts out the cancer as well as the parts of the colon or rectum that are next to it. Then the two healthy ends of the colon or rectum are sewn back together.

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What Is Rectal Cancer

The colon is a part of the digestive tract that connects the stomach and small intestine to the anus. The terminal portion of this colon is called the rectum, spanning approximately 12cm in length. About 20% of all cancers that occur in the colon arise in this rectum.

Bleeding is the most common symptom associated with rectal cancer, occurring in up to 60% of patients. Other frequent symptoms include change in bowel habit, and abdominal pain.

The diagnosis of rectal cancer usually involves colonoscopy, an examination of the colon using an instrument called colonoscope that enables an evaluation of the entire inner lining of the colon including the rectum. Once the diagnosis of cancer is made, the extent of the disease is often determined using a radiologic examination called CT scan. It allows an initial assessment of the extent of spread of cancer. In addition, an endoscopic ultrasound may be helpful in assessing the local spread of cancer. At the same time, routine blood tests including complete blood count (CBC), liver function tests, and a tumor marker called CEA are usually obtained during the initial evaluation.

There are 4 stages of rectal cancer. Rectal cancer is defined as Stage 1, if the cancer tissue is confined to the lining of the rectum. In Stage 2 cancer, the cancer tissue has invaded the layers of rectal wall, and may have invaded nearby organs such as bladder or uterus. In Stage 3 rectal cancer, the cancer tissue has spread to nearby lymph nodes, tiny bean shaped glands of lymphatic system. In Stage 4 cancer, the cancer has spread to other organs such as liver or lung.

The staging of rectal cancer is important since the prognosis of affected individual is highly dependent on the staging of cancer. For example, patients diagnosed with Stage 1 rectal cancer have overall 5-year survival rate of 74%. On the other hand, those diagnosed with stage 4 cancer can only expect 6% survival rate at 5 year.

The treatment of rectal cancer often involves combination of surgery, radiation therapy, and chemotherapy. Because of the complex anatomy of anal sphincter, there are various surgical techniques that may be utilized to preserve the anal sphincteric function. In addition, radiation therapy and chemotherapy are often administered to shrink the tumor, prior to performing the surgery.

For cancer that is localized and has not spread, the excision surgery is the treatment of choice. More advanced cancer usually requires chemo-radiation therapy, followed by surgery. The type of surgery performed will be dependent on the exact location, size, and extent of cancer with the intent of preserving anal sphincteric, if at all possible. Recently,

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