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Colon and Rectal Cancer - Symptoms and Treatment
The colon is the last portion of the intestine, known also as the large intestine. The colon ends at the rectum which connects to the outside via the anus.
Cancers of the large intestine, which includes both colon and rectum, are the second most common malignancy found in males and females.
RISK FACTORS FOR COLORECTAL CANCER
1. FAMILY HISTORY OF COLORECTAL CANCER.
2. PERSONAL OR FAMILY HISTORY FOR POLYPS IN THE COLON OR RECTUM.
3. PERSONAL HISTORY FOR ULCERATIVE COLITIS.
4. DIET HIGH IN FAT AND LOW IN FIBER (complex carbohydrate).
Symptoms of colorectal cancers
Common symptoms of colorectal cancers include: a change in the shape, frequency, or size of the stools ("pencil stools"). Blood in the stool or rectal bleeding is common. Lower abdominal pain that may present as an intestinal blockage can indicate a tumor blocking the bowel. Weight loss, generalized weakness, and anemia are also seen. Patients with colorectal cancers will often have occult blood in the stool, blood which is not visible to the naked eye (but must be tested for).
Evaluation and Treatment
Evaluation will include history and physical examination. Digital rectal examination can detect a large percentage of lower rectal cancers in the over 40 age group. Blood tests for blood counts will be done. The stool will be chemically tested for occult blood. Colorectal screening kits (for occult blood) are now available at the pharmacy, so you can test your own stools on a regular basis.
The American Cancer Society currently recommends annual testing of the stools for occult blood in males and females over age 50. Colonoscopy and sigmoidoscopy are endoscopic procedures useful for directly visualizing the inner lining of the colon and rectum. Both these procedures make use of the fiberoptic endoscope, enabling the physician to look inside, take tissue specimens, and remove any questionable growths (polyps). The specimens are studied by a Pathologist trained to detect cancerous cells in a tissue sample. It may take several days before the final report on the specimen is completed.
Treatment is based on biopsy results. If cancer is detected, the physician will determine the best course of action to remove the cancer. Well localized tumors, without evidence of spread, may be removed through the endoscope. Further evaluation, looking for possible spread of the disease will be undertaken with other diagnostic examinations (CT-scanning of the abdomen, or nuclear bone scanning).
Approximately 85% of the patients with well localized cancers of the colon and rectum will live at least 5 years with treatment (and some will never have a recurrence). Five year survival drops to 30% if there is spread outside of the bowel. Colorectal cancer that shows evidence of spread may warrant surgical removal of the diseased portion of the bowel.
Some patients, 10 to 15%, may require a colostomy. This is an artificial opening established in the abdomen for elimination of body wastes. Many times, the colostomy is temporary, giving the colon a chance to heal after surgery. Advanced or recurrent disease may require combined regimens of radiation therapy and chemotherapy.
Patients under treatment for advanced colon cancer will require a nutritious diet.
A gastroenterologist will be the expert in the evaluation of the patient with suspect colorectal cancer.
RECOMMENDATIONS FOR PREVENTION
1. Annual physician physical examinations (with digital rectal examination) for patients over the age of 40.
2. Regular screening of stools (every 12 months) for occult blood, using the colorectal screening kits mentioned above.
3. High fiber diet has been shown to decrease the risk of colon cancer. A diet low in fat is also recommended.
4. Patients with a history for prior colon cancer, or a family history for colon cancer may require yearly lower GI endoscopy for evaluation. Your physician can guide you with regard to these recommendations.
5. The American Cancer Society recommends sigmoidoscopy (flexible) every 3-5 years for all patients over the age of 50.
I hope this article will provide you information about colon and rectal cancer.
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