During the course of this post, I will be discussing extensively on a popular type of cancer known as colorectal (colon) cancer. I will try as much as possible to simplify what you need to know about this disease. This post will include a little about the large intestine, which is where this issue is situated. I will also talk about the symptoms, treatment, risk factors (and others). If you find my post interesting or helpful in anyway, do well to drop your constructive thoughts and opinions at the comment session.

Introduction

Colon cancer is an abnormal malignant tumor originating in the rectum or colon. It is also called cancer of the large intestine, which is at the last part of your digestive tract. Individuals diagnosed with colon cancer are often around their fifties. This one of the most popular cancers seen in both males and females. In most cases, colon cancer begins as noncancerous clumps of cells popularly known as polyps. Polyps turn cancerous overtime, if not well taken care of

Knowing the correct anatomy of a disease, gives you a solid edge in having a painstaking understanding about that disease. There is a complex system in the human body, which is responsible for digestion, this system is called the gastrointestinal tract (digestive system).

The gastrointestinal tract is a long cylindrical system in the human body that begins in the mouth --> Oral pharynx --> oesophagus --> stomach --> small intestine --> and the large intestine, which is also known as the colon, which is our major concern/focus for today. The major function of the gastrointestinal tract is to process the food and nutrients we put into the body, to create energy, and also remove waste matter from the body

When you chew and swallow your food, it goes through your mouth down to your stomach. while in the stomach, the food is broken down for easy passage through the small intestine, which is about 20 feet long. The small intestine is also the longest part of the digestive system. This is where the food is further broken down, and most of the nutrients are also absorbed here, before the food is passed to the large intestine

The large intestine is a muscular tube which is located around the abdominal region. This wide muscular tube is about 5 feet long. One of the major function of the large intestine, is the absorption of nutrients, calcium, water, vitamins, potassium. The large intestine stores waste matter, which later moves to the final 6 inches of the gastrointestinal tract, before the waste is finally removed from the body

The colon can be divided into several sections, including the first part that goes upward (Ascending colon), The section that lies horizontally (Transverse colon), the next part moves downward (Downward colon), the next part is somewhat "s" shaped (Sigmoid colon), then the final part which is known as the rectum

Taking a closer look at the colon, you will observe its smooth walls, known as mucosa There are times people experience little growths on the mucosa, this growth is what is known as polyps. The presence of polyps, can sometimes be an early sign of cancer. Polyps are supposed to be surgically removed to avoid cancer spread

Colon cancer staging

This is one of the most important things to find out once an individual has been diagnosed with colon cancer. This is because it helps in determining the treatment option to use. Staging is also important for prognosis. Colon cancer begins from carcinoma In-Situ, where it almost looks like there is nothing present, i mean the cancer hasn't spread to the lymph nodes, down to stage 4, where the cancer has spread down to the liver, lung. lymph nodes, (and others)

There are many ways to stage colon cancer. Some people use TNM staging, others use Duke's staging. But knowing the depth of penetration of that cancer is often considered one of the best and accurate way of staging colon cancer

Stage (I)

This is the earliest stage of colon cancer. In stage one of colon cancer, the cancer have already spread from mucosa to sub mucosa, but hasn't penetrated through the complete thickness of the bowel wall. In other words, the cancer is still inside the rectum or the walls of the colon.

Surgery is often the first step in this stage. This involves surgically removing the tumor mass, part of the colon around the mass is also removed, and some connective tissues which connects the individuals colon to the blood vessels of his abdomen, were the lymph nodes are. They are then taken to a pathologist, who then conducts further examination do determine how far the tumor has really gone through the colon wall, or if the tumor has involved any lymph nodes just yet

Stage (II)

Stage 2 colon cancer is also known as Duke's B colon cancer, and can be further divided into two groups

Stage 2A - This stage is less advanced
Stage 2B - This stage is more advanced
In this stage the cancer has began to go spread through the colon wall. Treatment begins to get a little complicated here, but not too complicated. Just like in stage one, surgery is the first step in this stage. Chemotherapy follows after surgery for some patients whose colon cancer has gotten to this stage

Stage (III)

This stage is characterized by tumor in the lymph node, meaning the tumor have already started spreading to the individual's lymph nodes. Surgery is used here, but followed by chemotherapy. People often reject chemotherapy because of its side effects. Chemo drugs goes ahead to destroy all rapidly growing cells. The problem is, there are other cells in our bodies that grows rapidly, an example is the human hair. This explains why most people going through chemotherapy often experience hair loss.

Stage (IV)

A colon cancer is considered as stage 4 when it has metastasized to other regions of the body like lymph nodes, liver, lungs, etc. There is a whole variety of treatment in this stage of colon cancer, depending on how far the disease has spread. Surgery is often used in stage 4 colon cancer, where doctors removes the part of yor colon, liver, or lungs that has been affected

Signs and symptoms

The signs and symptoms of colorectal cancer is largely dependent on the location of the cancer. Its intensity and how advanced it is, are other factors that determines what signs and symptoms you'll observe. A single sign or symptom may not mean you have a cancer, as other illnesses share most of the signs and symptoms seen in colon cancer, which is why i always advise people to see a doctor if they observe anything funny about their health

There are also times when these symptoms don't show up until your cancer has advanced. Below are some signs and symptoms to look out for.

1. Digestive issues.

Most individuals diagnosed with colon cancer often looks back to realise they've been struggling with bathroom issues, but didn't pay much attention to it. It gets quite embarrassing to talk about sometimes, but the more you close your mouth, the more you are at risk of any diseases with that symptom. Some examples include Gas, constipation, chronic diarrhoea. Some say they noticed their bowels were not being completely emptied. Bowel conditions like colitis, irritable bowel syndrome, etc are also risk factors.

2. Weakness and fatigue

Most people confuse fatigue with easily being tired. People work, and can naturally get exhausted. When this exhaustion doesn't go away after the individual rests for a while, it could possibly could be fatigue. This fatigue could also be a symptom of diarrhoea, anaemia, or heart disease.

3. Cramps around the abdomen

There are so many noncancerous conditions whose symptoms could be cramps around the abdominal region, an example is hemmorhoid. This is why most individuals often see it as mild. If you feel an abdominal pain for a long time, it is best you check out the cause of that pain, it could be a colon cancer symptom. Colorectal cancer originates in the large intestine, and often affects bowels habits. The changes in bowel habits, can cause cramping, other times it could lead to bloating, and abdominal pain.

4. Rectal bleeding

This occurs when an individual begins to bleed in his lower colon (rectum). Rectal bleeding is a very common symptom in colorectal cancer. Sometimes, people experience a bright red colour on the toilet paper after some bowel movement. There are times when people also experience a red or pink water in their toilet bowl. These are indications of rectal bleeding

Most times, when people discover these symptoms, they often think it to be hemmarrhoid, leading to them not checking for colon cancer, until it has metastasized. If you experience any bleeding from your rectum, see a doctor at once

5. Tenesnus

This is a case where an individual often feels a need to pass out stool, but nothing ends up coming out at the end

Here are the causes and risk factors of colon cancer

Just like many other cancers, colon cancer doesn't have an underlined cause. But there are some risk factors that often points towards this issue

There are some non modifiable risk factors in colon cancer, one of which is age. You are at a higher risk of developing this illness if you are around the age of 50. This is why it is often advised to see a doctor around that age, who will then perform a colonoscopy which is one of the best/accurate method in determining the presence of colon cancer

Family history is another major risk factor. If you have a first degree relative, which could be a parent, a sister, brother or even a child, who has had cancer below age 45, then your risk is higher. Also watch the amount of red processed meat you consume. Obesity is another risk factor, excessive alcohol consumption and cigarette smoking are also risk factors

Here is how you can prevent colon cancer

Below are some very common sense tips to reduce your risk of developing a colon cancer.

One of the best preventive measures is to consciously watch what you eat. Consume less red and processed meat. Citrus fruits like oranges and lemons are very good for you, consume foods rich in vitamin B, like green vegetables. You also have to minimize your alcohol consumption, excess weight isn't good for you. For those that have already detected a growth or polyps, do well to stick to a diet low in fat, and see a doctor

Most adults over 50, might already have polyps in their colon. This is why an early checkup is advised. Polyps aren't cancer, but if left unattended to for a long time, might develop into a cancer. Cigarettes aren't only tied to lung cancer, they also put you at risk of developing a colon cancer. If you have already been diagnosed of colon cancer and you still smoke, you should stop immediately, because is extremely bad for your health, and it is never too late to stop the habit

Colon cancer diagnosis

In colonoscopy, the tissue is visualized and a biopsy is taken. Amongst all the available colon cancer diagnosis methods, colonoscopy is considered to be one of the most important and accurate test to have. There are countries like The United States of America where colonoscopy is already paid for by insurance. Once you are fifty, endeavour to see your doctor not just for colorectal cancer check up but for early detection of any other possible appearances

This revolutionized the ability of doctors to detect polyps and other early signs of colon cancer, thereby greatly cutting down the amount of people who would have developed a late stage colon cancer. Prior to passing that bill, the main issue was the cost of having a colonoscopy

CT colonoscopy is often used for individuals who for one reason or another cannot undergo a colonoscopy, they fall back to a CT colonography. This is used for tumor diagnosis. During a CT scan, the colon is inflated with carbon dioxide, and a 2D or 3D image is collected. CT scans are often needed for cancer staging, patients needs to go through a CT scan to access the level of invasion and possible metastasis

Magnetic resonance imaging is another screening method for colorectal cancer. This helps identifies the risk of colon cancer recurrence. It also makes room for better surgical plans in order to prevent recurrence. In certain cases were magnetic resonance imaging cannot be performed, transanal u/s is often conducted

How is colon cancer treated

There are some factors that determines the treatment pattern to use in colon cancer. Some of these factors includes staging and the tumor's genetic characteristics.

There is hardly a one size fits all in recent cancer therapies. This is because doctors now see each person differently, understanding that cancer behaviour varies in different individuals. For example, some treatment strategy will end up giving some people a wonderful outcome, there are others where that same treatment will turn out a mediocre outcome, and some will see no benefit whatsoever.

The same treatment, three different outcomes. Doctors now use molecular analysis to determine the treatment that will be best for that particular person. Knowing from the history of that kind of tumor, that the patient will respond to either chemotherapy, radiation, surgery or any other available treatment (could be a combination of two. e.g surgery and radiation). Understanding the difference in a particular person's tumor from that of others, makes treatment quite specific, and accurate.

Surgery is often performed especially in early stages to remove the tumor with a clear margin, especially when there isn't a case of metastasis

To shrink the tumor before surgery, radiotherapy is needed, it is also needed to reduce the chances of colon cancer recurrence after treatment. There are also times when a patient isnt fit for surgery, in that case, radiotherapy is often used

Chemotherapy can also be used to shrink the tumor before surgery, and after surgery to reduce the risk of recurrence. Chemotherapy is also used in cases where the cancer has metastasized. Note also that this isn't curative.

Targeted therapy is a recent approach in cancer therapy. It involves tailoring a specific treatment for a particular person. Making treatment plans that is peculiar to a person's tumor. These drugs inhibit angiogenesis, which is the ability for tumors to grow their own blood supply. These drugs goes ahead to inhibit vascular growth factors. They also inhibit epidermal growth factor receptor (EGFR)

Conclusion

In conclusion, it is very important to meet with your doctor on a regular basis, and make sure you have an open discussion with him or her, the more he knows about what you feel, the better he can help you. Colon cancer risk factors includes age, family history, smoking, drinking, obesity, red meat (and others). Like I always say, the best therapy for any form of cancer is prevention, which is always cheaper and better than cure. If every country can provide an insurance which covers colon cancer diagnosis like some countries are already doing, then we will by far decrease the number of individuals developing late stage colorectal cancer

Reference

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[1] Colorectal cancer symptoms and causes

[2] Medicine.net

[3] Wikipedia.org

[4] Cancer.gov

[5] What is colorectal cancer

[6] Cancer.net

[7] Colon cancer overview

[8] Colon cancer screening

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