Colon & Rectal Cancer
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"Colon & Rectal cancer is Preventable, Detectable & Curable

About two thirds of all colorectal tumours develop in the colon and the remainder in the rectum. Most tumours are adenocarcinomas which evolve from polyps, which may be present for ten years or more before malignancy develops.

Colon cancer is cancer of the large intestine (colon), the lower part of digestive system. Rectal cancer is cancer of the last few  inches of the colon. Together, they are  referred to as colorectal cancers.
Most cases of colon cancer begin as small, noncancerous (benign) lumps  called adenomatous polyps. Over time some of these polyps become colon cancers.
Polyps may be small and produce few, if any, symptoms. For this reason,it is  recommended to undergo regular screening tests to help prevent colon cancer by identifying polyps before they become colon cancer.
Signs and symptoms of colon cancer include:

  • A change in  bowel habits, including diarrhea or constipation or a change in the consistency of your stool
  • Blood in stool
  • Persistent abdominal discomfort, such as cramps, gas or pain
  • A feeling that  bowel doesn't empty completely
  • Weakness or fatigue
  • Unexplained weight loss

Many people with colon cancer experience no symptoms in the early stages of the disease. When symptoms appear, they'll likely vary, depending on the cancer's size and location in your large intestine.

Precancerous growths in the colon
Colon cancer most often begins as lumps of precancerous cells (polyps) on the inside lining of the colon. Polyps can appear mushroom-shaped, or they can be flat or recessed into the wall of the colon. Removing polyps before they become cancerous can prevent colon cancer.

Factors that may increase your risk of colon cancer include:

  • Older age. The great majority of people diagnosed with colon cancer are older than 50. Colon cancer can occur in younger people, but it occurs much less frequently.
  • African-American race. African-Americans have a greater risk of colon cancer than do people of other races.
  • A personal history of colorectal cancer or polyps. If you've already had colon cancer or adenomatous polyps, you have a greater risk of colon cancer in the future.
  • Inflammatory intestinal conditions. Chronic inflammatory diseases of the colon, such as ulcerative colitis and Crohn's disease, can increase your risk of colon cancer.
  • Inherited syndromes that increase colon cancer risk. Genetic syndromes passed through generations of your family can increase your risk of colon cancer. These syndromes include familial adenomatous polyposis and hereditary nonpolyposis colorectal cancer, which is also known as Lynch syndrome.
  • Family history of colon cancer and colon polyps. It is more likely to develop colon cancer if you have a parent, sibling or child with the disease. If more than one family member has colon cancer or rectal cancer, your risk is even greater. In some cases, this connection may not be hereditary or genetic. Instead, cancers within the same family may result from shared exposure to an environmental carcinogen or from diet or lifestyle factors.
  • Low-fiber, high-fat diet. Colon cancer and rectal cancer may be associated with a diet low in fiber and high in fat and calories. Research in this area has had mixed results. Some studies have found an increased risk of colon cancer in people who eat diets high in red meat.
  • A sedentary lifestyle. If you're inactive, you're more likely to develop colon cancer. Getting regular physical activity may reduce your risk of colon cancer.
  • Diabetes. People with diabetes and insulin resistance may have an increased risk of colon cancer.
  • Obesity. People who are obese have an increased risk of colon cancer and an increased risk of dying of colon cancer when compared with people considered normal weight.
  • Smoking. People who smoke cigarettes may have an increased risk of colon cancer.
  • Alcohol. Heavy use of alcohol may increase your risk of colon cancer.
  • Radiation therapy for cancer. Radiation therapy directed at the abdomen to treat previous cancers may increase the risk of colon cancer.

Diagnosing colon cancer 

  • Using a scope to examine the inside of your colon. Colonoscopy uses a long, flexible and slender tube attached to a video camera and monitor to view your entire colon and rectum. If any suspicious areas are found,biopsy is taken and sent for analysis.
  • Using multiple CT images to create a picture of your colon. CT colonography, also called virtual colonoscopy, combines multiple CT scan images to create a detailed picture of the inside of colon.

Staging colon cancer 
Once it is diagnosed with colon cancer, it is necesary to determine the extent (stage) of  cancer. Staging helps determine what treatments are most appropriate.
Staging tests may include imaging procedures such as abdominal and chest CT scans. In many cases, the stage of cancer may not be determined until after colon cancer surgery.
The stages of colon cancer are:

  • Stage I. Cancer has grown through the superficial lining (mucosa) of the colon or rectum but hasn't spread beyond the colon wall or rectum.
  • Stage II. Cancer has grown into or through the wall of the colon or rectum but hasn't spread to nearby lymph nodes.
  • Stage III. Cancer has invaded nearby lymph nodes but isn't affecting other parts of body yet.
  • Stage IV. Cancer has spread to distant sites, such as other organs — for instance to  liver or lung.
  • The type of treatment  depends on the stage of cancer. The three primary treatment options are: surgery, chemotherapy and radiation


May be performed either to attempt cure (removing the draining lymphatic field) or to relieve symptoms:

  • One of the most important advances for surgery of rectal cancer has been the concept of total mesorectal excision, which reduces local recurrences and perioperative morbidity.
  • Right hemicolectomy: for tumours in the caecum, ascending and proximal transverse colon.
  • Left hemicolectomy: if in the distal transverse colon or descending colon.
  • Sigmoid colectomy: for tumours of the sigmoid colon.
  • Anterior resection: if in the low sigmoid or high rectum. Anastomosis is achieved at the first operation.
  • Abdomino-perineal (AP) resection: for tumours low in the rectum (less than approximately 8 cm from the anal canal). Permanent colostomy and removal of rectum and anus.
  • Laparoscopic surgery (including laparoscopically assisted surgery) may be considered as an alternative to open surgery for some people with colorectal cancer.
Partial colectomy to remove the part of colon that contains the cancer, along with a margin of normal tissue on either side of the cancer. Nearby lymph nodes are usually also removed and tested for cancer.

Healthy portions of  colon or rectum are reconnected. But when that's not possible, for instance if the cancer is at the outlet of  rectum, one may need to have a permanent or temporary colostomy. This involves creating an opening in the wall of  abdomen from a portion of the remaining bowel for the elimination of body waste into a special bag. Sometimes the colostomy is only temporary, allowing  colon or rectum time to heal after surgery. In some cases, however, the colostomy may be permanent.

Surgery for advanced cancer

If cancer is very advanced or overall health very poor, it may recommended  to relieve a blockage of  colon or other conditions in order to improve symptoms. This surgery isn't done to cure cancer, but instead to relieve signs and symptoms, such as bleeding and pain.

In specific cases where the cancer has spread only to the liver and if  overall health is otherwise good, it may be possible to remove the cancerous lesion from liver. Chemotherapy may be used before or after this type of surgery. This treatment may improve your prognosis.


Chemotherapy uses drugs to destroy cancer cells. Chemotherapy for colon cancer is usually given after surgery if the cancer has spread to the lymph nodes. In this way, chemotherapy may help reduce the risk of cancer recurrence.

Chemotherapy can also be given to relieve symptoms of colon cancer that has spread to other areas of the body. Chemotherapy may be used before surgery to shrink the cancer before an operation. In people with rectal cancer, chemotherapy is typically used along with radiation therapy.

Radiation therapy

Radiation therapy uses powerful energy sources, such as X-rays, to kill cancer cells that might remain after surgery, to shrink large tumors before an operation so that they can be removed more easily, or to relieve symptoms of colon cancer and rectal cancer.

Radiation therapy is rarely used in early-stage colon cancer, but is a routine part of treating rectal cancer, especially if the cancer has penetrated through the wall of the rectum or traveled to nearby lymph nodes. Radiation therapy, usually combined with chemotherapy, may be used after surgery to reduce the risk that the cancer may recur in the area of the rectum where it began.

Targeted drug therapy

Drugs that target specific defects that allow cancer cells to grow are available to people with advanced colon cancer, including bevacizumab (Avastin), cetuximab (Erbitux), panitumumab (Vectibix) and regorafenib (Stivarga). Targeted drugs can be given along with chemotherapy or alone. Targeted drugs are typically reserved for people with advanced colon cancer.

Alternative medicine

No complementary or alternative treatments have been found to cure colon cancer.
Alternative treatments may help  cope with a diagnosis of colon cancer. Nearly all people with cancer experience some distress. Common signs and symptoms of distress after  diagnosis might include sadness, anger, difficulty concentrating, difficulty sleeping and loss of appetite. Alternative treatments may help redirect  thoughts, at least temporarily, to give some relief.
Alternative treatments that may help relieve distress include:

  • Exercise
  • Meditation
  • Music therapy
  • Relaxation exercises

A cancer diagnosis can be emotionally challenging. In time, each person learns to cope in his or her own way.
Know what to expect. Learn enough about  cancer to feel comfortable making treatment decisions.

  • Keep friends and family close. Keeping  close relationships help  deal with cancer. Friends and family can provide the practical support one needs, such as helping take care of  house if one in the hospital. And they can serve as emotional support when one feels overwhelmed by cancer.
  • Find someone to talk with. Find a good listener who is willing to listen to. This may be a friend or family member. The concern and understanding of a counselor, medical social worker, clergy member or cancer support group also may be helpful.


Get screened for colon cancer 
People with an average risk of colon cancer can consider screening beginning at age 50. But people with an increased risk, such as those with a family history of colon cancer, should consider screening sooner. African-Americans and American Indians may consider beginning colon cancer screening at age 45.
Make lifestyle changes to reduce your risk 
One can take steps to reduce your risk of colon cancer by making changes in  everyday life. Take steps to:

  • Eat a variety of fruits, vegetables and whole grains. Fruits, vegetables and whole grains contain vitamins, minerals, fiber and antioxidants, which may play a role in cancer prevention.
  • Drink alcohol in moderation, if at all. 
  •  Stop smoking
  • Exercise most days of the week. Try to get at least 30 minutes of exercise on most days.
  • Maintain a healthy weight
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