Recognizing Important Signs of Colon Cancer
Understanding Colon Cancer:
Colon cancer, also known as colorectal cancer, originates in the large intestine (colon) and is responsible for transporting digested food to the rectum and out of the body.
Impact of Colon Cancer:
The development of colon cancer begins with the formation of polyps or abnormal growths in the inner lining of the colon. Healthcare professionals employ screening tests to detect precancerous polyps before they evolve into cancerous tumors. Failure to detect or treat colon cancer can lead to its spread to other areas of the body. Fortunately, early detection, timely treatment, and advancements in therapy have significantly reduced mortality rates associated with colon cancer.
How Colon Cancer Affects Individuals:
The colon wall consists of mucous membrane, tissue, and muscle layers. Colon cancer originates from the mucosa, which comprises cells responsible for producing and releasing mucus and other fluids. Any mutation or alteration in these cells may result in the formation of colon polyps.
Over time, these polyps can progress to cancerous stages. However, it generally takes approximately 10 years for a polyp to develop into cancer. If left undetected or untreated, cancer cells penetrate the layers of tissue, muscle, and the outer lining of the colon, and may also metastasize to other parts of the body through lymph nodes or blood vessels.
Affected Population:
Colon cancer ranks as the third most commonly diagnosed cancer in the United States. The disease affects men and individuals assigned male at birth (AMAB) slightly more often than women and individuals assigned female at birth (AFAB). Additionally, it disproportionately affects Black individuals compared to other ethnic groups or races.
Typically, colon cancer occurs in individuals aged 50 and above. However, over the past 15 years, there has been a gradual increase in the number of individuals aged 20 to 49 diagnosed with colon cancer. The reasons behind this trend remain unclear to medical researchers.
Recognizing Colon Cancer Symptoms:
It is possible to have colon cancer without experiencing any symptoms. When symptoms do arise, individuals may find it challenging to determine whether the changes in their bodies are indicative of colon cancer. This is because some colon cancer symptoms resemble those of less severe conditions. Common symptoms of colon cancer include:
Presence of blood in or on the stool: If blood is visible in the toilet bowl or on toilet paper after bowel movements, or if the stool appears dark or bright red, it is crucial to consult a healthcare professional. It is important to note that the presence of blood in the stool does not necessarily indicate colon cancer, as other factors like hemorrhoids, anal tears, or dietary choices can affect stool appearance. However, it is always advisable to seek medical advice when blood is observed.
Persistent changes in bowel habits: Consult a healthcare professional if you experience persistent constipation and/or diarrhea or feel the need to have a bowel movement even after using the bathroom.
Abdominal pain: Seek medical attention if you have unexplained and ongoing abdominal pain that persists or intensifies. Although many factors can cause abdominal pain, it is advisable to consult a healthcare professional regarding unusual or frequent discomfort.
Abdominal bloating: Similar to abdominal pain, bloating can be caused by various factors. If you experience bloating that lasts longer than a week, worsens over time, or is accompanied by additional symptoms such as vomiting or blood in or on the stool, it is essential to consult a healthcare professional.
Unexplained weight loss: Significant weight loss without intentional efforts can be a warning sign. If you notice a noticeable decrease in body weight without actively trying to lose weight, it is recommended to seek medical advice.
Vomiting: Consult a healthcare professional if you experience periodic vomiting without an apparent cause or if you experience frequent episodes of vomiting within a 24-hour period.
Fatigue and shortness of breath: These symptoms can be indicative of anemia, which may be associated with colon cancer.Determining the Causes of Colon Cancer:
Similar to other cancer types, colon cancer occurs when cells experience uncontrolled growth and division. In a healthy body, cells grow, divide, and eventually die in a regulated manner. However, in colon cancer, cells lining the colon and rectum continue to grow and divide, disregarding the natural process of cell death. The origin of these cancerous cells can be traced back to polyps in the colon.
Medical researchers have yet to fully understand why some individuals develop precancerous polyps that eventually progress into colon cancer. However, certain risk factors increase the likelihood of developing polyps and colon cancer.
Risk Factors Associated with Colon Cancer:
Several medical conditions and lifestyle choices influence an individual’s risk of developing colon cancer. However, having one or more risk factors does not guarantee the development of the condition; it merely indicates an increased susceptibility. Understanding these risk factors can help individuals determine whether they should consult a healthcare professional to assess their risk of developing colorectal cancer.
Lifestyle Choices as Risk Factors:
Smoking: The use of tobacco products, including chewing tobacco and e-cigarettes, heightens the risk of colon cancer.
Excessive alcohol consumption: Men and AMAB individuals are advised to limit alcoholic beverage intake to two servings per day, while women and AFAB individuals should limit it to one serving per day. Even light alcohol consumption can increase the risk of developing cancer.
Obesity: A high-fat, high-calorie diet may contribute to weight gain and increase the risk of colon cancer.
Consumption of red and processed meat: Red meat and processed meat, such as bacon, sausage, and lunchmeat, should be limited to two servings per week according to healthcare professionals' recommendations.
Lack of physical activity: Engaging in any form of physical activity can reduce the risk of colon cancer.Medical Conditions that Increase the Risk of Colon Cancer:
Inflammatory bowel disease: Individuals with chronic ulcerative colitis and Crohn's colitis, which cause inflammation in the colon lining, have an elevated risk of developing colon cancer. The risk further increases if the inflammatory bowel disease persists for over seven years and affects a significant portion of the colon.
Inherited conditions: Certain inherited conditions, such as Lynch syndrome and familial adenomatous polyposis, can raise the risk of developing colon cancer. Inherited genetic mutations can predispose individuals to cancer.
Family history of colon and other cancers: Having a close family member with colon cancer increases the risk of developing the condition. Close family members include biological parents, siblings, and children. The risk is higher if a biological family member developed colon cancer before the age of 45.
Family history of polyps: If a parent, sibling, or child has advanced polyps, the risk of developing colon cancer is increased. Advanced polyps refer to large polyps that exhibit specific changes under microscopic examination, indicating the presence of potentially cancerous cells.
Multiple polyps: Individuals with a large number of colon polyps, including adenomas, serrated polyps, or other types, are at an increased risk of developing polyps and colon cancer. In some cases, a predisposition to developing numerous colon polyps can be inherited.Diagnosis and Testing:
How is colon cancer diagnosed?
Healthcare providers employ various tests to diagnose colon cancer, including:
Complete blood count (CBC): This test assesses the number and characteristics of blood cells.
Comprehensive metabolic panel (CMP): This test measures various substances and electrolytes in the blood, providing insight into organ function.
Carcinoembryonic antigen (CEA) assay: CEA is a protein released by cancer cells and normal cells. Elevated CEA levels can indicate the presence of colon cancer.
X-rays: These imaging studies provide a basic evaluation of the colon.
Computed tomography (CT) scan: CT scans utilize X-rays and computer technology to generate detailed images of the colon.
Magnetic resonance imaging (MRI) scan: MRIs employ magnetic fields and radio waves to produce detailed images of the colon.
Positron emission tomography (PET) scan: PET scans use a radioactive tracer to detect areas of abnormal cell activity in the body.
Ultrasound: This imaging technique uses sound waves to visualize the colon.
Biopsy: Tissue samples from the colon are examined under a microscope to confirm the presence of cancer cells.Distinguishing Screening Tests from Diagnostic Tests:
Screening tests aim to detect cancer in individuals without any signs or symptoms. If abnormalities are detected during screening, additional tests may be recommended by healthcare providers.
Common Colon Cancer Screening Tests:
Colonoscopy is the most prevalent screening test for colon cancer. Other screening methods include:
Fecal immunochemical test (FIT): This test detects hidden blood in the stool by analyzing samples for blood not visible to the naked eye.
Guaiac-based fecal occult blood test (gFOBT): Similar to FIT, this test detects non-visible blood in the stool.
Fecal DNA test: This test examines the stool for genetic mutations and blood components.
Flexible sigmoidoscopy: During this procedure, a flexible scope called a sigmoidoscope is used to examine the lower colon and rectum.
Virtual colonoscopy: A virtual colonoscopy employs X-ray technology to identify polyps, tumors, and ulcers in the colon and rectum.Staging Colon Cancer:
Healthcare providers utilize the TNM cancer staging system developed by the American Joint Committee on Cancer to determine the stage of colon cancer. The staging system consists of five stages, with three sub-stages for stages II and III. The stages include:
Stage 0: Also known as carcinoma in situ, this stage refers to the presence of abnormal or precancerous cells in the innermost lining of the colon wall (mucosa).
Stage I: In stage I colorectal cancer, the tumor has infiltrated the wall of the intestine but has not spread beyond the muscular layer or nearby lymph nodes.
Stage II: At this stage, the cancer has advanced further into the intestinal wall but has not affected nearby lymph nodes. Stage II colon cancer comprises three sub-stages:
Stage IIA: The cancer has spread throughout most of the colon wall but has not reached the outer layer.
Stage IIB: The cancer has infiltrated the outer layer of the colon wall or penetrated through it.
Stage IIC: The cancer has extended to an adjacent organ.
Stage III: Stage III colon cancer involves the spread of cancer cells to the lymph nodes. Like stage II, stage III colon cancer comprises three sub-stages:
Stage IIIA: Cancer is present in the first or second layers of the colon wall and has spread to one to four lymph nodes.
Stage IIIB: The cancer affects more layers of the colon wall but involves only one to three lymph nodes. However, if the cancer affects fewer layers of the colon wall and spreads to four or more lymph nodes, it is also categorized as stage IIIB colon cancer.
Stage IIIC: Cancer is present in the outer or next outermost layer of the colon and involves four or more lymph nodes. Stage IIIC colon cancer also encompasses cases where cancer has spread to an adjacent organ along with one or more lymph nodes.
Stage IV: At this stage, cancer has metastasized to other areas of the body, such as the liver, lungs, or ovaries. Stage IV colon cancer consists of three sub-stages:
Stage IVA: Cancer has spread to either one organ or lymph nodes located further away from the colon.
Stage IVB: The cancer has spread to multiple distant organs and lymph nodes.
Stage IVC: Cancer affects distant organs, lymph nodes, and abdominal tissue.Management and Treatment:
Surgery is the primary treatment for colon cancer and can involve various procedures:
Polypectomy: This surgical procedure involves the removal of cancerous polyps.
Partial colectomy: Also known as colon resection surgery, this procedure entails removing the colon section containing the tumor, along with some adjacent healthy tissue. Subsequently, the healthy sections of the colon are reconnected in a process called anastomosis.
Surgical resection with colostomy: Similar to a colectomy, this surgery entails removing the colon section with the tumor. However, if it is not feasible to reconnect healthy colon sections, a colostomy is performed. During a colostomy, the bowel is redirected to an opening in the abdominal wall, allowing the collection of stool in a bag.
Radiofrequency ablation: This procedure employs heat to eliminate cancer cells.In some cases, healthcare providers may combine surgery with adjuvant therapy, which involves administering treatment before or after surgery. Additionally, adjuvant therapy may be used for colon cancer that has metastasized or recurred. Common treatment options include:
Chemotherapy: Healthcare providers may employ chemotherapy drugs to shrink tumors and alleviate colon cancer symptoms.
Targeted therapy: This form of treatment focuses on genes, proteins, and tissues that facilitate the growth and multiplication of colon cancer cells. Monoclonal antibody therapy is a frequently used type of targeted therapy. It employs lab-created antibodies that bind to specific targets on cancer cells or supporting cells, effectively eliminating cancer cells.Prevention:
Can colon cancer be prevented?
While it may not be possible to completely prevent colon cancer, individuals can adopt measures to reduce their risk of developing the condition:
Avoid tobacco: If you are a smoker and desire to quit, consult a healthcare professional regarding smoking cessation programs.
Limit alcohol consumption: Moderate alcohol consumption is advised. Men and AMAB individuals should limit their alcoholic beverage intake to two servings per day, while women and AFAB individuals should limit it to one serving per day. Even light alcohol use can increase the risk of developing cancer.
Maintain a healthy weight: A balanced diet and regular physical activity are key to weight management and reducing the risk of colon cancer.
Healthy dietary choices: Incorporating fruits and vegetables into your diet while minimizing the consumption of red and processed meats, high-fat foods, and calorie-dense foods can help reduce the risk of colon cancer. Drinking coffee may also contribute to a lower risk.
Monitor family medical history: If there is a history of colon cancer or advanced polyps in your biological parents, siblings, or children, inform your healthcare professional. Additionally, share any instances of cancer occurring before the age of 45 within your family.
Adhere to colon cancer screening guidelines: Consult your healthcare professional to determine when you should undergo colon cancer screening. Individuals with chronic inflammatory bowel disease or a family history of colon cancer may require earlier screening.Outlook and Prognosis:
Can colon cancer be cured?
According to data from the U.S. National Cancer Institute (NCI), over 90% of individuals treated for early-stage colorectal cancer survive at least five years after diagnosis. It is important to note that NCI data does not differentiate between colon and rectal cancer in terms of survival rates.
Survival rates for colon cancer vary based on the stage at diagnosis. Overall, the five-year survival rate for colorectal cancer stands at 65% according to NCI data. However, specific survival rates are dependent on various factors, including the stage of cancer. For instance, individuals with colorectal cancer that has spread to nearby tissues, organs, or lymph nodes have a five-year survival rate of 73%. In contrast, if the cancer has metastasized to distant organs or lymph nodes, the five-year survival rate drops to 17%.
It is important to recognize that survival rates are estimates derived from the experiences of large groups of individuals with colorectal cancer, encompassing both colon and rectal cancer. Numerous factors can influence an individual’s prognosis, and healthcare professionals are the best source of information regarding an individual’s specific case.
Living with Colon Cancer:
If diagnosed with colon cancer, individuals should prioritize self-care. However, the management and care requirements may vary depending on the stage and progression of the cancer. Individuals treated for early-stage colon cancer may achieve remission, while those with advanced colon cancer may require treatment to alleviate symptoms, as a complete cure may not be possible. Palliative care can be beneficial in managing symptoms and treatment side effects.
Regular follow-up care is essential for individuals at different stages of colon cancer. Depending on the stage, follow-up colonoscopies, blood tests, and imaging studies may be necessary to monitor the condition. It is crucial to promptly contact healthcare professionals in case of any changes or signs that may indicate cancer recurrence or progression.
In emergency situations, individuals undergoing colon cancer treatment should seek immediate medical attention if they experience severe side effects, a high fever, persistent chills, severe abdominal pain, or persistent diarrhea leading to dehydration.
Questions for Healthcare Providers:
When diagnosed with colon cancer, it is natural to have questions about the condition and treatment. Some questions to consider asking your healthcare provider include:
What type of colon cancer do I have?
Is this type of colon cancer curable?
What is the stage of the cancer?
What are the most effective treatments for colon cancer?
If surgery is required, what type of procedure do you recommend?
Will a colostomy be necessary?
Are there additional treatments besides surgery that I may need?
What are the potential side effects of these treatments?
Is participation in a clinical trial an option for me?
What is the likelihood of cancer recurrence?
If a cure is not possible, can the spread of cancer be controlled?
Should I consider palliative care?Advancements in colon cancer screening and treatment have led to improved outcomes, as more cases are detected and treated at early stages. The survival rates for early-stage colon cancer indicate favorable prognosis, and newer therapies offer promising options. For personalized information and treatment recommendations, it is advisable to consult healthcare professionals.
