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Colon Cancer

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A diagnosis of colorectol cancer can be quite overwhelming. Dr. Perez is here ot help his patients sort through the colorectoal cancer treatment options and work with their entire healthcare team to help manage their care.  

colon cancer symptoms

WHAT IS COLORECTAL CANCER

Colorectal cancer is cancer that starts in either the colon or the rectum. Most colorectal cancers develop slowly over several years and start as a polyp in the inner lining of the colon or rectum. Only certain types of polyps (called adenomas) can become cancer. Other types of polyps – hyperplastic polyps and inflammatory polyps – are generally not pre-cancerous. Some doctors believe hyperplastic polyps can become pre-cancerous or might be a sign of having a greater risk of developing adenomas and cancer.

Dysplasia is another pre-cancerous condition of the GI tract. Dysplasia occurs is an area in the lining of the colon or rectum where abnormal cells develop. While not initially cancerous, these cells can change into cancer over time. Dysplasia is usually seen in people with chronic inflammatory conditions like ulcerative colitis and Crohn's disease. 

Cancer screening has been very effective in finding these non-cancerous polyps early, enabling surgeons to remove them before they can become cancerous.

Types of colorectal cancer:

Adenocarcinomas: Nearly everyone with colorectal caner (95%) has a type of tumor called  adenocarcinoma. These cancers start in cells that form glands that make mucus to lubricate the inside of the colon and rectum. 

Of the remaining 5% of colon cancers there are:
Carcinoid tumors: Tumors that start in the intestine in hormone-producing cells.

Gastrointestinal stromal tumors (GISTs): Tumors that start in the wall of the colon in interstitial cells of Cajal. Some are non-cancerous, but other can be cancerous.

Lymphomas: These are cancers of immune system cells that typically start in lymph nodes, but they may also start in the colon, rectum, or other organs.

Sarcomas: These tumors can start in blood vessels as well as in muscle and connective tissue in the wall of the colon and rectum. 

2017 Colorecatal Cancer Projections

CAUSES & RISK FACTORS FOR COLORECTAL CANCER

The causes of colorectal cancer are the subject of a great deal of study and research. These cancerous cells are caused by DNA mutations which can be inherited or acquired. Acquired gene mutations are more common adnd are related to risk factors.

UNCONTROLLABLE RISK FACTORS:

  • Your risk gets higher as you get older
  • A history of having polyps
  • A history of ulcerative colitis or Crohn's disease
  • Family history of colorectal cancer
  • Being African American or Ashkenazi
  • Having Type 2 diabetes
  • Having familial adenomatous polyposis or hereditary non-polyposis colon cancer (also called Lynch syndrome)

CONTROLLABLE RISK FACTORS:

  • A diet high in red meats (beef, lamb, or liver) and processed meats (like hot dogs, bologna, and lunch meat) 
  • Cooking meats at very high heat (frying, broiling, or grilling)
  • Lack of exercise
  • Being very overweight (or obese)
  • Smoking
  • Heavy alcohol use

PREVENTION OF COLON CANCER

How to Fight Colorectal Cancer

There are some lifestyle changes individuals can make in order to reduce their risk of developing colorectal cancer. 

  • Increase the intensity and amount of physical activity
  • Limit intake of red and processed meats
  • Get the recommended levels of calcium and vitamin D
  • Eat more vegetables and fruits
  • Avoid obesity and weight gain around the midsection
  • Avoid too much alcohol (2 drinks a day for men, one drink a day for women)

Screening tests

Regular colorectal cancer screening is one of the best ways to help prevent colorectal cancer. Colon cancer takes 10 to 15 years to develop from polyps into colorectal cancer. Polyps can be removed before they have the chance to turn into cancer. Screening can also help find colorectal cancer early, when it is small and more likely to be cured.

  • If you have no known risk factors, begin screening at age 50
  • Those with risk factors should talk with their doctor about starting screening at a younger age or getting screened more often

SYMPTOMS OF COLORECTAL CANCER

Many of the symptoms of colorectal cancer can be caused by other conditions, so it is vitally important to see a doctor if you have any of these symptoms and have your condition properly diagnoses. 

  • Diarrhea, constipation, or narrowing of the stool that lasts for more than a few days
  • A feeling that you need to have a bowel movement that is not relieved after having one
  • Rectal bleeding
  • Blood in the stool 
  • Cramping or abdominalpain
  • Weakness and fatigue
  • Unintended weight loss
  • Colorectal cancers can bleed and lead to low red blood cell counts (anemia). Sometimes the first sign of colorectal cancer is a blood test showing a low red blood cell count.

DIAGNOSING COLORECTAL CANCER

Colorectal cancer can be found after symptoms appear, but often there are no symptoms. Screening is very effective for this type of cancer because it can identify polyps before they become cancer and cancer when it is most treatable. Screening is done using several types of tests.

 Type of tests:

  • Fecal occult blood test and fecal immunochemical test: Samples of stool (feces) are checked for blood, which might be a sign of a polyp or cancer (mostly to find cancer)
  • The following tests find both cancer and polyps:(1)Sigmoidoscopyxible, lighted tube is put into the rectum and lower colon to check for polyps and cancer(2)Colonoscopy: A long flexible tube is used to look at the entire colon and rectum
  • Double contrast barium enemas is an x-ray test of the colon and rectum
  • CT colonographyis is a type of CT scan of the colon and rectum
Colorectal Cancer 5-Year Survival Rates
Stage I 92%
Stage IIA 87%
Stage IIB 63%
Stage IIIA 89%
Stage IIIB 69%
Stage IIIC 53%
Stage IV 11%

TREATMENT

There are four main types of treatment for colorectal cancer.

Surgery

Surgery is the main treatment used for colon cancer.
Polypectomy – Some early colon cancers (stage 0 and some early stage I tumors) or polyps can be removed by surgery through a colonoscope. This minimally invasive procedure does not require cutting into the abdomen.  

Colectomy – Surgery to remove all or part of the colon. Nearby lymph nodes are removed as well.

Diverting colostomy – When a tumor blocks the colon, sometimes surgery is done to relieve the blockage without removing the part of the colon containing the cancer. 

Ablation & Embolization

Ablation refers to treatments that destroy tumors without removing them. These are most often used to treat cancer spread in the liver, but can be used to treat tumors in other places. Ablation can be done use high-energy radio waves, alcohol injections, or by freezing with cryosurgery. Embolization injects substances to try to block or reduce the blood flow to cancer cells in the liver when colon cancer has metastasized there.

Radiation therapy

Radiation therapy uses high-energy rays (such as x-rays) to destroy cancer cells. Radiation therapy may be used when the cancer has attached to an internal organ or spread to the bones or brain. It is used after surgery to help eliminate any remaining cancer cells that were not removed and help prevent the cancer from returning. It can also be used before surgery to help make removal of the cancer easier or to alleviate pain in cases where surgery is not an an option.

Chemotherapy

Chemotherapy is treatment with powerful anti-cancer drugs. Chemotherapy can be administered by injection or taken orally. When taken this way, the chemo is spread throughout the body. With regional chemotherapy, the drugs are injected directly into an artery leading to the part of the body containing the tumor. Chemo can be administered before surgery to shrink the tumor or after surgery to help keep cancer from coming back. 

Targeted therapies

A class of these therapies are drugs that target vascular endothelial growth factor (VEGF), a protein that helps tumors form new blood vessels. The drugs are administered intravenously every 2 or 3 weeks. When combined with chemo, these drugs can help patients with advanced colon or rectal cancers live longer.

Whether you are newly diagnosed, supporting a loved one battling colorectal cancer, or seeking a second opinion about treatment for colorectal cancer, Dr. Jorge Perez is here for you. Make an appointment at one of our four northern Nevada/Lake Tahoe area clinics.   

Sources: http://www.cancer.org/