Colon Cancer or Colorectal Cancer
Early detection and treatment gives best outcomes

What is colon cancer?

Colon, or large intestine, is the final portion of digestive tract in the human body. Cancers affecting this part of the body are known as colon cancers. Alternatively, they are also termed as large bowel cancer or cancer of large intestine. Any part of the colon can get affected by cancer and is called as –

• Colon cancer, cancer affecting the colon.
• Rectal cancer, cancer affecting the rectum, lower part of the colon that connects with the anus.
• Colorectal cancer, cancer affecting both the colon and the rectum.

What are the causes of colon cancer?

The reason why colon cancers occur is not known completely. Sometimes, healthy cells in the colon continue to divide due to a DNA error, even when new cells are not needed. Generally, colon cancer begins as a small collection of cells called polyps. Initially, these polyps may not be cancerous (benign). Later, these polyps can develop into colon cancers.

What are the symptoms or warning signs of colon cancer?

In early stages, colon cancer may not cause any symptoms. Also, symptoms of colon cancer vary depending on the location and size of the cancerous polyps. Some early warning signs and symptoms of colon cancer in both, men and women are:

• A noticeable change in bowel habits, (constipation or diarrhoea) for more than four weeks with or without changes in stool consistency (hard or watery stools)
• Any kind of bleeding from the rectum (anus), or blood-stained stools
• Persistent discomfort in the abdomen and symptoms like gas, cramps, or pain
• Persistent feeling of incomplete emptying of bowels
• Fatigue or weakness
• Unexplained weight loss

Who is more prone to colon cancer?

Some factors that may increase the risk of colon cancer include:

• Older age (>50 years)
• Previous history of colorectal cancer or polyps
• Family history of colon cancer
• Inflammation of the intestines (such as ulcerative colitis and Crohn’s disease)
• Inheritance of certain conditions of polyps and colorectal cancer
• Lifestyle-related risk factors: low-fibre, high-fat diet, sedentary lifestyle, obesity, smoking and alcohol abuse
• Diabetes and insulin resistance
• Exposure to radiation therapy for cancer

What are the four stages of colon cancer?

Like other cancers, colon cancer progresses through 4 stages. Sooner the diagnosis, better is the treatment approach and faster is the recovery.

Based on the tumor location, involvement in the lymph nodes and spreading, TNM (tumor, node, metastasis) staging of tumor is performed. By staging the colon cancer, your doctor gets a better idea as to –

• Where the tumor is located exactly?
• Is the tumor spreading (also called as tumor metastases), if so, spread to lymph nodes?
• What is the prognosis for the patient – chances of complete recovery and survival?

Next, the doctor combines the TNM report and stages colon cancer either as –

Stage 0 – Cancer at this stage is still at the origin of DNA error or polyp, usually, in the inner surface of the colon. They can safely be treated by removing the causative polyp. Colon polyps are just an outgrowth that is not cancerous yet.

Stage 1 – Here, the cancer has invaded into the muscular portion of colon or rectum. However, the cancer is still benign. Doctors suggest removal of tumor and nearby lymph nodes.

Stage 2 – Stage 2 colon cancer has grown through outer wall of the colon and is slowly spreading into the muscle lining of the abdomen and nearby tissues. However, the cancer has not touched the lymph nodes yet. The treatment usually involves surgery and adjuvant chemotherapy (treatment after surgery aimed at trying to destroy any remaining cancer cells with or without radiation therapy).

Stage 3 – Stage 3A colon cancer marks the spread of cancer into the lymph nodes, the gateway to move into different parts of the body. Through stage 3B and 3C, the cancer progressively spreads through more number of lymph nodes and invades the nearby organs and bowel wall but not far away organs. Treatment options are similar to that of stage 2.

Stage 4 – At this stage, cancer has spread to at least one distant part of the body – such as liver, lungs. The last stage 4B marks the spread of cancer into more than one part of the body.

What is colon cancer survival rate?

Once a person is diagnosed with colon cancer, the immediate question that comes to mind is, “what are my chances of survival?”

Survival rate is an estimate that can guide you if you can live through a few years. The percentage of survival rates indicate how many people have lived at least so far after diagnosis. For example, a 5-year survival rate of 90% indicates 9 in 10 cancer patients lived for a minimum 5 years after being diagnosed.

Survival rates for a patient with cancer varies with the stage of cancer he/she is at. As guided by the National Cancer Institute’s SEER database, 92% 5-year survival rate is noted at stage 1 colon cancer. The percentage of 5-year survival rate reduced to 87%, 89% and 11% at stages 2, 3 and 4, respectively. Involvement of nodes as in stages 2B, 3B and 3C reduces the chances of survival to 63%, 69% and 53%, respectively. The trend remains almost same for rectal cancer patients as well.

As mentioned before, the survival rate is just an estimate and applies only in general circumstances. Discuss with your doctor to better understand your situation and to receive individualized prognosis.

There have been exceptions of people living beyond these estimated years with prompt treatment, care and support.

When to seek medical opinion?

Do not neglect or avoid meeting a doctor if –

• You suspect any of the above symptoms.
• You have possible risk factors of colon cancer.
• In case of any noticeable symptoms like blood in the stools or persistent change in bowel habits, one should consult a doctor immediately.
• Positive results of regular cancer screenings, you need immediate medical attention here.

How is colon cancer diagnosed?

The diagnosis of colon cancer is confirmed on the basis of:

• Physical examination and history
• Fecal occult blood test (FOBT)
• Barium enema
• Sigmoidoscopy
• Colonoscopy
• Biopsy

Colonoscopy

One of the most commonly performed detection techniques for polyps and colon cancer is colonoscopy. In this technique, the doctor examines the entire colon with the help of a long and flexible tube which has a camera (colonoscope) attached at the end. This helps in detecting any abnormalities in the colon. 

How is colon cancer or colorectal cancer treated?

Treatment of colon cancer or colorectal cancer requires multimodal approach with state-of-art facilities and well-experienced team of oncologists.

The type of treatment for colon cancer depends largely on the stage of the cancer. Discuss with your oncologist about different treatment options. Generally, there are three primary treatment options: surgery, chemotherapy, and radiation, followed by supportive care. Based upon the disease condition, the oncologist will suggest the best treatment plan. Adhere to instructions from the oncologist to ensure better treatment results.

Surgical removal – Based on the diagnosis, the doctor may decide to remove the colon polyp, colon tumor and lymph node in order to control the growth and spread of cancer. Surgical procedures may also involve the placement of stent to avoid blockade of colon due to cancer.

Your doctor will guide you to choose the best from the available surgical procedures. With advances in cancer therapy and surgery, Yashoda Hospitals performs laproscopy and minimally invasive procedures, colectomy or diverting colostomy so you have better chances at faster recovery.

In case you undergo a surgery to remove tumors and lymph nodes, you will be put on adjuvant chemotherapy to support your body to remove any residue of cancer.

Chemotherapy – It is medicinal therapy for cancer. The doctor will prescribe medicines as soon as the cancer looks abnormal. Other factors that go into deciding on the chemotherapy include – your age, health requirements, and radiation therapy.

In advanced cancer, chemotherapy is necessary with or without surgery. There are chances you may receive chemotherapy before a planned surgery, it is called neoadjuvant chemotherapy.

Radiation therapy – For colon cancer, radiation therapy is not commonly used. However, doctor may recommend radiation therapy –

• After surgery to kill remaining colon cancer cells attached to lining of the abdomen.
• In rectal cancer, radiation therapy is recommended along with chemotherapy, before or after surgery.
• For candidates who cannot undergo surgery.
• To prevent metastasisor spread of cancer.

Other treatment options include ablation, embolization, hepatic artery infusion. They are used when the tumor has spread to liver.

What is the cost of colon cancer treatments?

The cost to treat colon cancer may vary based on –

Complexity and stage of cancer

1. Age of the patient
2. Co-existing diseases
3. Hospital stays and home care
4. Colonoscopy and imaging tests – equipment, medicine and radiologist fees
5. Chemotherapy – chemotherapy cycles, medicines, supplements, and procedure related
6. Radiation therapy – extent of body exposure, intensity of radiation, implants or external radiation, and radiologist fees
7. Surgery – surgeon and team, operating room fees, equipment, medicines, and other utilities

Pointers to make your journey easier

• Look out for hospitals with best Oncology teams and advanced facilities.
• Make sure the hospital is covered under your insurance plan. Check with your insurance provider if you are eligible for the coverage.
• Join cancer support groups to stay motivated.

To know more about colon cancer and its treatment, you can request for a call back and our experts will call you and answer all your queries.

How can colon cancer be prevented?

• Regular screening for colon cancer

Generally, colon cancer screenings are recommended at age 50. However, in people who are more prone to develop colon cancer, screening at a younger age is advisable. Since small polyps may have no or few tell-tale signs, regular screening tests are strongly recommended to identify the polyps so that these can be removed before they turn cancerous.

• Lifestyle changes to reduce risk

Adopting a healthy lifestyle can reduce the risk of developing colon cancer. Some of the lifestyle-related modifications are:

• Include fruits, vegetables, and whole grains in diet: vitamins, minerals, antioxidants, and fibersmay help in preventing cancer
• Avoid alcohol or skip it altogether
• Quit smoking
• Exercise regularly (at least 30 minutes on most days)
• Maintain a healthy weight

To know more about colon cancer and its treatment, you can request for a call back and our experts will call you and answer all your queries.

Our informative blogs on cancer:

• • What is the rehabilitation for cancer patients after chemotherapy?
  • Lymphoma is a group of blood cancers that develop in the lymphatic system

References:

• Mayo Clinic. Colon cancer. Available at:https://www.mayoclinic.org/diseases-conditions/colon-cancer/diagnosis-treatment/drc-20353674.Accessed on 28th October 2017.
• National Cancer Institute. Colon Cancer Treatment (PDQ)-Patient Version. Available at:https://www.cancer.gov/types/colorectal/patient/colon-treatment-pdq.Accessed on 28th October 2017.
• UpToDate. Colorectal cancer overview. Available at: http://www.uptodate.com/contents/colon-and-rectal-cancer-beyond-the basics?source=search_result&search=colon+cancer&selectedTitle=2%7E25. Accessed on 28th October 2017.
• American Cancer Society. Signs and Symptoms of Colon Cancer. Available at: https://www.cancer.org/latest-news/signs-and-symptoms-of-colon-cancer.html. Accessed on 28th October 2017.

Disclaimer:

“The content of this publication has been developed by a third party content provider who is clinicians and/or medical writers and/or experts. The information contained herein is for educational purpose only and we request you to please consult a Registered Medical Practitioner or Doctor before deciding the appropriate diagnosis and treatment plan.”