Colorectal cancer. What is that?
Colorectal cancer is third in the diagnosis and second in mortality rate among malignancies in the United States. However, if detected at an early stage, the chances of a cure are great. It is formed by the growth of altered (abnormal) cells on the inner wall colon or rectum.
Colorectal cancer: how it starts
It most often begins as a polyp – a benign formation on the intestine’s inner surface. The two most common types of polyps are adenomatous and hyperplastic. They occur due to an error in the growth or renewal of cells of the intestine’s inner wall. They mostly retain a benign form, but some have malignant potential. Their removal at an early stage prevents colorectal cancer.
Risk factors that you cannot influence
The risk of colorectal cancer depends on genetics and lifestyle. Risk factors that you cannot influence are:
• Age – most patients are older than 50 years
• Polyps or inflammatory bowel disease
• Family medical history
• Ovarian or breast cancer
Risk factors you can influence
Some factors that increase the risk of disease can be controlled:
• Meat diet
• Insufficient physical activity
• Smoking and alcohol consumption
Warning signs in colorectal cancer
There are usually no early signs of the disease. Therefore, it is necessary to make timely examinations because early detection means a greater possibility of a cure. As the disease progresses, it can occur blood in the stool, abdominal pain, changes in bowel movements (constipation or diarrhea), sudden weight loss, and fatigue. If these symptoms are present, the tumor will likely be large and more difficult to treat.
Examinations to detect colorectal cancer
Colorectal cancer develops insidiously, so preventive examinations are necessary for early diagnosis. The recommendation for people over the age of 50 is to do a colonoscopy once every ten years. It is a diagnostic method that examines the colon and rectum with a tiny camera. With this procedure, it is not only possible to detect colorectal cancer, but it is also possible to prevent it by removing polyps.
In recent times, the so-called virtual colonoscopy made 3-D colon models using CT images. The advantage of this method is that it detects poles and long column abnormalities without using a camera. However, in their finding, a classic colonoscopy is necessary to remove the formations.
X-ray of the intestine
Intestinal X-ray (irigography) – in which barium is used as a contrast agent – is a method that provides a good insight into the condition of the intestine and rectum. With this method, tumors are often presented as an “apple bite” that narrows the intestinal lumen. As with a virtual colonoscopy, all abnormalities detected by irigography require a conventional colonoscopy.
If tests show suspicion of a tumor, a biopsy is necessary. Thus, during colonoscopy, polyps are removed, and tissue samples of all suspicious formations are taken. They are then examined microscopically to make a clear diagnosis. The picture shows enlarged colon cancer cells.
Determination of colorectal cancer stage
Once the diagnosis is confirmed, the cancer stage is determined based on its extent. The tumor size does not have to be correlated with the stage. Furthermore, determining the tumor stage is necessary due to the choice of the type of treatment.
• Stage I – the tumor has not spread beyond the inside of the intestine or rectum
• Stage II – the tumor has affected the muscular layer of the intestine or rectum
• Stage III – the tumor has spread to one or more surrounding lymph nodes
• Stage IV – the tumor has spread to other organs, e.g., liver, lungs, or bones.
Colorectal cancer survival rate
The appearance of survival depends on the stage of cancer. The higher the stage, the lower the chances are. The five-year survival rate refers to the percentage of patients who have lived for at least five years from the time of diagnosis. The five-year survival rate for stage I is 93%, and for stage IV, only 8%.
Colorectal cancer surgery
The usual therapeutic procedure for all stages of colorectal cancer, except the fourth, is the surgical removal of the tumor and surrounding tissue. If it is a larger tumor formation, the intestine or rectum segment is removed. Surgery provides a high survival rate in the early stages of cancer. In case it spreads to other organs, the operation is performed to alleviate the symptoms of the disease.
Treatment of advanced colorectal cancer
Treatment of colorectal cancer is also possible when one or more surrounding lymph nodes are involved (stage III). It then includes surgery, radiation, and chemotherapy. If cancer recurs after the initial treatment or affects the surrounding organs, it is more difficult to cure. But even then, radiation and chemotherapy can alleviate the symptoms of the disease and prolong survival.
Deal with chemotherapy
Recently, important steps have been taken to alleviate chemotherapy’s side effects. Newer drugs are causing less and less nausea. Clinical research is focused on discovering new, more effective, and better-tolerated ones.
Radiofrequency ablation is a method of removal of tumor heat. A needle-like device is used to enter the tumor area and applies heat based on a CT scan. The method is suitable for removing cells that have not been surgically removed. In patients with liver metastases, radiofrequency ablation is often combined with chemotherapy.
Prevention of colorectal cancer: diet
There are several steps you can take to prevent colorectal cancer. Research has shown that proper nutrition, exercise, and fat reduction reduce disease risk by 45%. Reduction diets with plenty of fiber, and at least five meals containing fruits and vegetables are recommended.
Physical activity is significant in preventing colorectal cancer. Studies show that physically active people have a 24% lower risk of disease, whether the activity is work-related or entertaining. It is recommended to exercise daily for 30 minutes.