Colon Cancer

Colon cancer, also referred to as colorectal cancer when involving both the colon and rectum, is a type of cancer that originates in the large intestine, the last segment of the digestive tract. Typically, this cancer starts as small, noncancerous clusters of cells known as polyps that form on the colon's inner lining. Over time, some of these polyps may turn cancerous. Colon cancer ranks as the third most common type of cancer diagnosed in both men and women. Several risk factors contribute to the development of this disease, including age, family history, certain inherited genetic syndromes, a diet low in fiber and high in fat, lack of physical activity, diabetes, obesity, smoking, and alcohol consumption. Early detection through regular screenings is essential, as it increases the likelihood of successful treatment by identifying and removing polyps before they become cancerous.

Causes

Several potential causes and risk factors are linked to colon cancer:

• Obesity

• Lack of physical activity

• Alcohol consumption

• Smoking

• High intake of red and processed meats

• Type 2 diabetes

• Age, particularly being over 50

• African or Ashkenazi Jewish ancestry

• Family history of colorectal cancer or polyps

• Personal history of polyps, ulcerative colitis, or Crohn’s disease

• Rare inherited syndromes like familial adenomatous polyposis or Lynch syndrome

While research continues to explore these factors’ roles in increasing colon cancer risk, having one or more risk factors does not mean you will inevitably develop cancer. Some risk factors, such as age or family history, are unchangeable, but lifestyle-related risk factors can often be modified.

Symptoms

It is important to be aware of the common signs and symptoms of colon cancer:

• Changes in bowel habits, such as diarrhea or constipation

• Alterations in stool shape, color, or size

• Rectal bleeding

• Bloody or dark black stools

• Abdominal pain

• Anemia, which indicates low red blood cell count

• Unexplained fatigue and weakness

• Sudden weight loss

These symptoms often manifest when a tumor grows within the colon or into surrounding structures. In early stages, colon cancer symptoms may be absent, emphasizing the importance of regular screenings to detect potential issues early, leading to more effective treatment options.

Diagnosis

Colon cancer can be diagnosed through various approaches. Often, it is discovered when certain signs and symptoms appear, though it can also be identified during routine screenings, even if symptoms are absent. In some instances, sudden complications like gastrointestinal bleeding may uncover the disease during emergency hospital visits. If you experience any symptoms, it's vital to consult a healthcare provider promptly, as they can determine appropriate steps, typically involving a colonoscopy. This procedure allows a specialist to examine your rectum and colon with a camera and can involve the removal of precancerous polyps or small tumors.

People without symptoms are advised to start screenings at age 45 or earlier if risk factors are present. Colorectal cancer screening tests include colonoscopy, flexible sigmoidoscopy, stool tests, and CT colonography. Your healthcare provider can recommend the optimal screening strategy for you. Even without a primary care provider or health insurance, colorectal cancer screening remains accessible.

Treatments

The stage of colon cancer largely determines the treatment approach. For early-stage cancer confined to the colon, surgical removal, known as a colectomy, is often curative. This procedure also involves removing nearby lymph nodes and can be performed using minimally invasive techniques like laparoscopic or robotic surgery for quicker recovery. In certain cases, a traditional open colectomy may be needed.

• Stage 0: Polyp removal through colonoscopy is typically sufficient.

• Stage 1: Surgery via colectomy or colonoscopy is standard.

• Stage 2: Primary treatment is surgery, with optional medical treatments.

• Stage 3: Treatment involves surgery, potential radiation therapy, and medical treatments.

• Stage 4: When cancer spreads to other organs, treatment focuses mainly on medical therapies. Surgery might still be considered based on the metastases’ size and location.

Patients may require a stoma temporarily after a colectomy, with the possibility of reconnecting the intestine and rectum later on. For advanced cancer stages, surgery is often combined with chemotherapy regimens or targeted therapies to manage progression and alleviate symptoms when surgery alone is insufficient.

Living

Life with colon cancer involves significant adjustments, and it is natural to have questions and concerns. Common challenges include managing a stoma, dealing with chemotherapy side effects, adjusting dietary habits, and coping with changes in bowel habits. Concerns about intimacy, relationships, or cancer recurrence might arise. Though you may feel uneasy discussing these issues initially, sharing your concerns with your cancer care team is encouraged. They can provide guidance, resources, and support, whether it's regarding nutrition, mental health, various therapies, nursing care, or home supplies. Do not hesitate to reach out for assistance when needed.

Prevention

To reduce the risk of colon cancer, consider adopting these preventative measures:

• Begin regular screenings at age 45, or earlier if specific risk factors exist.

• Discuss testing options with your healthcare provider if you have a personal or family history of colon polyps or cancer.

• Increase fruits and vegetables in your diet and reduce meat consumption.

• Engage in regular physical exercise.

• Avoid smoking.

• Limit or abstain from alcohol consumption.

• Consult your healthcare provider on the appropriateness of taking a daily Aspirin.

These lifestyle changes not only help lower the risk of colon cancer but also other cancer types and improve overall health. Long-term aspirin use for individuals over 50 without a high risk of bleeding can be beneficial, though starting after age 70 may not offer additional advantages.