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Colorectal

Colorectal cancer (CRC), also known as bowel cancer and colon cancer, is the development of cancer from the colon or rectum (parts of the large intestine). A cancer is the abnormal growth of cells that have the ability to invade or spread to other parts of the body.

Only a small percentage of colon cancers are linked to inherited genes. The most common inherited syndromes that increase colon cancer risk are familial adenomatous polyposis (FAP) and Lynch syndrome, which is also known as hereditary nonpolyposis colorectal cancer (HNPCC).

Symptoms of colorectal cancer include:

  • Changes In Bowel Habits
  • Diarrhea Or Constipation
  • A Feeling That The Bowel Does Not Empty Properly After A Bowel Movement
  • Blood In Feces That Makes Stools Look Black
  • Bright Red Blood Coming From The Rectum
  • Pain And Bloating In The Abdomen
  • A Feeling Of Fullness In The Abdomen, Even After Not Eating For A While.
  • Fatigue Or Tiredness
  • Unexplained Weight Loss
  • A Lump In The Abdomen Or The Back Passage Felt By Your Doctor
  • Unexplained iron deficiency in men, or in women after menopause

Most of these symptoms may also indicate other possible conditions. It is important to see a doctor if symptoms persist for 4 weeks or more.

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Treatment

Treatment will depend on several factors, including the size, location, and stage of the cancer, whether or not it is recurrent, and the current overall state of health of the patient.

Treatment options include chemotherapy, radiotherapy, and surgery.

Surgery for colorectal cancer

This is the most common treatment. The affected malignant tumors and any nearby lymph nodes will be removed, to reduce the risk of the cancer spreading.

The bowel is usually sewn back together, but sometimes the rectum is removed completely and a colostomy bag is attached for drainage. The colostomy bag collects stools. This is usually a temporary measure, but it may be permanent if it is not possible to join up the ends of the bowel.

If the cancer is diagnosed early enough, surgery may successfully remove it. If surgery does not stop the cancer, it will ease the symptoms.

Chemotherapy

Chemotherapy involves using a medicine or chemical to destroy the cancerous cells. It is commonly used for colon cancer treatment. Before surgery, it may help shrink the tumor. Targeted therapy is a kind of chemotherapy that specifically targets the proteins that encourage the development of some cancers. They may have fewer side effects than other types of chemotherapy. Drugs that may be used for colorectal cancer include bevacizumab (Avastin) and ramucirumab (Cyramza).

A study has found that patients with advanced colon cancer who receive chemotherapy and who have a family history of colorectal cancer have a significantly lower likelihood of cancer recurrence and death.

Radiation therapy

Radiation therapy uses high energy radiation beams to destroy the cancer cells and to prevent them from multiplying. This is more commonly used for rectal cancer treatment. It may be used before surgery in an attempt to shrink the tumor.

Both radiation therapy and chemotherapy may be given after surgery to help lower the chances of recurrence.

Ablation

Ablation can destroy a tumor without removing it. It can be carried out using radiofrequency, ethanol, or cryosurgery. These are delivered using a probe or needle that is guided by ultrasoundor CT scanning technology.

Recovery

Malignant tumors can spread to other parts of the body if left untreated. The chances of a complete cure depend enormously on how early the cancer is diagnosed and treated. A patient's recovery depends on the following factors:

  • the stage when diagnosis was made
  • whether the cancer created a hole or blockage in the colon
  • the patient's general state of health

In some cases, the cancer may return.

Risk Factors

Possible risk factors include:

  • Older age
  • A diet that is high in animal protein, saturated fats, and calories
  • A diet that is low in fiber
  • High alcohol consumption
  • Having had breast, ovary, or uterine cancer
  • A family history of colorectal cancer
  • Having ulcerative colitis, Crohn's disease, or irritable bowel disease (IBD)
  • Overweight and obesity
  • Smoking
  • A lack of physical activity
  • The presence of polyps in the colon or rectum, as these may eventually become cancerous.
  • Causes

    It is not clear exactly why colorectal cancer develops in some people and not in others.

    Stages

    The stage of a cancer defines how far it has spread. Determining the stage helps chose the most appropriate treatment. A commonly used system gives the stages a number from 0 to 4. The stages of colon cancer are:

    Stage 0: This is the earliest stage, when the cancer is still within the mucosa, or inner layer, of the colon or rectum. It is also called carcinoma in situ.

    Stage 1: The cancer has grown through the inner layer of the colon or rectum but has not yet spread beyond the wall of the rectum or colon.

    Stage 2: The cancer has grown through or into the wall of the colon or rectum, but it has not yet reached the nearby lymph nodes.

    Stage 3: The cancer has invaded the nearby lymph nodes, but it has not yet affected other parts of the body.

    Stage 4: The cancer has spread to other parts of the body, including other organs, such as the liver, the membrane lining the abdominal cavity, the lung, or the ovaries.

    Recurrent: The cancer has returned after treatment. It may come back and affect the rectum, colon, or another part of the body.

    In 40 percent of cases, diagnosis occurs at an advanced stage, when surgery is likely the best option.

    Prevention

    A number of lifestyle measures may reduce the risk of developing colorectal cancer:

    Regular screenings: Those who have had colorectal cancer before, who are over 50 years of age, who have a family history of this type of cancer should have regular screenings.

    Nutrition: Follow a diet with plenty of fiber, fruit, vegetables, and good quality carbohydrates and a minimum of red and processed meats. Switch from saturated fats to good quality fats, such as avocado, olive oil, fish oils, and nuts.

    Exercise: Moderate, regular exercise has been shown to have a significant impact on lowering a person's risk of developing colorectal cancer.

    Bodyweight: Being overweight or obese raises the risk of many cancers, including colorectal cancer.

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