COLON CANCER

Symptoms
Diagnosis
Treatment

Cancer that originates in the colon or rectum is called colorectal cancer. Most colorectal cancers develop when a change occurs in cells that line the wall of the colon or rectum. Many times it begins as an intestinal non-cancerous polyp, which is an abnormal growth of tissue. Even non-cancerous polyps are serious because they are considered precancerous growths that can become cancerous over a period of time.

Like most cancers, colorectal cancer doesn’t discriminate. It is the third most common type of cancer in both men and women.

Symptoms

We all experience normal gastrointestinal problems, but it’s important
to keep tabs on your body and discuss with your doctor anything that
is long term or out of the ordinary. Early detection is key to the fight. Contact your physician if you experience the following symptoms:

• Blood in stool
• Change in bowel habits
• Diarrhea, constipation, vomiting
• Abdominal discomfort such as gas, bloating, fullness or cramps
• Constant tiredness
• Narrower than normal stools
• Unexplained anemia
• Unexplained weight loss

Diagnosis

The best way to cure colorectal cancer is to prevent it altogether.
That requires diligence with a regular program of screening. For
patients with no family history of the disease, screening is recommended
beginning at age 50 and includes:

• Digital rectal examination (DRE) and fecal occult blood test annually and
• Double-contrast barium enema every 5 – 10 years and
• Flexible sigmoidoscopy every 5 years, or
• Total colonoscopy every 10 years

At risk patients with a family medical history of colorectal cancer should have a colonoscopy every 5 years beginning at age 40. If your mother
or father was diagnosed with colorectal cancer before age 50, you should start screening when you are 10 to 20 years younger than when he or she was diagnosed. So, if your father was diagnosed at 46, you should start screening between 26 and 36.

Screening and Diagnostic Tests
• Digital Rectal Examination: The physician inserts a lubricated, gloved finger into the patient’s rectum to feel for tumors. Approximately 5–10% of colorectal cancers are palpable or can be felt.
• Colonoscopy: The physician can view images of the entire colon and rectum using a long flexible tube with a light and camera (called a colonoscope). Biopsy of suspicious tissue can be performed using instruments inserted through the tube.
• Fecal occult blood test: Also known as a stool blood test, is used to detect microscopic blood in the stool, which may indicate early colorectal cancer.
• Flexible sigmoidoscopy: Is similar to a colonoscopy, but uses a shorter tube to inspect the lower colon.

Staging
When colorectal cancer is suspected, additional tests are performed to determine the progress of your cancer. Staging can be an effective tool in deciding the type of treatment best for you.

Imaging Tests
• Chest x-ray can determine if the cancer has spread to the lungs
• CT or PET scans can determine if the cancer has spread to lymph nodes, liver, or lungs
• Blood tests for CEA, a protein that is a marker for colorectal cancer
• Angiography can find blood vessels next to cancer that has spread to the liver, which helps the surgeon minimize blood loss during surgery
• Endorectal ultrasound probe is used for rectal cancer only and uses sound waves to produce a picture of the tumor to see how much cancer is in the rectal wall

Treatment

Treatment depends on the stage of the disease and the overall health of the patient. We understand patients want to maintain normal bowel, urinary and sexual functions after treatment, so we go to great lengths to find the best method of treatment so you can live the life to which you’re accustomed. Treatment options include surgery, radiation therapy, chemotherapy or a combination of all three, but surgery is the most common method of treatment.

Surgery for Colon Cancer
If the cancer is limited to a portion of a polyp, a colonoscopy is usually ordered. Other times surgery is more extensive and part of the colon must be removed. In a hemicolectomy the part of the colon containing the tumor and nearby lymph nodes are removed and healthy parts of the colon are reconnected.

After surgery, patients may experience pain, weakness, fatigue, and loss of appetite, and surgeons usually recommend a change in diet to help the healing process. Bowel functions usually return to normal with a few months.

Surgery for Rectal Cancer
This surgery is more difficult than colon cancer surgery. Tumors that
have not grown through the wall can be removed with little of the healthy tissue around the tumor affected, but cancers that have grown through the wall of the rectum and reached the lymph nodes are more difficult.
A technique known as sharp mesorectal excision can remove all cancerous tissue from the rectum, but avoid the nerves involved in
sexual and urinary function.

Laparoscopic surgery
We continue to find ways to use minimally invasive surgery for the
comfort of our patients. Using laparoscopic technology and fiber
optics, surgeons can perform complex procedures through a small incision, which may result in a shorter hospital stay and a faster
recovery time.

Adjuvant Therapy Treatment
Surgery is effective at removing cancer from the body. But microscopic cells sometimes remain and other methods of treatment, such as chemotherapy and radiation, are necessary.

Chemotherapy is often used as a first-line treatment for metastatic colorectal cancer, or tumors that have spread to other parts of the
body, and may be used with radiation therapy to shrink tumors prior to surgery. Chemotherapy drugs used to treat colorectal cancer include 5-fluorouracil, leucovorin, and irinotecan.