Colon and Rectal Cancer

Colon cancer and rectal cancer can occur at any age

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What is Colon and Rectal Cancer?

Colon and Rectal Cancer consists of the mutation and uncontrolled growth of malignant cells in the colon or rectum.

The term brings together both types because their behavior is basically the same, but it is also possible that they are mentioned according to the precise place of their appearance: colon cancer or rectal cancer.

Most of this type of cancer evolves from the appearance of polyps inside these regions of the large intestine. Not all polyps develop into cancer; However, so-called adenomatous polyps (adenomas) are considered precancerous.

If a polyp becomes larger, there is more than one, or an area of abnormal (but not cancerous) cells is seen around the area where it was removed, special attention should be paid.

Colon cancer and rectal cancer can occur at any age; however, there is a higher risk among older people or older adults.

The large intestine is made up of the colon; a muscular tube that completes the digestive process by absorbing water and salts from the material it receives; and the rectum, which finally stores fecal material until it is expelled.

There are 2 different regions:

The proximal colon. It begins in the cecum, brings together the ascending and transverse colon.
The distal colon. It refers to the sections of the descending and sigmoid colon (the final area that joins the rectum).

Symptoms

The most frequent symptoms of Colon and Rectal Cancer are:

Needing to have a bowel movement that does not go away after emptying the bowel

Change in bowel habits that remain constant (diarrhea, constipation, or other changes in stool)

Discomfort or pain in the abdomen

Obvious bleeding that accompanies the stool

Dark stools

Accelerated weight loss

Weakness and fatigue

Anemia

In the early stages of the disease, there are almost no symptoms. Similarly, it should be taken into account that several of these can be caused by diseases other than cancer.

Diagnosis

The initial interview with the patient is very important to know the individual’s family history as one of the most determining risk factors.

Other aspects that can predispose the appearance of these types of cancer are previous inflammatory bowel diseases, diabetes, eating habits with low fiber intake and excessive fat consumption, obesity and sedentary lifestyle, high alcohol and cigarette consumption, among others.

During the physical exam, your doctor will check your abdomen and may perform a digital rectal exam to look for any palpable abnormalities.

The diagnostic tests that are applied for the detection of colon cancer and rectal cancer are:

Laboratory tests

They include tests for blood in stool, and blood tests (blood count, tumor markers, liver enzymes). Colonoscopy / Proctoscopy. These endoscopic evaluations not only allow internal observation of the intestinal tract or the location of the lesion; They may also be used for tissue sample collection (biopsy) and/or polyp removal.

Colonoscopy/Proctoscopy

These endoscopic evaluations not only allow internal observation of the intestinal tract or the location of the lesion; They may also be used for tissue sample collection (biopsy) and/or polyp removal.

Other imaging tests

Tomography, ultrasound or magnetic resonance imaging can be diagnostic in addition to being diagnostic; a good source to determine the degree of spread of the disease and throughout treatment, a reliable way to measure the results.

Treatment

Stage 0 and I colon and rectal cancer is usually treated with surgery; however, some of them are applied only in more advanced cases, since there are also other treatment protocols. Among the procedures that are performed, it is possible to describe the following:

Polypectomy and endoscopic mucosal resection

When a colonoscopy is performed, one of these procedures may be done. The first consists of removing the cancer contained in the polyp with a cut that is made in the stem that adheres it to the mucosal wall. The second involves removing in addition to the polyp, a section of diseased and healthy tissue from the wall of the colon to eliminate risks of spreading these cells.

Colectomy

This is surgery that allows the colon and nearby lymph nodes to be partially or completely removed. This procedure can be performed with an open wound or minimally invasive (laparoscopy).

Colostomy

When the cancer causes obstruction in the intestinal tract or it is not possible to connect the ends of the colon after a colectomy; An opening is made in the abdomen (stoma) where a collection bag is attached to store waste. It is a procedure that is generally temporary.

Propectomy

Lymph node is the removal of the entire rectum and nearby lymph nodes. After this procedure, the colon must be connected to the anus so that the patient can evacuate normally (coloanal anastomosis).

Pelvic exenteration

When rectal cancer has spread to other organs, your rectum, bladder, prostate or uterus and other nearby tissues may need to be removed. This intervention, which is much more complex, will also require openings in the abdomen so that the patient can expel urine and feces (urostomy / colostomy).

Chemotherapies and radiotherapies

They may be given together to control the size and/or spread of cancer prior to surgery; However, chemotherapy is usually applied after the intervention to try to eliminate any possible cancer cells that have remained in the patient. It is also given when the cancer is very advanced to help relieve discomfort.

Targeted therapy

It consists of the administration of specific drugs to attack some proteins of the cancer cell that have already been identified and are sensitive to the drug, with the intention of weakening them.

Immunotherapy

It is recommended when the cancer is advanced and consists of the administration of drugs that strengthen the immune system.

Preparing for Surgery

The patient with colon cancer or rectal cancer should take into account before any surgical intervention (and even when performing a diagnostic colonoscopy), that their bowel must be completely clean.

To perform the emptying; The patient is treated with laxatives, enemas and must comply with a strict diet to help them prepare for their operation.

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