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Symptoms, Diagnosis and Treatment of Colon Cancer

Colon cancer is a particular form of cancer (carcinoma) which affects the body’s colon. The colon is part of the large intestine. In fact, it is the largest portion of the large intestine. Most colon cancers derive from adenocarcinomas, which are cancer cells that begin in our cells that produce mucus and other body fluids.

Fast Facts about Colon Cancer

Colon cancer is a serious form of cancer that starts in the rectum or colon. It is most common among people who are over 50 years of age. In certain cases, though, a genetic form of colon cancer might occur in person under the age of 50. There are many ways to treat colon cancer, which can involve simple endoscopic style procedures to general surgery. Prevention measures can be a big help in catching the disease early in the disease process, which greatly improves a person’s chances of undergoing complete recovery. The best advice of all is to regularly see your health care provider, so your provider has the chance to help you check of symptoms and signs of colon cancer.

Common Causes of Colon Cancer

The exact cause of colon cancer is not currently known to modern science. As is the case with many other forms of cancer, our best understanding of the causes of colon cancer comes from the risk factors that have been identified with colon cancer. These risk factors range from very basic things like age and sex, to a person’s genetics. There are also some risk factors we bring upon ourselves, such as is the case with smoking cigarettes.

Risk Factors for Colon Cancer

You risk of developing colon cancer cannot be known completely. However, modern medical research has been able to identify many risk factors that can increase the odds of a person developing colon cancer during their life time. Studies have found the following risk factors for colorectal cancer:

  • Age – Anyone can statistically develop a higher chance of developing colon cancer once they reach the age of 50. This is why this age has been established as the prime age to first access a person’s risk for colon cancer. The average age for onset is 72 years of age.
  • Colorectal polyps – polyps are a kind of growth that grows out from the inner lining of the colon or rectum. A person who develops polyps is statistically more at risk. Most colorectal polyps end up being benign. Some, however, end up becoming cancerous. At that point, a cancerous polyp is called an adenoma.
  • A family history of colorectal cancer in close relatives can increase your risk. If you have multiple relatives with the disease, it greatly increases your odds of developing colon cancer. The genetic connection is still not fully understood; but it is a good risk factor indicator.
  • Changes in a person’s genes over life can increase your odds. There are two known genes that can increase a person’s odds of developing colon cancer:  the HNPCC and the APC gene.  They are related to two genetic forms of colon cancer, called Hereditary Nonpolyposis Colon Cancer and Familial Adenomatous Polyposis (FAP) respectively.
  • A personal history of cancer of the colon will also be at risk for getting the disease a second time.
  • A person who suffers from some form of colorectal inflammatory disease is at greater risk for colon cancer. Some of these types of diseases include Crohn’s disease, ulcerative colitis, and irritable bowel syndrome (IBS).
  • Eating a diet that is high in fat can increase your risk for colon cancer.
  • Cigarette smoking can increase your risk of developing polyps and colorectal cancer.

Symptoms of Colon Cancer

There are several common symptoms of colon cancer. All of them relate, in some fashion, to changes in bowel habits. Those symptoms include:

  • Diarrhea or constipation
  • Feeling that your bowel is never getting completely empty
  • Finding blood in your stool (regardless of the color of the blood)
  • Very narrow stool (as compared to normal).
  • Having frequent gas pains, cramps and bloating
  • Unknown, sudden weight loss
  • Constant fatigue
  • Nausea and vomiting

The hard part about these types of symptoms is that they can also occur with a variety of other diseases. This is probably why many people never seek treatment for colon cancer, until the disease has progressed quite a bit. Having a regular, yearly physical past the age of 50 can really help increase the probability for early detection and treatment.

Diagnosing Colon Cancer

There are some basic tests that a health care provider can do to help diagnose colon cancer. Those tests include a fecal occult blood test (which tests for blood in the stool), a biopsy of suspicious cells, and a screening colonoscopy or flexible sigmoidoscopy. Typically, these types of tests will start around your 50th birthday, unless there are other reasons to start early.

If your doctor finds cancer in the colon and/or rectum, then the cancer is given a stage level, which indicates how far advanced the cancer has become. The following stages are used to describe the disease process:

  • Stage 0 – At this stage, the cancer was found only in the innermost lining of the colon or rectum. This stage is also commonly referred to as carcinoma in situ.
  • Stage I – There is a tumor that has grown into the inner wall of the colon or rectum, but has not gone completely through the wall.
  • Stage II – At this stage, the tumor extends very deeply into and through the wall of the colon or rectum. It may also be in other types of tissues that surround the colon or rectum. At this point, though, cancer has not spread into the lymphatic system.
  • Stage III – The cancer has spread through the colon and into the lymph nodes that are in the colon and rectum. At this point, the cancer has not spread to other parts of the body.
  • Stage IV – The colon cancer has spread to other organs of the body, like the liver or lungs.
  • Recurrence – Cancer has returned after a period of remission.

Treatment Options for Colon Cancer

There are many treatments for colon cancer that can involve therapies, surgery, and specialized medical doctors. Your primary care provider may make a decision to refer you to a gastroenterologist, who specializes in diseases of the digestive system. You may also see a radiation oncologist (for radiation therapy), a medical oncologist (who specializes in the treatment of cancer) or a surgeon.

The choice of how to treat colon cancer can almost be as unique as the person with the disease. Treatment options are decided based upon the severity of the disease, the location of tumors, and whether the disease is in the colon or rectum.

Surgery for Colon Cancer

Without a doubt, the most common treatment for colorectal cancer is some form of surgery. The most common types of surgery are:

  • Colonoscopy with polyp removal – Small polyps can be removed from the rectum and colon during a colonoscopy. A scope is inserted through the anus, which has a small camera and small surgical tools, which can let a doctor see the inside of the colon. The small wire loop serves to remove polyps.
  • Laparoscopic surgery – With the aid of a lighted tube, a surgeon can see into the abdomen. This usually involved a few small cuts that allow the surgeon to get to the colon. The tumor and a small part of the health colon are removed, and the ends are reconnected. By common protocol, the rest of the colon is also checked for any other issues.
  • Open General Surgery – General surgery involves making a large cut in the abdomen, in order to remove a cancerous tumor.

In laparoscopic and general surgery, the ends of the colon can be re-connected. However, re-connection is not always possible. When this happens, the surgeon must reconstruct a way for waste to be removed from the body. A surgeon will make an opening in the wall of the abdomen (called a stoma). The surgeon then connects the upper end of the intestine to the stoma, and closes the end. This process is called a colostomy. A bag is designed to fit over the stoma, in order to collect the waste. The bag is held in place by a very special type of adhesive, designed to hold the bag, but not permanently damage the skin.

Healing time after surgery can be different for each individual case. Rest and recuperation time are needed, so follow the instructions of your doctor. Your physician may prescribe different types of pain medication to help with any pain. People tend to feel weak for some time after surgery. Your health care providers will need to know of any signs of bleeding and infection.

When people get a colostomy, it is not uncommon to develop a skin irritation around the stoma. Your health care provider needs to know this. You will also receive special education about how to care for the colostomy bag, and the stoma. This can be your doctor, a nurse, or a specialized care provider called an enterostomal therapist.

Prevention of Colon Cancer

There are a common set of screening tests that are used to help detect colon cancer. The thing to remember is the need to have these tests done on a regular basis. Your health care provider will give you instructions on how often these tests need to be performed. The common tests are:

  • A fecal occult blood test (FOBT) is a test that is designed to capture the fact that there are tiny amounts of the blood in the stool. Blood in the stool can be an early sign of colon cancer, though not always. For example, you might simply have hemorrhoids that are bleeding. Your health care provider will follow up the results of the test to know the best course of actions.
  • A flexible sigmoidoscopy (Flexsig) is a procedure where a doctor checks the lower portion of the colon with a lighted tube. If polyps are found, they can be removed. When this happens, it is called a polypectomy.
  • Colonoscopy involves the use of a lighted tube to look at the entire colon, versus just the lower section. Again, your doctor can remove polyps along the way.
  • A Barium Enema is a process that can help your doctor see polyps and tumors better, especially when they are small.  A Barium solution and air are used to help highlight the small polyps and tumors under X-ray.
  • Digital Rectal Exam is a procedure, where the doctor inserts a gloved finger into the rectum to check for problems in the rectal area. If you are a man, your doctor will also commonly check the prostate gland.

Coping with Colon Cancer

Many people live a totally normal life after being diagnosed with colon cancer. If caught early, the cancer can be surgically removed, and the person just experiences a minor recuperation period from the surgery. At this point, the lifestyle change would involve regular visits to the doctor to check for any re-occurrence of cancer.

For others, lifestyle changes might involve chemotherapy or radiation therapy. These types of treatments can leave a person tired and weak, and may involve loss of hair. For a person who has a colostomy, it will involve care of the stoma for the rest of the person’s life.

Where to Get More Information:
Colon Cancer Alliance
Colon Cancer Coalition