Colorectal Cancer

Introduction

Colorectal cancer, also known as bowel cancer, that develops in the large intestine. It commence when healthy cells in the lining of the colon or rectum change and grow out of control, and forming a mass called tumor. Early cases can begin as non-cancerous polyps which mostly have no symptoms but can be detected by screening. Colorectal cancer is the third most common cancer worldwide and is more frequentlyseen in men that in women. Most colorectal cancer are due to old age and sedentary lifestyle.

Signs & Symptoms

  • Change in bowel habits
  • Abdominal discomfort
  • Fatigue
  • Weight loss
  • Blood in stool

Diagnosis

  • Diagnosis is performed by sampling of colon areas suspicious for possible tumor development, typically by endoscopy. Endoscopy is an examination in which a lighted tube is inserted via anus into the intestine that further allows seeing the inside of the intestine. When a tumour is found within 15 cm from the anus it is considered as rectal tumour and if it is found 15cm away from the anus it is considered as colon tumour.
  • Radiological tests like CT scan, PET and MRI are used to visualize the localisation and size of the tumour.
  • Blood analysis for carcinoembryonic antigen (CEA), a tumour marker which might be useful in selected situations.
  • The confirmation of diagnosis is only given by laboratory analysis of the tumour and tissues biopsy.

Management

Colorectal cancer is treatable and chances of survival increases if it is detected on time. Treatment of colorectal cancer depends on stages (0-IV) that is how far advance the cancer is and types of cancer. Colorectal cancer is 'staged' according to tumour size, involvement of lymph nodes and whether it has spread outside the colon, rectum and lymph nodes to other parts of the body or not. This information is used to help decide and plan the best treatment. Treatment of colorectal cancer include surgery, chemotherapy, radiotherapy and sometimes combination of both (radiotherapy & chemotherapy). In later stages (IV) targeted biological therapy is used.

Life style modification plays a vital role in management of colorectal cancer by improving prognosis and quality of life. Life style modification includes weight management, physical activity (at least 150 minutes per week), diet (fruits and vegetables rich in antioxidants), avoiding alcohol, smoking and tobacco. Avoiding red and processed meats as it has shown to increase the risk of colorectal cancer.

Follow-Up

There is no follow-up protocol generally accepted for colorectal cancer. Your doctor will schedule visits after the treatment completed with purpose of monitoring side effects of the therapy, possible recurrence of the disease and to provide you with support to be back to your normal life. The follow-up may last up to 5 years.

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