COLORECTAL CANCER

COLORECTAL CANCER OVERVIEW Colon and rectal cancers are cancers that involve the lower digestive tract and often occur together.  Colon cancer develops from polyps. Polyps are often small and produces little to dos symptoms. Appropriate monitoring and screening especially in high risk individuals help detect the presence of polyps and their risks of becoming cancerous. SYMPTOMS OF COLORECTAL CANCER The symptoms that may be indicative of colorectal cancer includes;  Stomach pain. Frequent constipation or diarrhea. Presence of blood in the stool. Tiredness and fatigue. Low iron level. Black stool. Unexplained weight loss. ​ DIAGNOSING COLORECTAL CANCER When you notice any of the above concerning symptoms or you are known to have high risks (family history of colorectal cancer), it is important that you see a physician and discuss your concerns.  The diagnosis is made primarily with colonoscopy and biopsy (biopsy is when a part of tissue is take and studied for any changes in the cell type). With endoscopy and biopsy a confirmation of the cancer can be made. Once this is confirmed, the physician will then proceed to stage the cancer. The staging of the cancer will help determine how aggressive the cancer is and how much it has spread to other parts of the body, guiding the treatment options. BLOOD TEST: Most right sided colon cancers are often associated with iron deficiency anemia, therefore it is important that blood test is done to evaluate for any possible anemia. Also serum tumor marker levels are often checked, carcinoembryonic antigen (CEA antigen) is sensitive marker for colon cancer but not specific to colon cancer as it may be present in other cancers and also can serve as a prognostic marker in the management of colon cancer. COLON CANCER STAGING:  Stages I and III are often treated with surgery with or without chemotherapy, while stage IV (advanced cancer stage) is often managed with chemotherapy. Stage I indicates that the cancer has spread to the intestines but it has not invaded the walls of the intestine, while stage IV indicates that the cancer has spread to the distance organs such as the liver, therefore surgically removing the cancer will not be the best treatment option, chemotherapy will be required to help destroy the cancer cells that have spread. Other investigations that may be done includes; MRI of the abdomen and pelvis, chest x-ray, and CT scans to look for possible spread. RECTAL CANCER STAGING: Rectal cancers are often treated with the combination of surgery, radiation and chemotherapy. The treatment option is dependent on the staging of the cancer. Stage I cancer is often cured with surgical treatment, while stage II and III are often managed with surgery along with chemo and radiotherapy, and stage IV (advanced) is often treated with chemotherapy with or without surgical removal. COLON SURGERY During surgery, the tumors and the section of the colon may be resected and the remaining parts of the colon may be reconnected during surgery. However in some cases, there reconnection may not be done immediately probably because of a high risk of reconnection failure, if this happens, a temporarily ostomy with a bag to collect the fecal products or bowel movements may be done (an ostomy is when the colon is sowed to an opening in the skin). After few months the colon will often be reconnected back and in some cases the ostomy may be permanent. CHEMOTHERAPY This treatment is given to slow or stop the replication and growth of cancer cells. It may be given an adjutant therapy (meaning given after the surgical removal of the cancer) to help kill any left over cancer cells. The physician will advise as to the duration of the chemotherapy and the side effects to be expected.