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oncology1

Colon Cancer

Colon cancer is cancer of the large intestine (colon), the lower part of one’s digestive system

Signs & Symptoms:

  • A change in your bowel habits, including diarrhea or constipation or a change in the consistency of your stool
  • Rectal bleeding or blood in your stool
  • Persistent abdominal discomfort, such as cramps, gas or pain
  • A feeling that your bowel doesn’t empty completely
  • Weakness or fatigue
  • Unexplained weight loss

Risk Factors:

  • Lifestyle-related factors
  • Diet high in red meats (such as beef, pork, lamb, or liver)
  • Processed meats (hot dogs and some luncheon meats)
  • Cooking meat at very high temperatures (frying, broiling, or grilling)
  • Physical inactivity
  • Obesity
  • Smoking
  • Heavy alcohol use
  • Age
  • Personal history of colorectal polyps or colorectal cancer
  • Personal history of inflammatory bowel disease
  • Family history of colorectal cancer or adenomatous polyps
  • Inherited syndromes
  • Familial adenomatous polyposis (FAP)
  • Type 2 diabetes (usually non-insulin dependent)

Common Types:

  • Adenocarcinoma
  • Gastrointestinal carcinoid tumors
  • Gastrointestinal stromal tumors
  • Primary colorectal lymphoma
  • Leiomyosarcoma
  • Melanoma
  • Squamous cell carcinoma

Diagnosis:

  • Physical exam and health history
  • Endoscopic procedures
  • Fecal occult blood test 
  • Lab tests
  • Biopsy
  • CT scan
  • MRI
  • PET-CT scan
  • Ultrasound

Stages:

  • Stage 0

These cancers have not grown beyond the inner lining of the colon

  • Stage 1

These cancers have grown through several layers of the colon, but they have not spread outside the colon wall itself (or into the nearby lymph nodes)

  • Stage 2

These cancers have grown through the wall of the colon and they may extend into nearby tissue. They have not yet spread to the lymph nodes

  • Stage 3

These cancers have spread to nearby lymph nodes, but not yet spread to other parts of the body

  • Stage 4

These cancers have spread from the colon to distant organs and tissues.

Prevention:

  • Eat a variety of fruits, vegetables and whole grains
  • Drink alcohol in moderation, if at all.
  • Stop smoking
  • Exercise most days of the week.
  • Maintain a healthy weight

Management:

Surgery
If the cancer is small, localized in a polyp and in a very early stage, the doctor may be able to remove it completely during a colonoscopy. Larger polyps may be removed using endoscopic mucosal resection. If the pathologist determines that it’s likely that the cancer was completely removed, there may be no need for additional treatment. Polyps that can’t be removed during colonoscopy may be removed using laparoscopic surgery.

Surgery for Invasive Colon Cancer
If the colon cancer has grown into or through the colon, the surgeon may recommend a partial colectomy to remove the part of colon that contains the cancer, along with a margin of normal tissue on either side of the cancer. Nearby lymph nodes are usually also removed and tested for cancer. The surgeon is often able to reconnect the healthy portions of colon or rectum. But when that’s not possible, for instance if the cancer is at the outlet of rectum, the patient may need a permanent or temporary colostomy. This involves creating an opening in the abdomen wall from a portion of the remaining bowel for the elimination of body waste into a special bag. Sometimes the colostomy is only temporary, allowing the colon or rectum time to heal after surgery. In some cases, however, the colostomy may be permanent.

Surgery for Advanced Cancer
If the cancer is very advanced or the overall health is very poor, the surgeon may recommend an operation to relieve a blockage of the colon or other conditions in order to improve symptoms. This surgery isn’t done to cure cancer, but instead to relieve signs and symptoms, such as bleeding and pain. In specific cases where the cancer has spread only to the liver and if the overall health is otherwise good, the doctor may recommend surgery to remove the cancerous lesion from liver. Chemotherapy may be used before or after this type of surgery.

Chemotherapy    
Chemotherapy uses drugs to destroy cancer cells. Chemotherapy for colon cancer is usually given after surgery if the cancer has spread to the lymph nodes. In this way, chemotherapy may help reduce the risk of cancer recurrence.

Radiation Therapy
Radiation therapy uses powerful energy sources, such as X-rays, to kill cancer cells that might remain after surgery, to shrink large tumors before an operation so that they can be removed more easily, or to relieve symptoms of colon cancer and rectal cancer.

Targeted Therapy
Drugs that target specific defects that allow cancer cells to grow are available to people with advanced colon cancer. Targeted drugs can be given along with chemotherapy or alone. Targeted drugs are typically reserved for people with advanced colon cancer.

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