Colon & rectal cancer

Risk increases with age.

Race and Ethnicity

African-Americans have the highest risk of being diagnosed with, and dying from, colorectal cancer

About 20 - 25% of colorectal cancers occur among people with a family history of the disease. People who have more than one first-degree relative (sibling or parent) with the disease are especially at high risk.

• Dietary Factors.
• A diet high in red and processed meats increases the risk for colorectal cancer.
• Diets high in fruits and vegetables appear to be associated with reduced risk.
• Alcohol and Smoking. - increased risk for colorectal cancer.
• Obesity - increased risk for colorectal cancer, especially for men.
• Physical Inactivity. A sedentary lifestyle increases the risk of developing colorectal cancer. Regular exercise may help reduce risk.

• Adenomatous Polyps. - increased risk
• Inflammatory Bowel Disease. - include Crohns disease and ulcerative colitis, long-term inflammation caused by these chronic disorders can increase the risk for colorectal cancer.

• Exercising regularly
• Eating a healthy diet low in meat and high in fruits and vegetables
• Do not smoke, and do not drink alcohol
• Regular colorectal cancer screenings

• Abdominal discomfort such as gas, bloating, and cramps
• Rectal bleeding or blood in stool
• Unexplained weight loss
• Unexplained iron-deficiency anemia (low red blood cell count)
• Weakness and fatigue Changes in bowel movements, such as diarrhea or constipation, or change in consistency of stools
• Feeling that the bowel has not emptied completely after a bowel movement

• Flexible sigmoidoscopy every 5 years, or
• Colonoscopy every 10 years, or
• Double-contrast barium enema (DCBE) every 5 years, or
• CT colongraphy (CTC), also called virtual colonoscopy, every 5 years
• Stool tests must be repeated at regular intervals and a colonoscopy must be performed if stool test results are abnormal.

• Biopsy During a colonoscopy, a tissue sample removed.
• Blood Tests To evaluate the red blood cell count and check for anemia.
• Tumor markers include carcinoembryonic antigen (CEA) and CA 19-9.
• Imaging Tests To detect the presence of cancer or find out how far the cancer has spread. These tests include ultrasound, chest x-ray, magnetic resonance imaging (MRI) scan, positron emission tomography (PET) scan, and computed tomography (CT) scan.

1. Surgery is used for early-stage colorectal cancer. Usually, the tumor is removed along with part of the colon and nearby lymph nodes.
2. Chemotherapy may be given after surgery to kill any remaining cancer cells. It may also be given along with radiation before surgery to reduce tumor size.
3. Radiation therapy is commonly used to treat locally advanced cancer, combined with chemotherapy.

The most curable of cancers when it is caught in its early stages. The 5-year survival rate for colon cancer diagnosed and treated at stage I is 93%. The rates fall to 72 - 85% for stage II, 44 - 83% for stage II, and 8% for stage IV.

• Physical Examination. Every 3 - 6 months for the first 2 years, every 6 months through the fifth year, and yearly thereafter.
• Colonoscopy. 1 year after surgery. If the results are normal, then next colonoscopy 3 years later and then every 5 years.
• Carcinoembryonic Antigen Levels. Measured every 3 -6 months after surgery for 2 years in patients, and then every 6 months up to 5 years
• Imaging Tests. An annual computerized tomography (CT) scans of the chest, abdomen, and pelvis for the first 3 years after treatment.
• Complete blood count, liver function tests, and fecal occult blood tests.

In the earliest stages of colorectal cancer (stage 0 and some stage I cases) polyps can be removed during a colonoscopy in a procedure called polypectomy.

• Colectomy involves removing the cancerous part of the colon and nearby lymph nodes.
• The Surgical Approach.
• Open Surgery: Taking wide incision on the abdomen.
• Laparoscopy: Taking small incisions on the abdomen and using laparoscope is used for early cancers.

• The procedure generally involves creating a stoma, through the abdominal wall that is connected to the colon. The feces passthrough this passage and are eliminated.
• Permanent colostomies are more common when the cancerous regions are within 2 - 3 centimeters of the anus.

• Local Excision or Polypectomy for Early Stages.
• Radical Resection. In this lower part of rectum along with surrounding structures, including the sphincter muscles that control bowel movements, must often be removed.

Radiation therapy uses x-rays to kill cancer cells that might remain after an operation or to shrink large tumors before an operation so that they can be removed surgically.

• If you have:
  • Black, tar-like stools
  • Blood during a bowel movement
  • Change in bowel habits

• Pelvic examination by oncosurgeon.
• Blood investigations to look for anemia.
• Ultrasound of abdomen.

Low-fat and high-fiber diets may reduce your risk of colon cancer.