Colorectal Cancer: Symptoms, Causes And Treatment
Heading to the doctor? Here is a Physicians Checklist for Colon Cancer.
Colon cancer, also known as colorectal cancer, is one of the most prevalent cancers today. It accounts for 15% of all cancer cases in the US and 1 in 20 Americans will develop it at one point in their lives. Colon cancer develops in your colon and in some cases your rectum. It affects both women and men, and all races and ethnicities. Early detection is crucial for successful treatment. Since colon cancer is often linked to diet, weight, lack of activity, smoking and drinking alcohol, switching to a healthier diet and lifestyle, you can reduce your risk of colon cancer.
In this post, I want to discuss colon cancer in depth so you can have a better understanding of the disease, what it is, how it affects your body, what you can do to treat it and how to best work with your doctor to find healing and support.
What Is Colon Cancer?
Colon cancer is a disease in which cancer cells form in the colon. Your colon is a large, 5-feet long organ in your digestive system that plays an important role in removing and processing nutrients. It is also responsible for the removal of waste material through the rectum and anal canal. (1)
Overtime most people develop adenomatous polyps, which are small, noncancerous (benign) clumps of cells, in the colon. Though most cases of polyps remain benign, some turn into colon cancer over time. Most cases of colon cancer start as benign polyps. Polyps tend to have few or no symptoms at all, therefore regular screening is required to remove polyps while benign and to detect cancer early on. (2)
Colon cancer is a serious and growing problem. In the US it is the third most common type of cancer and third leading cause of cancer-related death. About 4.3 percent of the population is predicted to be diagnosed with colon cancer in the lifetime. There are 40.1 per 100,000 people are being diagnosed with colon cancer each year. 14.8 per 100,000 die from colon cancer.
Colon cancer affects both sexes, though male has a higher risk (46%) than female (35.1%). All ethnicities are affected, though black males have the highest risk of all (54.6%) and Asian females have the lowest risk (28.8%). Early detection is crucial as the 5-year survival rate is 39.2% for those diagnosed at an advanced stage and 89.9% for those with localized colon cancer. (3, 4, 5, 6)
Symptoms Of Colon Cancer
There are many potential causes for abdominal discomfort and digestive problems besides cancer. It is important to seek medical help and get regular screening to receive the proper diagnosis and in case of colon cancer, early detection is vital.
Symptoms of colon cancer include (2, 7, 8):
- Abdominal pain
- Abdominal discomfort
- Changes in bowel movement and/or stool consistency, including constipation, diarrhea, thinning and narrowing stools
- Bloody stools or unusually dark, tar-like stool
- Weight loss without trying
- Changes in appetite
Stages Of Colorectal Cancer
In case of a colon cancer diagnosis, stages help determine the seriousness of cancer, including size, location, and whether or not it has spread to other organs (metastasis). It helps to decide on the best treatment plan and determine the chances of survival.
The TNM system is the most widely used system to identify cancer stages. The T refers to the primary tumor (in this case the tumor in the colon). The N refers to regional lymph nodes. The M refers to distant metastasis in your body. (9)
Stages of colon cancer (10):
Stage 0: Stage 0 is otherwise known as carcinoma in situ. It means that there are abnormal cells in the innermost layer (mucosa) of the colon that may become cancer.
Stage 1: In stage 1, cancer has been formed in the mucosa of the colon and has spread to the layer of tissue under it (submucosa) and possibly to the muscle layer as well. Cancer is still localized at this stage.
Stage 2: In stage 2, colon cancer has spread to the outermost layer (serosa) of your colon wall and possibly to nearby organs as well.
Stage 3: In stage 3, cancer has spread to nearby lymph nodes or cancer cells have formed near the lymph nodes as well. Stage 3 has three substages (A, B, C) to determine how many lymph nodes and how much of the nearby tissue and muscle cells it has affected.
Stage 4: In this stage, cancer has spread to other organs. At this stage, treatment becomes increasingly difficult.
Recurrent: Recurrent cancer means that cancer was found after treatment. It may mean that cancer comes back in the same area, but it may come back at a different part of the body.
How Cancer Spreads
Who Is At Risk For Colon Cancer?
Your family history may help determine your risk of colon cancer. Though normally colonoscopies are recommended at age 50 and regularly beyond, if you have a family history of colon cancer, it may be recommended to get a screening as early as age 40. Familial adenomatous polyposis (FAP) and hereditary non-polyposis colorectal cancer (HNPCC) are to inherited symptoms that have been linked to colon cancer and Lynch Syndrome, Turcot Syndrome and Peutz-Jeghers Syndrome that may increase your risks as well. (12)
Colon cancer affects all races and ethnicities, but blacks have the highest rates of the disease. Ashkenazi Jews also have a higher risk than most other races. (3, 12)
Unhealthy diets high in red and processed meats, processed foods, and lack of fiber in your diet can increase your risk of colon cancer. Cooking methods, such as grilling, frying, broiling, using chemicals and high temperatures also increase your chances. Eating a high-fiber diet with lots of vegetables and fruits may reduce your risks of colon cancer. (12)
An inactive, sedentary lifestyle puts you at a higher risk of colon cancer. (12)
Smoking may increase your chances of colon cancer. (12)
Heavy alcohol use and alcoholism can increase your risk of colon cancer. (12)
Most cancer cases occur at age 45 or older. The median age for colon cancer is 68. That said, colon cancer can occur at age and it is becoming more common among those under 45. (12)
IBD, including Crohn’s disease and ulcerative colitis, may increase your chances of colon cancer making proper treatment of your IBD and aiming for remission is important. (12)
Being overweight or obese may increase your chances of developing colon cancer. (12)
Type 2 Diabetes
Type 2 diabetes may increase your risk of colon cancer. (12)
Complications Of Colon Cancer
Colon cancer has various complications. Many patients with colon cancer suffer from constipation or diarrhea, however, there are more serious complications as well. (13)
Colon cancer and its treatment can lead to intestinal obstruction in some cases, especially in Stage 4. It may be caused by a tumor that blocks the intestine, scar tissue, adhesion, damage to colon from radiation, chemotherapy, narcotics, or other drugs, and fecal impaction. Treatment may include resting the bowel, relieving the pressure of the abdomen, medication, or surgery. (14, 15, 16)
When cancer reoccurs after initial treatment or stops responding to treatment, it is called recurrent or relapsed. In some cases, recurrent cancer can be cured with surgery. Treatment may be determined by the size and stage of cancer and whether it has metastasized. (17)
Metastasis or metastatic growth is not primary cancer, but the development of secondary malignant growths at a distance from a primary site of cancer. Colon cancer most often spreads to the liver, however, metastasis in the lungs, bones, or other organs is possible as well. (18)
Development of Secondary Primary Cancer
The development of secondary primary cancer refers to a new type of cancer occurring in the body. It may develop months or years after the primary cancer was diagnosed and/or treated. Even if your treatment was successful, it does not mean you cannot get cancer again in the same location or in another part of your body. Secondary primary cancer in case of colon cancer may develop in the colon again, or in other parts of your digestive system (rectal, anal, stomach, bile duct etc), uterine, ureter, kidneys, or any other part of your body. (19, 20, 21, 22, 23)
How Is Colon Cancer Treated?
Detected early, the prognosis for colon cancer is better. If you are experiencing any symptoms of colon cancer, talk to your doctor to receive the diagnosis and treatment necessary. Get screened regularly past age 50, or earlier if it is recommended because of your family or personal health history. Of course, do not forget about prevention either through a healthy diet and/or lifestyle!
Diagnosing Colon Cancer
Detecting Colon Cancer
- Physical exam and history: Understanding your family and personal health history, as well as your symptoms, can help your doctor to understand your risk of colon cancer and to make the proper diagnosis. A thorough physical exam is the first step to proper diagnosis. (23)
- Digital rectal exam: When performing a digital rectal exam (DRE), your doctor examines your rectum with a lubricated, gloved finger. This exam is not very effective and misses about 90% of cases of cancer. (24)
- Fecal occult blood test: This test checks for blood in the stool and may be an indication of polyps or cancer. (25)
- Barium enema: Barium enema is also called a colon x-ray. A small amount of metallic substance (barium) is injected into your colon, then an x-ray is able to detect changes or abnormalities in the large intestine. (26)
- Sigmoidoscopy: Sigmoidoscopy can examine the lower 20 inches of your sigmoid colon and rectum through a tiny camera. It may detect polyps or cancer. (27)
- Colonoscopy: Colonoscopy is the best screening method that allows your doctor to look inside your colon and rectum. Do not worry, you are sedated during the procedure. (23)
- Virtual colonoscopy: Virtual colonoscopy is basically a CT scan that through x-ray images examines your colon and rectum and can find polyps, cancer, and other abnormalities. It examines your internal system without actually going inside your body. (28)
- Biopsy: During a biopsy, a small amount of tissue is being removed with a small needle guided into the tumor to be examined under a microscope. Such sample is necessary to make a definite diagnosis of colon cancer. (23)
Determining Severity/Stage Of Cancer
- CT Scan: Through cross-sectional images, a CT scan can be used to measure the tumor’s size. It can also check whether or not cancer has spread to other organs. (23)
- MRI: Unlike CTs and x-ray, MRI uses magnetic fields for creating detailed images of the body. MRIs can measure the size of the tumor and whether or not it has grown. (23)
- PET Scan: With help of a radioactive substance, PET scans can locate cancer in the body and determine its severity. PET scans are usually used in combination with CT scans to take images of organs and tissues. (23)
- Chest X-Ray: A chest x-ray can determine whether or not cancer has spread to your lungs. (23)
- Surgery: Surgery can remove tumors to be examined under a microscope outside of the body.
- Lymph node biopsy: During a lymph node biopsy a lymph node, or a piece of a lymph node, is removed to be examined under a microscope. (29)
- Carcinoembryonic antigen assay: Carcinoembryonic antigen assay can measure a protein called CEA in your body. People with cancer have higher than normal levels of CEA, and this test can determine whether the cancer has grown or if treatment has worked. (31)
Conventional Treatments For Colon Cancer
Surgery can remove polyps, tumors, part of the colon lining, and affected lymph nodes. When a partial colectomy surgery is performed to remove parts of the colon, the healthy portions are also being reconnected during surgery. (32)
Cyrosurgery is also known as cryotherapy. It uses extreme cold produced by liquid nitrogen (or argon gas) to destroy abnormal tissue in your body. It is often used for external growths and cancer. It can also be used for internal cancer when using a hollow instrument called a cryoprobe liquid nitrogen or argon gas is being placed by the tumor to freeze the tissue and kill cancer. (34)
Chemotherapy helps to destroy cancerous cells and prevent spreading with the use of a drug. In cases of colon cancer, chemotherapy usually happens before surgery. (32)
Radiation therapy uses energy sources, such as x-rays to help shrink tumors. (32)
Targeted drug therapy uses specific drugs to target specific malfunctions due to cancer. It is usually used at later stages of colon cancer. It can be used along with chemotherapy or as a stand-alone option. (32)
13 Natural Strategies To Manage Colon Cancer Symptoms
#1 Increase Fiber Intake
Foods that promote inflammation, have low nutritional value, and are low in fiber can increase your risk of colon cancer and worsen your symptoms as well. Processed meats particularly put you at higher risk. On the other hand, research has found that increasing your fiber intake can ease your symptoms and lower your risks of colon cancer. You want to focus on whole foods that are high in fiber such as greens, vegetables, fruits, nuts, seeds, and whole grains. (35)
High Fiber Foods:
- Apples and pears
- Brussel sprouts
- Sweet potatoes
- Beans and legumes
Other cancer-fighting foods include:
- sea vegetables
- green tea
- coconut oil
#2 Boost Antioxidant Intake
Antioxidant-rich foods can fight free radical damage, can lower your risk of cancer, and assist your fight against cancer. A diet rich in fruits and vegetables will provide plenty of antioxidants your body needs.
- kidney beans
- bell pepper
#3 Take Turmeric
Research has found that tumreric can reduce inflammation of your colon, improve issues in your digestive system, and reduce your risk of colon cancer. Take turmeric supplement, drink turmeric tea or golden milk, and add turmeric to your meals. (44, 45, 46)
#4 Stop Smoking
Smoking can increase your chances of colon cancer and worsen your symptoms. Stop smoking or if you are not smoking, do not start now.
#5 Limit Alcohol Consumption
High alcohol consumption can increase your risk of colon cancer. Limit your alcohol intake or do not drink at all.
#6 Avoid Large High-Fat Meals
Large, high-fat meals, in particularly greasy, deep fried, grilled, broiled, or oily fast foods and comfort foods can increase your risk of colon cancer and hinder your chances of getting better. Eat healthy, whole foods diet rich in greens, veggies, fruits, nuts, seeds, legumes, beans, and whole grains. Eat raw foods, or steamed, boiled, or lightly baked meals.
#7 Eat Smaller, More Frequent Meals
Instead of eating large meals that can clog up your digestion and leave you sluggish, eat smaller and more frequent meals. Remember to eat healthy, whole foods, instead of processed products and fast food.
#8 Maintain A Healthy Weight
Being overweight or obese has been linked to higher risk of colon cancer. Aim to lose weight if you need to and maintain a healthy weight through a healthy, balanced diet, exercise, plenty of sleep, and lower stress.
#9 Increase Physical Activity
A sedentary lifestyle has been linked to higher risk of colon cancer. Research has found that regular exercise can lower your risk. Aim to engage in some form of exercise for at least 20 – 30 minutes a day and be active in general. (36)
#10 Use Ginger and Ginger Oil For Nausea
Research has shown that ginger can reduce your risk of colon cancer. It can lower inflammation in your colon as well. Ginger can also improve chemotherapy related nausea. Drink ginger tea, add ginger to your juices and meals, and try ginger supplements. (39, 40, 41, 42, 43)
#11 Frankincense Essential Oil Therapy
Essential oils can improve your quality of life and health in general. Frankincense is particularly beneficial for a healthy digestion.
#12 Probiotic-Rich Foods And Supplements
Research has found that probiotic-rich foods can have anticancer effects. Take probiotic supplements daily and eat probiotic-rich foods, such as kefir, kombucha, saurkraut, kimchi, and yogurt. (37)
#13 Increase Vitamin D3 Intake
Research has found that increased vitamin D and calcium intake can lower your cancer risks. Take vitamin D3 supplements, and eat calcium-rich foods. (38)
Frequently Asked Questions About Colon Cancer
Q. Can colon cancer be cured?
A. Colon cancer is treatable. As long as it is localized in the bowel, it can be cured as well. The primary form of treatment is surgery that leads to a cure in 50% of the cases. It is important to detect colon cancer early
Q. Can colon cancer be mistaken for diverticulitis?
A. While diverticulitis can lead to inflammation, infection, bleeding or intestinal blockage, it does not lead to cancer. Symptoms may be similar but through sigmoidoscopy, colonoscopy, CT colonography or a combination of these tests, it is possible to differentiate the two and receive a proper diagnosis.
Q. Can colon cancer cause lower back pain?
A. Lower back pain may be a late sign of colon cancer.
Q. Where does colon cancer start?
A. Colon cancer tends to start from colorectal polyps, though most polyps don’t lead to cancer.
Q. Who diagnoses colon cancer?
A. Your gastroenterologist and/or oncologist can diagnose colon cancer through examination and cancer screening.
Q. What is a colon cancer screening?
A. There are various forms of colon cancer screening techniques that can detect colon cancer. Colonoscopy is the most well-known form, but Fecal immunochemical testing (FIT), tool blood test (fecal occult blood test–FOBT). flexible sigmoidoscopy (flex-sig), barium enema with air contrast, and virtual colonoscopy (CT Colonography)
Q. Why does colon cancer spread to the liver?
A. Cells break away from the primary tumor and metastasize in the liver.
Q. When is colon cancer awareness month?
If you have any of the symptoms of colon cancer or think that you may have or be at risk of colon cancer, visit your healthcare professional. Here is a Doctor Visit Checklist to help you have the most productive visit possible.
Remember, early detection is important for successful treatment. Healthy dietary and lifestyle choices can lower your risk of colon cancer, lower the risk of the spreading or recurrence of cancer, can assist treatment, and can help manage your colon cancer symptoms.
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