Colorectal Cancer

How does Colorectal Cancer start?

Most colorectal cancers start as a growth on the inner lining of the colon or rectum. These growths are called polyps. Some types of polyps can change into cancer over time (usually many years), but not all polyps become cancer. The chance of a polyp turning into cancer depends on the type of polyp it is.

There are different types of polyps-

• Adenomatous Polyps (adenomas): These polyps sometimes change into cancer. Because of this, adenomas are called a pre-cancerous condition. The 3 types of adenomas are tubular, villous, and tubulovillous.
• Hyperplastic Polyps and Inflammatory Polyps: An endoscope can be used in case of chronic pancreatitis if the condition has resulted from some blockage. The endoscope has the ability to clear the blockage.
• Sessile Serrated Polyps (SSP) and Traditional Serrated Adenomas (TSA): Surgical methods are indicated in cases of severe chronic pancreatitis where the pain has not responded to medications. unfortunately surgery can help in controlling pain of the patient, it cannot alter the disease process.

Other factors that can make a polyp more likely to contain cancer or increase someone’s risk of developing colorectal cancer include:

• If a polyp larger than 1 cm is found
• If more than 3 polyps are found
• If dysplasia is seen in the polyp after it's removed. Dysplasia is another pre-cancerous condition. It means there's an area in a polyp or in the lining of the colon or rectum where the cells look abnormal, but they haven't become cancer.

What are the symptoms of Colorectal Cancer?

Symptoms of colorectal cancer include:

• Changes in bowel habits
• Diarrhea or constipation
• A feeling that the bowel does not empty properly after a bowel movement
• Blood in feces that makes stools look black
• Bright red blood coming from the rectum
• Pain and bloating in the abdomen
• A feeling of fullness in the abdomen, even after not eating for a while
• Fatigue or tiredness
• Unexplained weight loss
• A lump in the abdomen or the back passage felt by your doctor
• Unexplained iron deficiency in men, or in women after menopause

Most of these symptoms may also indicate other possible conditions. It is important to see a doctor if symptoms persist for 4 weeks or more.

What are the causes of Colorectal Cancer?

Factors that cause colorectal cancer are as follows:

• Increasing age is associated with colorectal cancer. The study reveals, 90% of colorectal cancers are diagnosed after the age of 40.
• Consistently and prolonged habit of high fat intake can cause colorectal cancer.
• A history of colorectal cancer and polyps in the family may lead to such disease.
• Large intestine carries polyps for a considerable period may cause colorectal cancer.
• Chronic ulcerative colitis and inflammatory bowel disease can lead to colorectal cancer.

What are the treatments of Colorectal Cancer?

Treatment will depend on several factors, including the size, location, and stage of the cancer, whether or not it is recurrent, and the current overall state of health of the patient. Treatment options include chemotherapy, radiotherapy, and surgery.

1. 1. Surgery for Colorectal Cancer:

   

   This is the most common treatment. The affected malignant tumors and any nearby lymph nodes will be removed, to reduce the risk of the cancer spreading. The bowel is usually sewn back together, but sometimes the rectum is removed completely and a colostomy bag is attached for drainage. The colostomy bag collects stools. This is usually a temporary measure, but it may be permanent if it is not possible to join up the ends of the bowel. If the cancer is diagnosed early enough, surgery may successfully remove it. If surgery does not stop the cancer, it will ease the symptoms.

2. 2. Chemotherapy: Chemotherapy involves using a medicine or chemical to destroy the cancerous cells. It is commonly used for colon cancer treatment. Before surgery, it may help shrink the tumor. Targeted therapy is a kind of chemotherapy that specifically targets the proteins that encourage the development of some cancers. They may have fewer side effects than other types of chemotherapy. Drugs that may be used for colorectal cancer include bevacizumab (Avastin) and ramucirumab (Cyramza).
   
   A study has found that patients with advanced colon cancer who receive chemotherapy and who have a family history of colorectal cancer have a significantly lower likelihood of cancer recurrence and death.
   
3. 
   3. Radiation Therapy: Radiation therapy uses high energy radiation beams to destroy the cancer cells and to prevent them from multiplying. This is more commonly used for rectal cancer treatment. It may be used before surgery in an attempt to shrink the tumor.

Both radiation therapy and chemotherapy may be given after surgery to help lower the chances of recurrence.