Colon Cancer: Comprehensive Guide to Diagnosis, Treatment and Prevention

Colorectal cancer: what you need to know about this condition

What is colorectal cancer?

Colorectal cancer, also known as colon or rectal cancer, is a form of cancer that affects the colon (large intestine) or rectum (lower/terminal portion of the large intestine). It can be understood as a condition in which abnormal cells begin to grow and form malignant tumours in these areas. Colorectal cancer has similar, sometimes non-specific symptoms and can have a variety of causes and risk factors.

Symptoms of colorectal cancer: how to recognise the early signs

Symptoms of colorectal cancer: how to recognise the early signs

In its early stages, colorectal cancer may occur without obvious symptoms, but there are important signs and symptoms that may indicate the need for medical evaluation. It is essential to be aware of these signs so that you can recognise the early signs of colon cancer. Here’s what you need to know:

Changes in bowel movements: If you notice significant changes in bowel movements, such as persistent diarrhoea or constipation or changes in stool consistency that last for more than 2-4 weeks, it is important to talk to your doctor.

Rectal bleeding or blood in the stool: Rectal bleeding or blood in the stool may be signs of colorectal cancer. Dark stools (melena) may also indicate a problem in the colon or rectum. These symptoms should not be ignored and require immediate medical evaluation.

Persistent abdominal discomfort: If you experience constant abdominal discomfort in the form of cramping, bloating or pain, this may be a warning sign. This type of discomfort should not be ignored and should be communicated to your doctor.

Incomplete bowel movement: Sometimes colorectal cancer can cause you to have an incomplete bowel movement, even if you have finished defecating. This persistent sensation should be brought to the attention of the doctor for evaluation.

The ”pencil” shaped stool may suggest a stenosing tumour problem in the rectum.

Severe fatigue: Fatigue or undue tiredness can be signs of colorectal cancer in the advanced stages of the disease. If you constantly feel tired and there is no obvious cause, it is important to talk to a specialist.

Weight loss: Weight loss without an apparent cause can be a warning sign. If you notice significant weight loss in a relatively short time, see a doctor for a full assessment.

It is essential to understand that these symptoms can be caused by other conditions, but ignoring them can lead to delayed diagnosis and late treatment of colorectal cancer. If you suspect or experience these symptoms, do not hesitate to seek medical advice as soon as possible. Early detection and treatment can make a significant difference in the chances of recovery.

robotic colon surgery

Risk factors for developing colorectal cancer

Risk factors for colorectal cancer:

  1. Colorectal polyps: Small growths or polyps that develop on the lining of the colon or rectum can be a significant risk factor over time. These polyps can undergo cancerous changes, becoming colorectal cancer.
  2. Family history: People who have first-degree relatives with a history of colorectal cancer are at increased risk of developing the condition. Genetic/hereditary syndromes such as Lynch syndrome and familial adenomatous polyposis are examples of hereditary conditions associated with higher risk.
  3. Age: The risk of colorectal cancer increases with advancing age, especially for people over 50. Therefore, regular screening (by colonoscopy) is recommended in this age group.
  4. Inflammatory bowel disease: Conditions such as Crohn’s disease and ulcerative haemorrhagic colitis with a long course can increase the risk of colorectal cancer.
  5. Radiotherapy: Previous experience of radiotherapy to the abdomen and pelvis may influence the risk of developing colorectal cancer.
  6. Diet: A diet high in fat and low in fiber may contribute to an increased risk of colorectal cancer.
  7. Diabetes: People with diabetes may have an increased risk of developing colorectal cancer.
  8. Smoking and alcohol: Tobacco and alcohol use are known risk factors for colorectal cancer.
  9. Obesity and sedentary lifestyle: A sedentary lifestyle and obesity can increase the risk of colorectal cancer.

It’s important to talk to your doctor about your specific risk factors and engage in appropriate screenings and preventive measures to reduce your risk or detect colorectal cancer at early stages, when treatment has the greatest chance of success.

The importance of screening for colorectal cancer: when and how to get checked?

Early detection of colorectal cancer is crucial for treatment and long survival. Even in the absence of symptoms, regular screening can identify the presence of cancer or precancerous polyps at an early stage. Here you will find information on when and how to get checked for colorectal cancer.

When to screen for colorectal cancer?

  1. At the recommended age: Starting at age 40-50, most medical organizations recommend regular screening for colorectal cancer. However, for people with increased risk factors, such as family history or hereditary conditions, screening may be recommended earlier.
  1. If you have symptoms: If you experience symptoms such as bowel changes, rectal bleeding, abdominal discomfort or unexplained weight loss, you should seek medical advice immediately and discuss the need for screening.

How to screen for colorectal cancer?

There are several screening modalities available, and your doctor can help you decide which is right for you. Here are some of the most common screening methods:

  1. Rectal Cough: This is a routine examination in which the doctor inserts a finger into the rectum, through the anus, to check for abnormalities. This test can identify active bleeding, rectal pain or tumour formations located strictly in the lower rectum.
  1. Blood tests: Haemolucogram and tumour markers such as CAE (carcinoembryonic antigen) can provide useful information about your health and may indicate the need for further investigations.
  1. Occult bleeding test: This test identifies microscopic bleeding in the intestinal tract and is performed by examining the stool. It is an important way of detecting colorectal cancer in its early stages.
  1. Lower digestive endoscopy (colonoscopy): This procedure involves inserting a tube fitted with a camera into the colon through the anus, allowing the doctor to examine the inside of the colon on video and take tissue samples for biopsy, if necessary.
  1. Computed tomography (CT): CT can be used to take detailed images of the colon and determine the extent of distant cancer spread (metastases).
  1. Nuclear Magnetic Resonance Imaging (MRI): MRI can provide accurate images of organs and tissues and is used to assess the local spread of cancer, especially when discussing the rectum.

Staging colorectal cancer:

If someone is diagnosed with colorectal cancer, it is crucial to determine the stage of the disease. This helps determine treatment options and their sequencing and priority. Further investigations for staging may include serological tumour marker assays, abdominal ultrasound, endorectal ultrasound and CT or MRI imaging.

It is important to discuss your screening options with your doctor and to carry out the necessary assessments as recommended by your doctor. Early detection of colorectal cancer increases the chances of successful treatment and rapid recovery.

Types of treatments available for colorectal cancer

The treatment of colorectal cancer may vary depending on the stage of the cancer and the patient’s clinical condition. There are several treatment options (often in combination), which can include endoscopic treatment, surgical treatment and oncological treatment. Here is a detailed overview of these options:

1. Endoscopic treatment:

– This treatment is suitable for early stage cancers or small polyps that have not spread beyond the colon.

– Polyps can be removed during a colonoscopy.

– For large polyps, a submucosal endoscopic resection may be performed, which involves removing part of the lining of the colon or rectum.

2. Surgical treatment (partial or total colectomy):

– This procedure involves the removal of a part of the colon containing the tumour as well as a portion of healthy tissue on either side of the cancer (oncological borders).

– Resection of affected lymph nodes is also performed to assess the spread of the cancer and to decrease the risk of recurrence.

– Restoring the continuity of the digestive tract (anastomosis) or creating a stoma (artificial opening of the intestine at the abdominal wall) may be necessary in some cases.

– these operations, depending on the patient and the staging of the tumour, can be performed by minimally invasive procedures with 8-15 mm incisions (robotic or laparoscopic surgery) or ”classic” surgery (by laparotomy or cutting of the abdomen):

3. Chemotherapy:

– This treatment uses specific drugs to destroy cancer cells.

– Chemotherapy may be given before surgery (neoadjuvant chemotherapy) to reduce the size of the tumour.

– It can also be given after surgery (adjuvant chemotherapy) to prevent recurrence (risk of cancer coming back).

– Chemotherapy can be used as a single, palliative treatment for colorectal cancer in advanced stages where the multidisciplinary team (surgical oncologist and medical oncologist) determines that surgical treatment is not possible or indicated.

Radiotherapy:

– This treatment uses high-intensity radiation to destroy cancer cells.

– It can be given before or after surgery, depending on the case.

5. Radio-chemotherapy:

– This treatment combines chemotherapy with radiotherapy to increase the effectiveness of both treatments.

6. Biological therapy/Immunotherapy:

– It uses substances produced by the body or synthesised in the laboratory to strengthen the immune system in the fight against cancer.

– This type of therapy may be an option in some cases of advanced colorectal cancer.

It is important to talk to your doctor to determine which treatment is best for you, taking into account the stage of your cancer, your general health and other individual factors. A personalised treatment plan can provide the best chance of recovery.

Colorectal cancer surgery: what to expect and how to prepare?

Surgery is often an essential part of colorectal cancer treatment. This involves removing the tumour along with the affected portions of the colon or rectum. It is important to prepare yourself physically and emotionally for this procedure. Here’s what to expect and how to prepare:

  1. Pre-operative consultation:

– Before the operation, you will have a pre-operative consultation with your surgeon and medical team. Here you will discuss details of the surgical procedure, risks and benefits.

– This is a good time to ask questions and concerns, so don’t hesitate to ask anything you want to know.

  1. Pre-operative tests:

– Your doctor may order additional tests, such as blood tests, imaging or electrocardiograms, to assess your general health before surgery.

  1. Colon preparation:

– To ensure the most efficient surgery and to reduce the risk of infection, your doctor may recommend that you follow a special diet or take laxatives to cleanse your colon before surgery.

  1. Planning for the postoperative period:

– You will discuss with your doctor what to do after the operation, including the recovery period and any dietary or lifestyle changes.

– Care may be needed at home or in a rehabilitation centre after hospitalisation.

  1. Types of surgery:

– There are different types of surgery for colorectal cancer, including partial colectomy (removal of a portion of the colon), total colectomy (removal of the entire colon), rectal resection (removal of part of the rectum) and others; all of these can be performed by minimally invasive (robotic or laparoscopic) approach, depending on the case. The type of intervention depends on the location and stage of the cancer.

  1. Anesthesia:

– You will be anaesthetised during the operation (general anaesthesia) so you will not feel pain during the procedure.

  1. Risks and complications:

– Before consenting to surgery, you will be informed of potential risks such as bleeding, infection, damage to neighbouring organs or complications related to anaesthesia.

  1. Postoperative period:

– Recovery from colorectal cancer surgery can vary from person to person.

– You may need to spend some time in hospital after surgery and then continue your recovery at home.

– Your doctor will guide you on diet, physical activities and medication needed during the post-operative period.

  1. Emotional support:

– Surgery can be emotionally stressful. Don’t hesitate to seek emotional support from family, friends or a therapist.

– Support groups for cancer patients can also be useful for sharing experiences with others going through similar situations.

It is essential to communicate openly with your medical team and follow their advice and recommendations. With proper preparation and care, you can approach colorectal cancer surgery with confidence and hope for a successful recovery, including a cure, which is possible today.

GENERAL RECOMMENDATIONS: Nutrition and diet in the management of colorectal cancer

Nutrition and diet play a significant role in the management of colorectal cancer. A healthy diet can help maintain overall health and support the effectiveness of treatment. Below are tips and recommendations on nutrition and diet for colorectal cancer patients:

  1. Eat foods high in fibre:

– Include fruit, vegetables, whole grains and legumes in your diet as these foods are high in fibre.

– Fibre helps maintain regular bowel movements and can prevent constipation, which can be a problem in colorectal cancer patients.

  1. Limit your consumption of red meat and processed meat:

– Excessive consumption of red meat and processed meat has been associated with an increased risk of colorectal cancer.

– Try replacing red meat with healthier protein sources such as fish, chicken, tofu or legumes.

  1. Maintain adequate hydration:

– Make sure you are well hydrated, as dehydration can worsen symptoms such as constipation.

  1. Avoid excessive consumption of saturated fats:

– Saturated fats can be harmful to colon health. Limit consumption of foods high in saturated fat, such as fast food and butter-rich pastries.

  1. Take food supplements with care:

– Consult your doctor or a nutritionist before taking dietary supplements. Some supplements may interact with colorectal cancer treatments.

  1. Eat foods with antioxidants:

– Foods rich in antioxidants, such as berries, broccoli and tomatoes, can help protect cells against oxidative damage.

  1. Maintain a healthy weight:

– Maintaining a healthy body weight is important for reducing the risk of colorectal cancer and for effective treatment management.

  1. Avoid alcohol and smoking:

– Alcohol and smoking can increase the risk of colorectal cancer and interfere with treatment. Try to avoid these habits.

  1. Plan meals carefully:

– During treatment, you may experience side effects such as nausea, diarrhoea or feeling sick. Plan small, frequent meals to avoid empty stomachs and to make sure you get enough nutrients.

  1. Consult a nutrition specialist:

– A nutrition specialist can create a personalised meal plan to meet your specific needs and help you manage the side effects of treatment.

It is important to always talk to your doctor or a nutrition specialist before making significant changes to your diet, especially during treatment for colorectal cancer. A proper eating plan can support the healing process and help you feel better during treatment.

Managing the side effects of colorectal cancer treatments

Managing the side effects of colorectal cancer treatments is an important part of care and recovery. Treatments such as surgery, chemotherapy, radiotherapy and immunotherapy can have side effects that can be difficult to manage. It is essential to communicate openly with your medical team and follow their advice to deal with these side effects. Here’s how you can manage some of the most common side effects of colorectal cancer treatments:

  1. Nausea and vomiting:

– Antiemetic drugs can help control nausea and vomiting associated with chemotherapy or radiotherapy.

– Try to avoid heavy or spicy foods and eat in small, frequent portions.

  1. Diarrhoea and constipation:

– Diarrhoea can be managed by adjusting your diet to avoid irritating foods such as coffee or spicy foods.

– For constipation, make sure you drink enough water and eat high-fibre foods.

  1. Fatigue:

– Adequate rest and light exercise, such as short walks, can help manage fatigue.

  1. Loss of appetite and weight loss:

– Eat small, frequent meals and try to choose high-calorie, high-protein foods to maintain body weight.

– Nutritional supplements can also be useful to ensure adequate nutrient intake.

  1. Burning or discomfort in the skin (radiotherapy):

– Avoid sun exposure and use sunscreen products to protect the treated skin.

– Avoid tight clothing and the use of harsh soaps.

  1. Infections:

– Maintain personal hygiene and avoid crowds to reduce the risk of infection.

– If you notice signs of infection, such as fever or redness at the surgical site, contact your doctor immediately.

  1. Digestive problems:

– If you have difficulty digesting food, your doctor may recommend digestive enzymes or other treatments.

  1. Emotional problems:

– Colorectal cancer and associated treatments can have a significant emotional impact. Seek support from a psychologist or therapist to deal with stress and anxiety.

  1. Late side effects:

– Some patients may experience late side effects of treatments, such as digestive problems or heart problems. Monitor your health and report any new symptoms to your doctor.

Do not hesitate to discuss any side effects or concerns with your healthcare team. They may recommend adjustments in treatment or offer advice on managing side effects. It’s important to have a personalised care plan and to be actively involved in managing your health during your colorectal cancer treatment.

Survivorship and quality of life after colorectal cancer: tips for patients and survivors

Survival and quality of life after colorectal cancer are crucial issues for patients. After treatment, it is important to focus not only on recovery, but also on maintaining a healthy and fulfilling life. Here are some tips for colorectal cancer patients and survivors:

  1. Follow the care plan:

– Continue to have regular check-ups and follow the follow-up plan prescribed by your doctor. These regular check-ups can help detect relapses or other health problems early.

  1. Maintain a healthy lifestyle:

– Eating a balanced diet, exercising regularly and giving up smoking and alcohol can help maintain overall health and reduce the risk of relapse.

  1. Support your emotional health:

– Colorectal cancer can have a significant emotional impact. Seek support from a therapist or counsellor to help you manage stress, anxiety and depression.

  1. Healthy eating:

– Continue to follow a balanced diet rich in fruit, vegetables, whole grains and lean protein. Limit consumption of processed, fatty and high-sugar foods.

  1. Exercise:

– Exercise regularly. Physical activities can help maintain overall health, increase energy and improve emotional well-being.

  1. Participate in support groups:

– Support groups for colorectal cancer survivors can give you a space to share your experiences with others who have gone through similar situations.

  1. Continuing education:

– Learn about colorectal cancer and your treatment. The better you understand disease and care, the more informed decisions you can make for your health.

  1. Monitor late side effects:

– Some side effects of treatments may occur later, so it is important to keep monitoring your health and communicate with your doctor about any new symptoms or concerns.

  1. Enjoy life:

– Don’t forget to enjoy the good times in your life. Plan activities and get-togethers with friends and family and look for ways to relax and have fun.

  1. Get involved in your community:

– Participate in awareness events and volunteer activities to get involved in the community and provide support to others affected by colorectal cancer.

Each person has a unique experience with colorectal cancer and recovery can vary. However, with proper care for your physical and emotional health, you can enjoy a good quality of life and improve your chances of long-term survival. It is important to trust your medical team and seek the support you deserve during this journey.