Colorectal Cancer (Colon Cancer) is the development of cancer in the colon or rectum.It is a disease originating from the epithelial cells lining the colon.The colon is the last part of digestive system.The colon consists of four sections, such as the ascending colon, the transverse colon, the descending colon, and the sigmoid colon.
The Signs and Symptoms of Colorectal Cancer
- Blood in the stool
- Unexplained weight loss
- Tiredness all time
- A change in bowel movements
- Loss of appetite
- Nausea
- Vomiting
- Worsening constipation
- Decreasing in stool caliber (thickness)
- Frequent gas pains
- Bloating
- Diarrhea
- Cramps
- Feeling fullness
Risk Factors of Colorectal Cancer
- Family history of colon cancer
- Older age
- Male gender
- Race
- Lifestyle
- A diet high in red, processed meat
- Fat intake highly
- Tobacco smoking
- Alcohol
- Exposure to radiation
- Inherited genetic disorders, such as Familial adenomatous polyposis
- Lack of physical activity
- Colon polyps
- Obesity
- Diabetes
- Other diseases, such as inflammatory bowel disease ; Crohn's disease, ulcerative colitis
Diagnosis
Some tests and procedures are used to diagnose the colon cancer.
- Medical History is to get information about Patient"s health habit, past illness, and treatment.
- Physical Examination is to examine the body from signs or symptoms of colon cancer.
- Digital Rectal Exam is an exam of rectum.
- Fecal Occult Blood Test is a test to check the stool (solid waste) for blood that can onlybe seen with a microscope.
- Multitarget Stool DNA Screening Test is a noninvasive test used to screen for the presence of colorectal cancer or precancerous lesions.
- Barium Enema is a series of x-rays of the lower of gastrointestinal tract.
- Sigmoidoscopy is a procedure to look inside the rectum and sigmoid colon for polyps, other abnormal areas, or cancer.
- Colonoscopy is a procedure to look inside the rectum and colon for polyps, other abnormal areas, or cancer.
- Virtual Colonoscopy is a procedure that uses a seies of x-rays or computed tomography (CT) to make a series of pictures of the colon.
- Biopsy is the removal of cells or tissues and looked under a microscope.
- Computed Tomography (CT) scan produces detailed cross-sectional images of the body and determines the location and size of colorectal cancer and whether they have spread to nearby areas.
- Magnetic Resonance Imaging (MRI) scan provides very detailed images of colon and looks for cancer in the colon or cancer that has spread to nearby parts of body.
- Positron Emission Tomography (PET) scan is a radioactive substance is injected into the blood
- Ultra sound uses sound waves to create images of parts of the body.
- Chest X-Ray is an x-ray of the organs and bones inside the chest.
- Surgery is a procedure to remove the tumor and see how far cancer has spread through colon.
- Lymph Node Biopsy is the removal of all or part of a lymph node.
- Complete Blood Count is a procedure in which a blood sample is drawn and checked for the number of red blood cells, white blood cells, and platelets.
- Carcinoembryonic Antingen (CEA) Assay is a test to measure the level of CEA in the blood.
The Stage of Colon Cancer
- Stage 0 (Carsinoma In Situ) : Abnormal cells are found in the mucosa (innermost layer) and the colon wall.
- Stage I : Cancer has spread from the mucosa of the colon wall to the muscle layer.
- Stage IIA : Cancer has spread through the muscle layer of the colon wall to the serosa (outermost layer) of the colon wall.
- Stage IIB : Cancer has spread through the serosa of the colon wall but has not spread to nearby organs.
- Stage IIC : Cancer has spread through the serosa of the colon wall to nearby organs.
- Stage IIIA : Cancer has spread through the mucosa of the colon wall to the submucosa and may have spread to the muscle layer.Cancer has spread to one to three nearby lymph nodes or tissues near the lymph nodes or Cancer has spread through the mucosa to the submucosa and four to six nearby lymph nodes.
- Stage IIIB : Cancer has spread through the muscle layer of the colon wall to the serosa.Cancer has spread through the serosa but not to nearby organs.It has spread through one to three nearby lymph nodes or tissues near the lymph nodes.Or Cancer has spread through the muscle layer or to the serosa, and to four to six nearby lymph nodes.Or Cancer has spread through the mucosa of the colon wall to the submucosa and may have spread through the muscle layer.It has spread to seven or more nearby lymph nodes.
- Stage IIIC : Cancer has spread through the serosa of the colon wall but not to nearby organs.It has spread four to six nearby lymph nodes.Or Cancer has spread through the muscle layer of the colon wall to the serosa or Cancer has spread through the serosa of the colon wall but not to nearby organs.It has spread to seven or more nearby lymph nodes.Or Cancer has spread through the serosa to nearby organs and to one or more nearby lymph nodes or to tissues near the lymph nodes.
- Stage IV : The cancer has spread through the blood and lymph nodes to other parts of the body, such as the lung, the liver,the abdominal wall or the ovary.
The Standard Treatments Of Colon Cancer
1. Surgery is the removal of cancer cells in operation.
- Local Excision is the removal of cancer without cutting through the abdominal wall if the cancer is found in the very early stage.
- Resection of the colon with Anastomosis is removing of the cancer and a small amount of healthy tissue around it if the cancer is larger and then sewing the healthy parts of the colon together.
2. Radio Frequency Ablation is the use of a special probe with electrodes that kill cancer cells.
3. Cryosurgery is a treatment that uses an instrument to freeze and destroy abnormal tissue.
4. Chemotherapy is a treatment that uses drugs to stop the growth of cancer cells either by killing the cells or by stopping them from dividing.Chemoembolization of the hepatic artery is to treat cancer that has spread to the liver.
5. Radiation Therapy is a treatment that uses high-energy x-ray or other types of radiation to kill cancer cells or keep them from growing.There are two types of radiation therapy.External radiation therapy uses a machine outside the body to send radiation toward the cancer.Internal radiation therapy uses a radiactive substance sealed in needles, seeds, wires or catheters that are placed directly into or near the cancer.
6. Targeted Therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells.
The Stage Treatments Of Colon Cancer
The Treatment of Stage 0 includes
- Local excision or simple polypectomy.
- Resection and Anastomosis.
The Treatment of Stage I includes
- Resection and Anastomosis.
The Treatment of Stage II includes
- Resection and Anastomosis.
The Treatment of Stage III includes
- Resection and Anastomosis which may be followed by chemotherapy.
- Clinical trials of new chemotherapy regiments after surgery.
The Treatment of Stage IV includes
- Local excision for tumors that have recurred.
- Resection with or without Anastomosis
- Surgery to remove parts of other organs, such as the liver, the lungs, and the ovaries where the cancer may have recurred or spread
The treatment for the cancer has spread to the liver includes
- Chemotherapy is given before surgery to shrink the tumor.Chemotherapy is done after surgery or both before and after surgery.
- Radiofrequency Ablation or Cryosurgery for patuents who cannot have surgery.
- Chemoembolization of the hepatic artery.
- Radiation Therapy or Chemotherapy is offered to some patients to relieve symptoms and improve quality of life.
- Chemotherapy and/or Targeted Therapy with a monoclonal antibody or an angiogenesis inhibitor.
- Clinical trials of chemotherapy and/or Targeted Therapy
Drugs For Colon Cancer approved by The Food and Drug Administration (FDA)
- Avastin ( Bevacizumab)
- Bevacizumab
- Camptosar (Irinotecan Hydrochloride)
- Capecitabine
- Cetuximab
- Cyramza (Ramucirumab)
- Eloxatin (Oxaliplatin)
- Erbitux (Cetuximab)
- 5-FU (Fluorouracil Injection)
- Fluorouracil Injection
- Irinotecan Hydrochloride
- Leucovorin Calcium
- Lonsurf (Trifluridine and Tipiracil Hydrochloride)
- Oxaliplatin
- Panitumumab
- Ramucirumab
- Regorafenib
- Stivarga (Regorafenib)
- Trifluridine and Tipiracil Hydrochloride
- Vectibix (Panitumumab)
- Wellcovorin (Leucovorin Calcium)
- Xeloda (Capecitabine)
- Zaltrap (Ziv-Aflibercept)
- Ziv-Aflibercept
Drug Combinations for Colon Cancer
- Capox
- Folfiri
- Folfiri-Bevacizumab
- Folfiri-Cetuximab
- Folfox
- FU-LV
- Xeliri
- Xelox
Prevention of Colon Cancer
- Increased surveillance.
- Comsumption of whole grains, fruits, and vegetables.
- Reducing red meat intake.
- Physical exercises regularly.
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