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Colon Cancer

Definition

Colon cancer is cancer that starts in colon (or large intestine). The colon absorbs water and nutrients from foods. Then it passes solid waste to the rectum for storage. It stays there until it’s eliminated from the body.
Colon Cancer
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Causes

Cancer is when cells in the body split without control or order. These cells go on to form a growth or tumor. The term cancer refers to harmful growths. These growths attack nearby tissues. They also spread to other parts of the body. It’s not clear exactly what causes these problems. It’s likely a mix of genes and the environment.

Risk Factors

Your chances are higher for:
People of the Black race have the highest chance of getting and dying from colon and rectal cancers.

Symptoms

You may not notice any symptoms at first. When present, colon cancer may cause:
  • Bleeding without other problems
  • A change in bowel habits
  • Blood in the stool that is either bright red, or black and tarry
  • Pain or pressure
  • Feeling of a mass
  • Itching
  • Belly pain
  • Weight loss
  • Feeling tired
  • Breathing problems and pale skin—signs of anemia

Diagnosis

The doctor will ask about your symptoms and health history. Your answers and a physical exam may point to colon cancer. You may also have:
The exam and your test results will help find out the stage of cancer you have. Staging guides your treatment. Colon cancer is staged from 0-4. Stage 0 is a very localized cancer. Stage 4 is a spread to other parts of the body.

Treatment

How colon cancer is treated depends on:
  • How early it’s found
  • Where the tumor is
  • The stage of cancer
Colon cancer is treated with more than one method. Sometimes they’re combined. This can be done with:

Surgery

Surgery is the main way to treat colon cancer. This is done with:
  • Polypectomy and local excision—Cancer is removed during a sigmoidoscopy or colonoscopy.
  • Partial colectomy—A border of healthy tissue along with the cancer is removed. The healthy ends of the colon are reconnected.
  • Laparoscopic-assisted colectomy—A border of healthy tissue along with the cancer is removed. This is done through small cuts in the belly. Tubes are placed in the cuts. Tools and lights are used through the tubes.
  • Total colectomy—The colon is taken out. This results in the need for a colostomy. A path for solid waste to pass from the body is made through the belly wall. A special bag is needed to collect the waste.

Radiation Therapy

Radiation therapy is the use of radiation to kill cancer cells and shrink tumors. It may be given at the same time as chemotherapy. The types are:
  • External—radiation is aimed at the tumor from a source outside the body
  • Internal—radioactive materials are placed into the body near the cancer cells

Chemotherapy

Chemotherapy is the use of drugs to kill cancer cells. It may given by mouth, shots, or IV. The drugs enter the bloodstream and travel throughout the body.

Medicines

Targeted Therapy
These medicines block tumors from growing and spreading. It may be used with other methods. In many cases, these medicines aren’t used until cancer is in later stages.
Other Medicines
Some medicines are part of treatment. Others may help control side effects. These may include:
  • Corticosteroids
  • Medicines to make more red or white blood cells
  • Anti-nausea medicines
  • Pain relievers

Prevention

Screening

The purpose of these tests is find and treat cancer early. If you are aged 50 years and older, and are not at high risk, talk to your doctor to find the right test for you:
  • Colonoscopy—every 10 years
  • Sigmoidoscopy—every 5-10 years
  • CT colonography—every 5 years
  • Barium enema—every 5 years
  • Stool DNA test every 3 years
  • Fecal occult blood test (FOBT)—every year
  • Fecal immunochemical test (FIT)—every year
Talk to your doctor about testing after age 40 if you are Black, Asian, or a native of Alaska.
Talk to your doctor about how often you should be tested if you have:
  • People in your family with colon or rectal cancer, or polyps
  • People in your family with inherited diseases of the colon or rectum
  • Or had colon or rectal cancer, polyps
  • Inflammatory bowel diseases

Lifestyle Changes

To help lower your chances of colon cancer:
  • Quit smoking—your doctor will help you find the best way.
  • Eat a well-balanced, healthful diet.
  • Get at least 30 minutes of activity a day on most days of the week.
  • Alcohol—Don’t drink more than 2 a day if you’re a man or more than 1 a day if you’re a woman.
  • Keep a healthy weight.

RESOURCES

American Cancer Society
https://www.cancer.org
United Ostomy Associations of America
https://www.ostomy.org

CANADIAN RESOURCES

Canadian Cancer Society
https://www.cancer.ca
Ostomy Canada Society
https://www.ostomycanada.ca

References

Colorectal cancer. American Cancer Society website. Available at: https://www.cancer.org/cancer/colon-rectal-cancer.html. Accessed July 27, 2018.
Colorectal cancer. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T113642/Colorectal-cancer. Updated June 16, 2018. Accessed July 27, 2018.
Colorectal cancer screening. EBSCO DynaMed Plus website. Available at: https://www.dynamed.com/topics/dmp~AN~T114074/Colorectal-cancer-screening. Updated May 21, 2018. Accessed July 27, 2018.
Colorectal cancer screening tests. American Cancer Society website. Available at: https://www.cancer.org/cancer/colon-rectal-cancer/detection-diagnosis-staging/screening-tests-used.html. Updated May 30, 2018. Accessed July 27, 2018.
General information about colon cancer. National Cancer Institute website. Available at: https://www.cancer.gov/types/colorectal/patient/colon-treatment-pdq. Updated May 4, 2018. Accessed July 27, 2018.
Kushi LH, Doyle C, McCullough M, et al. American Cancer Society Guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity. CA: Cancer J Clin. 2012;62(1):30-67.
Moreno C, Kim DH, Bartel TB, et al. Colorectal cancer screening. American College of Radiology (ACR) Appropriateness Criteria. Available at: https://acsearch.acr.org/docs/69469/Narrative. Updated 2018.
Rex DK, Johnson DA, Anderson JC, et al. American College of Gastroenterology guidelines for colorectal cancer screening 2009. Am J Gastroenterol. 2009;104(3):739-750.
11/19/2010 DynaMed Plus Systematic Literature Surveillance. https://www.dynamed.com/topics/dmp~AN~T920886/Prevention-of-colorectal-cancer: Kirkegaard H, Johnsen NF, Christensen J, Frederiksen K, Overvad K, Tjønneland A. Association of adherence to lifestyle recommendations and risk of colorectal cancer: a prospective Danish cohort study. BMJ. 2010;341:c5504.
12/9/2011 DynaMed Plus Systematic Literature Surveillance. https://www.dynamed.com/topics/dmp~AN~T920886/Prevention-of-colorectal-cancer: Aune D, Chan DS, Lau R, et al. Dietary fibre, whole grains, and risk of colorectal cancer: systematic review and dose-response meta-analysis of prospective studies. BMJ. 2011;343:d6617.

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