COLON CANCER. Basic facts about colon cancer.Prevention, Management

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Colon cancer is a disease emanating from the epithelial cells lining the large intestine of the gastrointestinal tract; most frequently as a result of inherited or acquired mutations.  Colon cancer or bowel cancer or colorectal cancer, is an intestinal cancer caused by uncontrolled cell growth in the colon or rectum (parts of the large intestine) or appendix. Colon cancer typically starts in the lining of the bowel and can spread into the bowel wall, and muscle layers underneath if left unchecked medically. Cancers that are confined within the wall of the colon are often curable with surgery.

Colorectal cancer is the third most commonly diagnosed cancer in the world, and it is more common in developed countries. About 60% of cases were diagnosed in the developed world. In 2016 global scale, it is estimated that 1.25 million new cases of bowel cancer were clinically diagnosed and the said cancer killed about 610,000 people. Globally, more than 1 million people are attacked by colon cancer annually resulting in the death of about half of that population. As of 2016, colon cancer is the second most common form of cancer in women, the third most common in men and it is the fourth most common cause of cancer deaths. Generally, it is fortunate that the death rate of colon cancer has dropped in the past 15 years.

WHAT IS COLON CANCER

Colon cancer is a disease which originates from the epithelial cells of large intestine (colon) or the rectum (end of the colon) of the gastrointestinal tract; mostly due to inherited or acquired (shared environmental factors) mutations. Most colorectal cancers develop slowly in the colon or the rectum over several years. Before a cancer develops, a growth of tissue or tumor usually begins as a non-cancerous polyp on the inner lining of the colon or rectum. A tumor is an abnormal tissue and can be benign (not cancerous) or malignant (cancerous). If cancer forms in a polyp, it can eventually begin to grow into the wall of the colon or rectum. When cancer cells are in the colon wall, they can spread into blood or lymph vessels. Lymph vessels are thin, tiny channels through which body waste and fluid are transported. They first drain into nearby lymph nodes, which are bean-shaped structures containing immune cells that help fight against infections. Once cancer cells spread into blood or lymph vessels, they can travel to nearby lymph nodes or to distant parts of the body such as the liver with outcome of ill health consequences.

RISK FACTORS OF COLON CANCER

Most colon cancer cases are mainly associated with lifestyle modifications and older age; with only a minor contribution from underlying genetic disorders. However,  the most encountered additional risk factors include male gender, obesity, cigarette smoking,  high consumption of fat, alcohol or red meat; and lack of physical exercise.

SYMPTOMS AND SIGNS OF COLON OR RECTAL CANCER

Colon cancer is often detected after symptoms and signs appear, but most people with early colon or rectal cancer do not show symptoms and signs of the disease. Usually, symptoms and signs appear in more advanced cases. This is why undergoing the recommended colon screening tests before any symptoms and signs develop are extremely crucial. The symptoms and signs of colorectal cancer depend on the location of the tumor in the bowel and whether it has spread elsewhere in the body (metastasis). Generally, bowel or Colorectal cancer may present one or more of the symptoms and signs below.

There may be changes in frequency or character of stool or bowel habits (bowel movements) such as diarrhea, constipation or narrowing of the stool which lasts for few days. Rectal bleeding, presenting dark stools or blood mixed with the stool, anemia caused by prolonged bleeding from the colon or rectum tumor, cramping or abdominal (belly) pain caused by tearing (perforation) of the bowel and abdominal distension where the belly protrudes without weight gain, are common symptoms and signs of colon cancer. Other symptoms and signs of colon cancer include leaking of bowel contents into the pelvis, causing inflammation (peritonitis); weakness, fatigue, unintended weight loss and infection. There may be presentations of unexplained, persistent nausea or vomiting (especially in people of over 50 years old), sensation of incomplete evacuation after a bowel movement, fever and loss of appetite.

MEASURES THAT SUPPORT THE PREVENTION OF COLON CANCER  

People should avoid much consumption of diets that are high in red meats (beef, lamb or liver), processed meats (hot dogs and some luncheon meats) and cooking meats at very high temperatures (frying, broiling or grilling) so as to prevent the introduction of injurious chemicals which expose the body to colon cancer attack. Other things that need to be avoided with aim of preventing colon cancer are use of Aspirin, Calcium, Vitamin D and Celecoxib without proper medical advice and supervision. Cigarette smoking should be avoided. Excessive intake of alcohol (greater than 66 centilitres a day for men and 33 centilitres a day for women) and obesity or overweight should be avoided.

MANAGEMENT OF COLON CANCER

Depending on some factors which include the stage of the disease, many treatment /management options for colon cancer are available with some obvious challenges. Therefore, if you observe any of the symptoms and signs of colon cancer above, it is very important to see your medical doctor right away so that the cause can be investigated, detected and treated as quickly as possible.  If you are above 60 years of age and have such as inflammatory bowel disease (Crohn’s disease or ulcerative colitis), a family history (two or more first-degree relatives) of colon cancer and a personal history of breast cancer; see your medical doctor or colon cancer expert for genetic counseling and testing.

At the ages between 40 and 75 years old, go for medical screening every 5-10 years to prevent later stages of colon cancer that are hardly treatable. Take a safe dose of folic acid (1 mg) daily and engage in guided physical exercise daily. Increase the consumption of whole grains, fruits and vegetables every day. You can ease the stress of colorectal cancer by joining a colon cancer support group to share with others who have similar experiences and problems. Colon cancer survival rate is directly related to increased awareness and prompt detection which are the main trusts of this public document. Therefore early identification, prompt reporting and medical management of colon cancer, do interrupt disease progression and eventual death.

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