While colorectal and colon cancers are some of the most preventable types of cancer, colon cancer remains the second-leading cause of cancer-related deaths in the US. The Centers for Disease Control (CDC) and the American Cancer Society estimate that 50,000 people in America die from colon cancer each year. If colon cancer is found, immediate colon cancer treatment is imperative, as colorectal cancer spreads quickly. Read on to learn more about what colon cancer is, the risk factors, treatment options, and when to be screened for colon cancer.
When cells in the colon or rectum become abnormal and multiply, these tumor cells are the beginning of colon or rectal cancer. In most cases, colon cancer forms as adenomatous polyps, which are precancerous. There can be abnormal cells in the colon, rectum, or both. Very often, the terms colon cancer and colorectal cancer are used interchangeably, but it’s important to know that colorectal cancer affects the colon and rectum. It is also possible for polyps to only form in the rectum, and this is considered rectal cancer.
There are several parts of the colon, also known as the large intestine, and cancer can affect any or all parts of the colon. These include:
The rectum itself connects the anus to the colon and is about five to six inches long. Its function is to hold stool until you are ready to have a bowel movement.
As part of life, all of our cells grow and divide and go through a process called autophagy (cell death). When cells die off, it allows the body to regenerate healthier, new cells. However, when cells do not die off as they should, they can multiply, become abnormal, and grow out of control. If this occurs in the colon, it may be a precursor to the development of colorectal cancer. These abnormal cells begin to grow as polyps.
Many people have colorectal polyps, but they are not precancerous. However, polyps that cause colon cancer have adenomas and sessile serrated lesions. Often, patients may not feel polyps at all until they’ve grown in size or they begin to have other symptoms. This is part of why early detection of colon cancer is so important.
One of the reasons that colon cancer is the second-leading cause of cancer death is it goes undetected for too long. In early stage colon cancer, patients may not experience any symptoms at all and may not know that they have cancer. Early detection is best for the most effective colon cancer treatment. For those who do have symptoms, some signs of colon cancer include:
Other symptoms can include:
Those who have a family history of colon cancer also have an increased risk of developing it in their lifetime.
Your overall health history (including your family history) can impact the risk of colorectal cancer development. It’s important to know the risk factors so you can let your physician know, even if you are just having a colon cancer screening performed. Some of the risk factors for colon cancer include:
If you meet the criteria for any of these risk factors, let your gastroenterologist know. While the suggested age for colon cancer screening is now 45, you may be able to be screened earlier because of your risk factors.
Preventative measures are the best colon cancer “treatment,” because if colon cancer is discovered in its early stages, it is more easily eradicated.
If you’re experiencing symptoms or are age 45, your physician or gastroenterologist will want to screen you for colon cancer. The first-line screening test is a colonoscopy. You will be given either liquid or a pill (called prep), the day before your colonoscopy. The prep will help empty your bowels so that the provider can perform the procedure.
During the procedure, you will be put under anesthesia, and a thin, flexible tube will be inserted through the anus and rectum to examine the colon. The tube, called a colonoscope, has a tiny camera at the end that lets the doctor see any abnormalities in the colon. However, colonoscopy can also be a standard treatment, which is part of why it’s the gold standard in colon cancer screening. If your gastroenterologist detects polyps or abnormalities in their early stages, they can be removed with use of the colonoscope. Other screening tests include:
Other tests that may be used include a double contrast barium enema or fecal DNA test.
Colon cancer treatment depends on the stage of colon cancer. There are five stages of colon cancer, from Stage 0 through Stage 5.
Stage 0 is the earliest stage and is known as carcinoma in situ. This is a precancerous stage where polyps may be in the lining of the colon or rectum. Typically, these polyps can be removed with the colonoscope during a colonoscopy (known as a polypectomy).
In Stage 1, the cancer has embedded into the intestinal wall but has not yet spread to any nearby lymph nodes. Colon cancer treatment during Stage 1 often involves surgery to remove the cancer, called a colon resection. To remove the cancer, the affected part of the colon and the lymph nodes will be surgically removed. If it is stage 1 colorectal cancer, surgical treatment depends on the location of the cancer in the rectum. Laparoscopic surgery may also be used as colon cancer treatment in the early stages.
Stage 2 is divided into several substages:
The treatment for colon cancer in the second stage is also typically colon resection and may be followed by chemotherapy.
Stage 3 colon cancer is advanced and means that the cancer has spread to the lymph nodes. Stage 3 is also divided into substages:
Surgery is also the preferred treatment for stage 3 colon cancer. However, chemotherapy and radiation may also be a part of treatment. Sometimes, after surgery, adjuvant chemotherapy is used. This can kill off cancer cells that were left behind post-surgery.
Stage 4 colon cancer means that cancer has metastasized (spread) to other organs and parts of the body. This can include the lungs, ovaries, and liver, among others. Stage 4 also has substages:
Colon cancer treatment for stage 4 is also surgery, radiation, and chemotherapy. However, stage 4 colon cancer has a five-year survival rate of only 14 percent, and colon cancer treatment may not be effective. In order to make patients more comfortable and to lessen symptoms, chemotherapy and radiation therapy may continually be used.
