Colorectal Cancer Main Page - Colon Cancer Symptoms and Treatments

March 14th 2006

Intestines

Colorectal cancer is the second leading cause of cancer death in the United States. There are over 130,000 cases diagnosed each year and over 50,000 deaths from the disease. It can be survivable, especially if caught early. This is why screening for colon cancer is so important.

There are several types of colon cancer including lymphoma, carcinoid tumors, melanoma, and sarcomas. Colon carcinoma is the most common type. There are several risk factors for colon cancer including family history, diet, obesity, even smoking and alcohol consumption. Patients with a history of breast cancer have a slightly higher risk of developing colon cancer, and so do African Americans. Men are more likely to develop colon cancer than women.

Although it has not been proven that a high fiber diet can lower the risk of colon cancer, most experts believe that a diet high in fat and meat diet low in fiber will increase the risk.

Almost all men and women over the age of 50 should have a colonoscopy. African Americans should be tested 5 years earlier. There are a couple simple tests that can be performed for younger patients not wanting to undergo a colonoscopy. Fecal occult blood test, sigmoidoscopy, and barium enema, although there has been some debate whether these tests are accurate. Colonoscopy is considered the gold standard.

It is important to get tested because in most cases there are no symptoms. However, if there are some symptoms, these are the ones to look out for:

There may be a change in bowel habits or diarrhea or constipation that do not resolve
You may see some blood in the stool
Unexplained anemia where the skin become pale
Abdominal pain and tenderness in the lower abdomen
An intestinal obstruction
Weight loss without any known reason
Stools narrower than usual

It is important to get tested as early as possible, rather than wait until you have symptoms. If you have any of these symptoms, make an appointment with your doctor.

Treatment for colon cancer may depend on the stage of the disease. It is important to know how far the tumor has spread through the layers of the intestine. Here are the various stages for colon cancer:

Stage 0: Very early cancer on the innermost layer (more accurately considered a precursor to cancer)
Stage I: Tumor in the inner layers of the colon
Stage II: Tumor has spread through the muscle wall of the colon
Stage III: Tumor that has spread to the lymph nodes
Stage IV: Tumor that has spread to distant organs

For stage 0 the treatment will likely be cutting out the lesion, often in conjunction with a colonoscopy. For stages I, II, and III the surgery may be fore extensive, and in some cases a segment of the colon containing the tumor and reattachment may be necessary.

Patients in stage III will likely receive chemotherapy with the drug 5-fluorouracil given for approximately 6 - 8 months. This drug has been show to increase the chance for a cure. There has been some debate as to whether patients with stage II colon cancer should receive chemotherapy after surgery.

Stage IV patients will likely receive chemotherapy to shrink the tumor. The goal is to lengthen life, and improve the patient's quality of life. Irinotecan, oxaloplatin, and 5-fluorouracil are the 3 most commonly used drugs. They may be given individually or in combination.

Oxaliplatin is a new drug that was approved by the FDA in 2002. It is often used in combination with 5-fluorouracil. There are studies and clinical trials underway to find drugs that specifically target the abnormalities in cancer cells. There is a chemotherapy able to pass the acids in the stomach that can be given orally called capecitabine (Xeloda).

Again, it is important to get the colonoscopy early to avoid major surgery. The procedure will look for polyps, which can grow or develop into cancer. These are growths that protrude from the inner lining and some may appear to have a stalk. Most are benign and might cause some rectal bleeding. If you experience any bleeding make an appointment with your doctor immediately.