Colon cancer is a type of cancer that begins in the large intestine or colon, which is the final part of the digestive tract. It typically affects the older population, although it can occur at younger ages. It usually begins as small, noncancerous clumps of cells called polyps. Colon polyps are small growths of tissue that extend from the inner wall of the colon. While most are harmless, some can develop into cancer. That is why regular screening is essential.
According to the American Cancer Society, roughly 1 in 22 men and 1 in 24 women are at risk of developing colon cancer. The CDC recommends screening beginning at age 45, but those with a family history of colon cancer should consider it sooner. Screening options include a colonoscopy, stool DNA test, fecal occult blood test, and CT colonography. Each has pros and cons. Discussion with a Colorectal Surgical Associates specialist will determine the best option based on the patient’s medical history.
Colon screening is recommended every 10 years, with the possibility of increased frequency if there is a higher chance of developing colon cancer, e.g., noncancerous colon polyps are found. Because a colonoscopy is not a particularly pleasant experience, people delay screening. This is extremely risky. Regular screenings save lives!
Colon cancer begins when healthy cells in the colon develop changes in their DNA. Unhealthy cells continue to divide, even when cells are not needed, and they form a tumor. With time, the cancer cells can grow and destroy healthy nearby tissue nearby. Contributors to colon cancer are:
- Alcohol use
- Diet high in fat and refined carbohydrates
- Sedentary lifestyle
- Older age, although rates are increasing among those under 50
- History of inflammatory bowel disease
- History of noncancerous colon polyps
- Inflammatory intestinal conditions, e.g., ulcerative colitis, Crohn’s disease
- Family history of colon cancer or related conditions
- African-American race
Many do not experience symptoms in the early disease stages, which is why regular screenings are essential. Signs and symptoms of colon cancer include:
- Change in bowel habits, e.g., diarrhea, constipation, change in stool consistency
- Rectal bleeding or blood in stool
- Persistent abdominal discomfort, e.g., cramps, gas, pain
- Bowel does not feel empty
- Weakness or fatigue
- Unexplained weight loss
Diagnosis is accomplished via colon screening. If diagnosed with colon cancer, the doctor will recommend tests to determine the stage of the cancer (from 0 to IV).
Those fortunate enough to be diagnosed in the early stages of colon cancer are excellent candidates for a surgical procedure to remove the cancerous tissue. The various surgeries depend on the stage of the cancer and where it is located.
Surgery for early-stage colon cancer includes:
- Polypectomy – Polyps are removed during a colonoscopy. A wire loop is passed through the colonoscope and placed around the base of the polyp. An electrical current is passed through the wire to sever the polyp from the colon wall.
- Local Excision – Just like a polypectomy, this procedure removes harmful polyps. The main difference is the local excision removes part of the colon tissue. This is only necessary when cancer has begun to affect the colon lining. This minimally invasive technique is performed without making incisions in the abdomen which allows patients to recover more quickly and lowers the risk of complications.
A colectomy is performed for more advanced colon cancer when a substantial part of the colon, or the entire colon, needs to be removed.
- Partial Colectomy – Also known as a Segmental Resection, this removes a portion of the colon. After the necessary tissue has been removed, the surgeon will attach the remaining ends of the colon to one another.
- Total Colectomy – This removes the entire colon and is used to treat more chronic conditions like ulcerative colitis or familial adenomatous polyposis.
When a colectomy is performed, nearby lymph nodes are also removed and tested for cancer.
Following surgery, the following treatments may also be prescribed: chemotherapy, radiation therapy, targeted drug therapy.
It is possible for cancerous tissue to form a blockage inside the colon. This is especially dangerous and must be quickly addressed and treated before continuing with additional colon surgery.