Questions of diagnosis and treatment of colorectal cancer in recent years are becoming increasingly relevant. First of all, this is due to an increase in morbidity. The frequency of colorectal cancer among malignant tumors is about 10%.
Colorectal cancer most often occurs among African Americans. Slightly less likely to suffer from white and rarely suffer from this disease, asians, Pacific islanders, American Indians, indigenous people of Alaska, and immigrants from Latin America.
What are the risk factors for colorectal cancer?
- Your age
All people who have been over 50 years old have a sharp increase in the risk of colorectal cancer. And the older you become, the higher this risk. Most cases of colorectal cancer are found in people older than 50 years. In most patients, there were no other risk factors other than age.
- Family history
You have a sharp increase in chances of getting colorectal cancer if some of your relatives (parents, brothers, sisters or children) have been ill with this disease. The risk of getting sick depends also on the age at which your relative has fallen ill and how many members of your family are ill.
Colorectal Cancer: Family History
Family history is burdened if:
- At least 3 of your relatives have had cancer in the colon, and at least one of them has fallen into your father, brother or sister.
- if the sick relatives were in two adjacent generations, for example, grandmas and mom.
- One of the relatives has been diagnosed with cancer at the age of 50 years
If you have a history of colorectal cancer and related types of cancer, you have the opportunity to undergo genetic testing. Related types of cancer include: ovarian cancer, stomach cancer, liver cancer, cancer of the small intestine. Genetic testing is a blood test that detects changes in genes - mutations.
The most commonly occurring gene mutations are manifested by two main states:
1. Family Adenomatous Polyposis (CAP)
2. Lynch syndrome, also called non-polyposis hereditary colon cancer.
In most people with such mutations, colorectal cancer develops without careful monitoring of the health status.
A genetic study can tell you, we knew that you are the carrier of the mutation and what kind of mutation is this: a family's adenomatous polyposis or Lynch syndrome.
Most people who have fallen ill with colorectal cancer do not have a heavily family history.
Anamnesis of life
Your chances of getting a colorectal cancer are dramatically increased if:
- You already had colorectal cancer
- You have had another type of cancer, such as ovarian cancer or endometrial cancer
- you removed the intestinal polyps, especially if the remote polyp was large or there were a lot of them
- You have been suffering from nonspecific ulcerative colitis or Crohn's disease for more than 10 years
- You have been undergoing radiation therapy in the abdomen or pelvis area
What needs to be changed in my life to reduce the risk of colorectal cancer?
- Do not smoke if you smoke
- Ensure that your body mass index is within the normal range
- Mostly do sports
- eat more whole grains, fruits, vegetables, poultry and fish
- Drink less alcohol
When should I contact a doctor?
Contact your doctor immediately if you find yourself having such symptoms of colorectal cancer as:
- changes in the functioning of the intestines
- bleeding from the rectum, including an admixture of bright red or dark blood in the stool, if your stomach just seems dark
- Constant or frequent diarrhea, constipation, or feeling that your intestine is not completely emptied
- abdominal pain, increased gas formation, bloating
- Unconscious loss of body weight
- constant fatigue
Since colorectal cancer often occurs asymptomatic, it is worth discussing with your doctor screening tests for the detection of cancer. Screening methods allow doctors to detect the disease before any symptoms occur. When performing some screening tests for colorectal cancer it is possible to detect and remove small pre-cutaneous growth in the large and small intestine, called adenomatous polyps. If they are detected and removed early, they can not be transformed into cancer.
Colorectal Cancer: A Pulmonary Inspection
If your doctor suspects you of colorectal cancer, then for the first time, he will collect from you anamnesis (asking how and when the illness began to bother), then will review. He may then assign additional survey methods:
- Colonoscopy - a method of study in which the doctor with a colonoscope can inspect your intestines. Colonoscopy can be done in the presence of symptoms such as obscure bleeding from the rectum, constant diarrhea or constipation, blood in the chair, or pain in the lower abdomen. Colonoscopy is recommended when other screening tests indicate colorectal cancer.
- Retromomanoscopy - a method of study in which a doctor with the help of an endoscope can inspect the lower parts of the intestine. Retromomanoscopy can also be performed in the presence of symptoms such as obscure bleeding from the rectum, permanent diarrhea or constipation, blood in the chair, or pain in the lower abdomen. Sometimes, in the course of this study, the removal of polyps is carried out.
- Climes with barium - a method of study when a solution of barium is injected into the rectum, which fills the intestine, and when it is carried out later, it looks white - contrasts the intestinal wall.
- Biopsy - a method by which a small sample of tissues is taken from the gut wall, and then examined under a microscope. A pathomorphologist examining a sample will see cancer cells in her if they are there.
- General blood test - Used when symptoms such as fatigue, weakness, anemia, or weight loss.
It is recommended that colonoscopy be performed regularly for people at increased risk of developing cancer in this localization, as during this diagnostic procedure it is possible to remove polyps and to take the material for biopsy.
If you still have colorectal cancer during the examination, then you will be assigned additional testing methods to determine if the cancer has spread. These methods include:
- Computer tomography (CT), through which you can see the spread of cancer to the liver, lungs and abdominal cavity.
- X-ray examination of the chest - to detect metastases in the lungs
- MRI or PET to determine whether the cancer has spread to the thoracic or pelvic organs.
- Ultrasound, to determine the cause of abdominal pain or the cause of enlarging the abdominal circumference, it is also possible to assess the spread of cancer to the liver. An endoscopic ultrasound is used to determine how far the rectum cancer has spread.
- Blood tests for the presence of specific substances that indicate that the cancer has spread to the bones and liver
- Blood analysis for cancer-embryonic antigen
Treating colorectal cancer is much more successful at its early detection. Root screening can significantly reduce the number of deaths from colorectal cancer. In some studies, it is possible to detect and remove polyps before they were able to transform into cancer. Screening methods include:
- Fecal examination for latent blood, fecal immunochemical test
- Virtual colonoscopy
The use of these tests allows you to detect cancer in the early stages when it is better treated. Rectomoroscopy and colonoscopy are tests in which you can find and remove polyps to stop them from transforming into cancer. Virtual colonoscopy finds polyps. If the results of virtual colonoscopy and fecal analyzes suggest polyps, it is necessary to perform an endoscopic colonoscopy and remove them.
Discuss with your doctor what tests are right for you. People at high risk for developing cancer, such as African Americans or people with a family history of agony, may need to start regular routine screening tests of up to 50 and perform them more often.
If you have a family history, you can discuss the possibilities of genetic research.
Treatment for colorectal cancer
The first stage of treatment for colorectal cancer is surgical removal. Sometimes the simplest operations can be performed during colonoscopy - the removal of small polyps and a small amount of tissue. But, unfortunately, sometimes it is necessary to resort to large operations, during which parts of the intestine can be removed. And if the cancer has spread beyond the intestines, for example, on the liver, then an even deeper operation may be necessary.
Once the tumor has been examined under a microscope, it can be assigned a stage. The stage reflects how far cancer has spread. Defining the stage of the process also helps the doctor choose the treatment tactics.
Cancer, which has not spread beyond the walls of the colon and rectum, can only be cured by surgery. If the cancer has gone beyond the gut, radiotherapy or chemotherapy, or a combination of them may be needed.
Side effects of treatment
Side effects of treatment for colorectal cancer depend on the type of cancer, the chosen method of treatment, age and general health. Some side effects can be prevented. For example, a doctor may prescribe anti-ethics in advance.