Colorectal Cancer – Symptoms, Causes and Diagnosis. Treatments & Prevention

The most common Cancer in the world is colorectal or colon cancer. Cancer can develop in either the colon (large intestinal tract) or the rectum. Both are parts of the lower digestion system. Colorectal Cancer is treatable at an early stage, but it can become life-threatening when left undiagnosed and untreated.

This comprehensive guide provides a thorough overview of colorectal carcinoma, including its causes, risks, symptoms, diagnosis procedures, treatments, and prevention methods. It is aimed at patients, caregivers and the public.

What is colorectal Cancer?

Cancer of the colorectal lining begins when cells grow out of control in either the colon or rectum. The majority of cases begin as benign polyps. Some polyps can become cancerous over time. It is most common in adults older than 50 years old, but can affect younger individuals, particularly if they have a genetic or family history.

Colorectal Cancer causes

Colorectal Cancer is not always caused by a single cause; however, certain environmental and biological factors can contribute to the development of this Cancer. Mutations in DNA cells that line the colon and rectum are usually the first mutations to occur.

Some of the most common causes include:

• Increased risk of genetic mutations, Syndromes heritaires like Lynch Syndrome and Familial adenomatous polyposis (FAP).
• Changes in cellular structure: Mutations may lead to uncontrolled tumour growth.
• Chronic Inflammation: Conditions such as IBD –especially Crohn’s and ulcerative colitis–can raise the risk.

Risk Factors

You can increase your risk of colorectal carcinoma by a number of factors. They include:

1. Age

• The majority of cases affect people over 50 years old.

2. Family history

• The risk of colon cancer increases significantly if you have a family history.

3. Personal Medical History

• Polyps in the past, colon cancer or other inflammatory diseases.

4. Diet

• Diets high in meat and processed foods, as well as low-fibre foods, may increase the risk.

5. Lifestyle Choices

• Obesity, smoking, alcohol abuse, and lack of physical activity.

6. Type 2 Diabetes

• Individuals who have insulin resistance or type 2 diabetes are at a higher risk.

Colorectal cancer symptoms and signs

Early colorectal carcinoma may not show any symptoms. As the Cancer progresses, symptoms will become more evident.

Symptoms of a common condition include:

• Constant abdominal cramps or pain
• Constipation or diarrhoea
• Blood in the stool or bleeding from the rectum
• Unexplained Weight Loss
• Fatigue weakness
• Feeling that your bowels are not empty.

It is important to note that these symptoms can also be caused by non-cancerous conditions such as haemorrhoids and irritable intestinal syndrome (IBS); therefore, a professional assessment is necessary.

What is the diagnosis of colorectal Cancer?

Treatment is more effective when diagnosed early. Colorectal screening can detect Cancer even before symptoms are visible.

Diagnose Tools and Procedures

1. Colonoscopy: A flexible, thin tube equipped with a small camera is used to inspect the colon. It also removes suspicious polyps.
2. Faecal Occult blood test (FOBT) detects hidden stools.
3. Virtual Colonoscopy (CT Colonography)– Screens for tumours and growths using imaging.
4. Colonoscopy– Tissue samples can be collected for laboratory analysis during a colonoscopy.
5. Blood Tests Check for anaemia and tumour characteristics such as (carcinoembryonic Antigen, or CEA).

Colorectal Cancer: Stages

The stage of Cancer is a way to guide treatment and determine the extent of the disease.

There are four main stages:

• Stage 0. The Cancer is confined to the inner layer (carcinoma).
• Stage 1: The Cancer has spread to the inner layer of the colon.
• Stage 2: The Cancer has spread through the walls but not achieved the lymph nodes.
• Stage 3: The Cancer has spread to the nearby lymph nodes.
• Stage 4: The Cancer has spread (metastasis) to distant organs, such as the lungs or liver.

Colorectal Cancer Treatment Options

The treatment depends on several factors, including the patient’s preferences, the health of the patient, the cancer stage, and the overall state of their health. Multidisciplinary approaches are often employed.

1. Surgery

• Local excision or polypectomy is recommended for cancers in the early stages.
• Colectomy: To remove a part or the entire colon. This is often followed by reattachment, or colostomy.

2. Chemotherapy

• Use before or after surgery for shrinking tumours.
• There are many drugs like 5-FU and capecitabine.

3. Radiation Therapy

• Rectal Cancer: used to reduce tumours prior to surgery or alleviate symptoms.

4. Targeted Treatment

• The drugs bevacizumab (Avastin ) and Cetuximab (Erbitux ) block the specific proteins which help to grow cancerous cells.

5. Immunotherapy

• Checkpoint inhibitors can be used in advanced cases to aid the immune system against cancer cells.

Preventing and screening

Early detection and lifestyle changes can prevent many cases of colorectal carcinoma.

How to reduce risk:

• Regular screenings should begin at 45 years of age or sooner if you are at risk.
• Consume a diet high in fibre that is rich in vegetables, fruits and whole grains.
• Limit the consumption of red meats and processed meats.
• Maintain a healthy body weight and stay active.
• Limit alcohol and smoking.
• Manage chronic diseases such as diabetes and IBD.

Colorectal Cancer: Living with it

Diagnoses can be physically and emotionally challenging. Many people are able to live long and fulfilling lives following treatment thanks to advances in medical science.

Included in Supportive Care:

• Psychological Counseling
• Nutrition support
• Palliative care manages pain and symptoms.
• Cancer support groups

It is important to have regular follow-ups in order to manage side effects and monitor recurrence.

Colorectal Cancer FAQs

Q1. Can colorectal carcinoma be treated?

Early detection is key, in particular. Surgery alone or in combination with other treatments can cure cancers at stages 1 and 2.

Q2. Is colorectal Cancer hereditary?

Yes. Around 5-10% are caused by inherited disorders like Lynch Syndrome or FAP.

Q3. What foods help reduce colorectal cancer risk?

Foods high in fibre, such as vegetables, fruits and legumes. Also, foods rich in vitamin D, calcium and antioxidants can be helpful.

Q4. At what age should screening start?

Most guidelines suggest starting regular screenings at 45 years old. Risky individuals should start earlier.

Q5. What is the survival rate for colorectal Cancer?

It depends on what stage you are at.

• Stage I: 90%
• Stage II: 70-85%
• Stage III: Between 50-65%
• Stage IV: 10-15%