What is Colorectal Cancer?
When healthy cells surrounding the rectum or colon start to undergo changes and reach a stage where their growth into tumors becomes uncontrollable, a person has a higher risk of developing colorectal cancer. The tumor can be a benign, malignant, or non-cancerous. Malignant colorectal tumors can spread to other body parts, whereas benign colorectal tumors will keep growing, but they won’t spread.
How does Colorectal Cancer start?
Also known as colon cancer, rectal cancer, or bowel cancer, colorectal cancer, in most patients, is known to begin as a noncancerous growth called a polyp (adenocarcinoma). If not diagnosed or properly addressed for treatment, a colorectal carcinoma can turn into a life-threatening growth
What are the types of Colorectal Cancer?
The different types of colorectal cancer include:
- Colorectal adenocarcinoma
The prefix “adeno” in adenocarcinoma means glands, and “carcinoma” indicates a type of cancer that affects the epithelial cells along the body’s surface, either inside or outside, or both. Adenocarcinoma of colorectal cancer occurs and spreads along the walls of the large intestine. Their growth often starts from the inner wall and gradually, they spread to other layers of the large intestine.
Adenocarcinoma has two subtypes, diagnosed less commonly.
- Mucinous adenocarcinoma: Mucinous adenocarcinoma is composed of almost 60% mucus. The mucus may cause the cancer cells to spread on a wider scale at a faster rate, making mucinous adenocarcinoma more aggressive compared to typical adenocarcinomas.
- Signet ring cell adenocarcinoma: Signet ring cell adenocarcinoma gets its name from its appearance as seen through a microscope. This subtype is considered to be typically aggressive and is one of the harder to treat cancer types.
Symptoms of colorectal adenocarcinoma
- A recurring change in your bowel movements, such as persisting diarrhea or constipation, or a frequent change in the consistency of your stool
- Blood in the stool
- A bleeding rectum
- Non-stop discomfort in the abdomen, such as gas, cramps, or pain
- A sensation that your bowel doesn’t empty
- Fatigue or weakness
- Inexplicable weight loss
- Gastrointestinal carcinoid tumors
Carcinoid tumors are a type of neuroendocrine tumors that form in neuroendocrine cells, the primary function of which is to aid the regulation of hormone production. These tumors have a slow growth rate and account for 1% of all types of colorectal cancer.
Symptoms of gastrointestinal carcinoid tumors
- Pain in the abdomen
- Persisting nausea, vomiting, and bowel obstruction (the inability to pass waste or stool due to blockage of the intestines)
- Rectal pain
- Rectal bleeding
- A flushed skin
- Primary colorectal lymphomas
Primary colorectal lymphoma belongs to the category of non-Hodgkin lymphoma, which occurs in the lymphocytes of the lymphatic system. Lymphoma can develop in numerous parts of the body, such as the bone marrow, lymph nodes, thymus, the digestive tract, and the spleen. This type of lymphoma accounts for 0.5% of all types of colorectal cancer. This colorectal cancer type is mostly known to occur in older men than women.
Symptoms of primary colorectal lymphomas
- Pain in the abdomen
- Inexplicable weight loss
- Gastrointestinal stromal tumors
GISTs or gastrointestinal stromal tumors are one of the rare colorectal cancer types that develop in the ICCs (the interstitial cells of Cajal) or the walls of the gastrointestinal tract. More than 50% of GISTs have a chance of occurring in the stomach while the rest of it can develop in the small intestine and the rectum. Also known as sarcomas, GISTs form and mature in the connective tissues, such as blood vessels, fat, nerves, tissues, cartilage, and bones.
Symptoms of gastrointestinal stromal tumors
- Bloody stool
- Abdominal pain
- Persisting nausea and vomiting
- Bowel obstruction
- Abdomen feeling stony
- Fatigue and weakness
- Feeling full after consuming less
- A difficulty or pain while swallowing food
Leiomyosarcoma is another type of sarcoma, literally meaning, the “cancer of the smooth muscle”. The rectum and the colon have three layers of the muscle type which is affected by leiomyosarcoma, and these three layers function in guiding waste out the digestive tract. Since it accounts for only about 0.1% of all cases of colorectal cancer, leiomyosarcoma is considered as one of the rare colorectal cancer types.
Symptoms of leiomyosarcoma
- A bloated abdomen
- A nodule beneath the skin
- Vomiting and nausea
- Inexplicable weight loss
Melanoma is one of the common cancer types that can occur anywhere on the body such as rectum or colon, even though it is mostly known to develop in association with skin cancer.
Symptoms of Melanoma
- Abdominal pain
- Bowel obstruction
- Inexplicable weight loss
- Growth of primary lesion
What are the early signs of Colorectal Cancer?
The colorectal cancer signs are as follows.
- Visible changes in bowel movements
- Constipation or diarrhea
- A persisting sensation that the bowel hasn’t emptied after a bowel movement
- Bloody feces that make stools appear black
- Rectal bleeding
- Abdominal pain and bloating
- A feeling that the abdomen is full, even after not eating for hours
- Fatigue and weakness
- Inexplicable weight loss
- A colorectal cancer lump in the anal tract or abdomen found by your doctor
- Inexplicable deficiency of iron in men, or in women following menopause
These are signs of colorectal cancer and if these symptoms persist for more than four weeks, then you must get in touch with a doctor immediately.
What are the causes of Colorectal Cancer?
Scientists and researchers haven’t discovered the exact colorectal cancer causes, when and how it develops, but there are specific risk factors, which, if understood properly can aid in the prevention of colorectal cancer.
Colorectal cancer occurs when the DNA in cells located in and around the rectum or colon undergo mutations, thereby inciting an uncontrollable growth or division of the cells. The design of the immune system is such that it attacks the mutated cells and causes their death. But, sometimes, it so happens that the mutated cells escape the attack of the immune system, their growth getting out of control, and gradually evolving into a tumor in the rectum or colon.
Again, no one can pinpoint the exact causes of colorectal cancer but there are specific risk factors known to contribute to the development of colorectal cancer, such as tobacco smoking, diet, and excessive usage of alcohol.
Risk factors involved in Colorectal Cancer
The risk factors associated with colorectal cancer are as follows.
Those who maintain a diet comprising high amounts of processed and red meat must be careful as such diets have a higher risk of causing colorectal cancer. Meat that is subjected to grilling, frying, or broiling can produce chemicals in high temperatures, which, when consumed can contribute to high risk. Enriching your diet with fruits and vegetables can go a long way in ensuring that your risk of developing colorectal cancer signs is reduced.
- Inactive lifestyle
A sedentary lifestyle is known to increase the chance of contracting colorectal cancer.
Carcinogens associated with smoking, if swallowed, can play a potential role in increasing colorectal cancer risk.
- Alcohol usage
Excessive consumption of alcohol can have an adverse impact and contribute to the cause of colorectal cancer.
One can develop colorectal cancer at any age but people of 45 years or older have a higher risk of developing the disease. The National Cancer Institute records the median age of a colorectal cancer patient as 68.
- History of IBD (Inflammatory Bowel Disease)
If you have a history of IBD, including Crohn’s disease and ulcerative colitis, then your chances of acquiring colorectal cancer are quite high. Your risk of developing the disease may be higher the longer you’ve had IBD and would have a slight dependency on the extent to which your colon is affected.
How to prevent Colorectal Cancer?
A change in specific lifestyle measures (for the better) can aid in the prevention of colorectal cancer. They are:
- Nutritious diet
Replenish your diet with plenty of fruits, vegetables, fiber, and carbohydrates in healthy amounts. Bring down the content of red or processed meats in your diet, and include healthy fats instead of saturated ones, such as fish oils, avocado, olive oils, and nuts.
- Regular exercise
Indulging in regular, moderate exercises are known to bring down the chances of developing colorectal cancer significantly.
Always be mindful of your body weight as obesity or being overweight can raise your chances of contracting any cancer, including colorectal cancer.
- Early detection of the responsible gene
A specific research in the journal “Gut” reveals that a gene associated with shortened survival and colorectal cancer recurrence if detected early in a person through a colorectal cancer biopsy can help doctors make a prognosis.
Another study result revealed in “Science” suggests vitamin C present in 300 oranges can impair cancer cells, so it is likely that the power of vitamin C can be harnessed one day to combat colorectal cancer.
Scientists have discovered that drinking coffee daily, be it decaffeinated or otherwise, can prove to be useful as it can lower the risk of colorectal cancer substantially.
Diagnosis for Colorectal Cancer
Early colorectal cancer screening can help in the detection of precancerous polyps, which can help the doctor make a prognosis and ensure that the person gets the best colorectal cancer treatment.
The following are the tests conducted for colorectal cancer diagnosis.
- Blood stool test
The procedure involves checking a sample of the patient’s feces for the presence of blood. A blood stool test doesn’t have 100% accuracy because not every cancer causes blood loss. This test can, therefore, show a false negative result. A sample of stool may have the presence of blood owing to other illnesses or conditions as well, such as hemorrhoids.
- Stool DNA test
The test aims to analyze the DNA markers that precancerous polyps cells or colorectal cancer shed into the feces.
- Flexible sigmoidoscopy
In this procedure, the doctor makes use of a sigmoidoscope, a slender, flexible, lighted tube, to examine the patient’s sigmoid colon and rectum. The last part of the colon is the sigmoid colon, which comes before the rectum. This mode of diagnosis can help detect cancerous cells or polyps only at the end of the colon and not other parts of the digestive tract. In case the doctor detects any abnormalities, he might recommend a colonoscopy for analyzing the entire colon and thereafter remove polyps, if any.
- Barium enema X-ray
Barium, in an enema form, is placed in the patient’s bowel, and it displays images on an x-ray. The barium coats and fills the walls of the bowel, showing a clear image of the colon, rectum, and a section of the small intestine as well. If the barium enema x-ray detects polyps or anything abnormal, the doctor might advise a colonoscopy.
Longer than a sigmoidoscope, a Colonoscope is a flexible, long, slender tube, which has a video camera and a monitor attached to it. With this device, the doctor can see the entire colon and rectum. A colonoscopy helps easy discovery of polyps and the doctor might take tissue samples to conduct a colorectal cancer biopsy. The procedure is painless but to calm down patients, the best colorectal cancer hospital prescribes mild sedatives.
- CT colonography
A CT machine carries out colonography by taking images of the colon. If any polyps are detected, the doctor might recommend a conventional colonoscopy for further assessment and clarification. Compared to colonoscopy, this procedure might be a better-tolerated and less-invasive alternative for patients with a risk factor of contracting colorectal cancer.
- Imaging scans
The reports of MRI scans or ultrasound can show if colorectal cancer has spread to other parts of the body.
What are the treatment options for Colorectal Cancer?
Colorectal cancer treatment depends on multiple factors, such as the location and the size of the colorectal tumor. Different stages of colorectal cancer demand different treatments. The various colorectal cancer treatments include chemotherapy, radiotherapy, and surgery.
The most commonly employed method for colorectal cancer treatment is chemotherapy, which consists of intake of chemicals or medicines to destroy tumors. If the condition is severe, and the patient requires surgery, then the best colorectal cancer hospital would suggest chemotherapy first, which can shrink the tumor.
One kind of chemotherapy is targeted therapy which involves targeting specific proteins that are known to trigger the development of colorectal tumor and advance colorectal cancer symptoms. Drugs prescribed as part of chemotherapy for subduing the effects of colorectal cancer symptoms include ramucirumab and bevacizumab.
- Radiation therapy
Radiation therapy or radiotherapy employs high energy rays or radiation beams which destroy the colorectal tumors and prevent them from multiplying.
Surgery is the most common route taken for effective colorectal cancer treatment. Through surgery, malignant colorectal tumors and the surrounding lymph nodes, if any, will be removed, thereby reducing the chances of colorectal tumors spreading. After surgery, the surgeon would sew back the bowel together, but if the rectum was removed, a colostomy bag would be attached for drainage. The purpose of a colostomy bag is to collect stools. It can be a temporary fixation, or permanent, in case the ends of the bowel couldn’t be stitched back together.
Surgery can treat colorectal cancer detected at an early stage. If surgery doesn’t cure colorectal cancer, then it will surely reduce the severity of colorectal cancer symptoms.
Colorectal cancer stages and treatment
The large intestine is composed of two main components, i.e., colon and rectum. The intestinal wall consists of several layers, such as mucosa, submucosa, and the serosa. The colorectal cancer staging is done based on the extent to which the cancerous cells have spread through the various layers of the rectum or colon.
- Stage 0
Abnormal growths, cells, or polyps are found in the inner lining of the colon or rectum, called the mucosa. The abnormal growths are termed as carcinoma in situ, as the polyps are confined to their place of growth. Cells discovered in this stage may be cancerous or precancerous.
What are the symptoms and signs of Colorectal cancer stage 0?
Symptoms of colorectal cancer stage 0 include rectal bleeding, a change in bowel movements, fatigue, abdominal pain, and inexplicable weight loss.
Surgery is often the only method of treatment followed for colorectal cancer treatment, stage 0. A polypectomy performed during colonoscopy can remove all cancerous growths and polyps. Rare, but cited side-effects of a polypectomy include bleeding from the site where the polyp was present and perforation of the colon.
Can you survive colorectal cancer stage 0?
The five-year survival rate of colorectal cancer stage 0 is 89.8%.
- Stage 1
Stage 1 colorectal cancers have penetrated the submucosa from the mucosa, without spreading to the lymph nodes.
What are the symptoms and signs of Colorectal cancer stage 1?
Symptoms of colorectal cancer stage 1 include diarrhea, constipation, alternating constipation and diarrhea, abdominal bloating, rectal bleeding, excreting stools thinner than normal, and a sensation that the bowel hasn’t emptied.
The standard treatment for this stage is surgery. The affected section of the colon may be removed by partial colectomy. General complications of colectomy include bleeding, blood clots in the lungs and legs, torn sutures that reconnect other parts of the digestive system, infection, injury to bladder or small intestines.
What is the survival rate of colorectal cancer stage 1?
The survival rate of colorectal cancer stage 1 is 80-95%.
- Stage 2
Stage 2 colorectal cancer is more advanced than stage 1 and has penetrated the submucosa of the colon. Stage 2 is further classified into:
- 2A Stage
Colorectal cancer has not advanced to the nearby lymph nodes or tissues. It has spread to the outer layers of the colon but hasn’t completely grown through.
- 2B Stage
In this stage, the colorectal cancer cells have not affected the lymph nodes yet, but have grown through the serosa, i.e., the outer layer of the colon, toward the visceral peritoneum, which holds the abdominal organs together.
- 2C Stage
Lymph nodes show no presence of colorectal cancer cells, but they have advanced to nearby structures or organs.
What are the symptoms and signs of Colorectal cancer stage 2?
Symptoms of colorectal cancer stage 2 include a change in the frequency of bowel movements, constipation, changed consistency of stool, bloody stools, abdominal pain, rectal bleeding, and a sensation that the bowel hasn’t emptied.
A partial colectomy is the suggested mode of treatment.
Can you survive colorectal cancer stage 2?
The stage 2 colorectal cancer survival rate is 55-80%.
- Stage 3
Stage 3 colorectal cancer is classified into:
- 3A Stage
The tumor has penetrated the colon’s muscular layers and has invaded the nearby lymph nodes. It hasn’t advanced to distant organs or nodes.
- 3B Stage
The tumor has infiltrated the outer layers of the colon, the visceral peritoneum, and affected one to three lymph nodes.
- 3C Stage
Colorectal cancer cells have affected four or more lymph nodes.
The symptoms experienced are the same as that of colorectal cancer stage 2.
Suggested colorectal cancer treatments for stage 3 include chemotherapy, radiotherapy, and surgery, although their order may differ from person to person.
Colorectal cancer stage 3 has about a 40% chance of a successful cure.
- Stage 4
Stage 4 is metastatic colorectal cancer, which is classified into:
- 4A Stage
The tumors have penetrated one distant site, either the lungs or liver.
- 4B Stage
The tumors have penetrated two or more distant sites such as both the lungs and the liver.
What are the symptoms and signs of Colorectal cancer stage 4?
Symptoms of metastatic colorectal cancer are fatigue, pain, abdominal bloating, pain in the right side of the stomach or abdomen, jaundice, itching, appetite loss, weight loss, leg pain, and bloody stools.
Just as in stage 3, metastatic colorectal cancer treatments include chemotherapy, targeted therapy, radiotherapy, and surgery, to remove the affected lymph nodes and other areas. Chemo is given before or after the surgery.
Colorectal cancer stage 4 has about a 10% chance of a successful cure.
Integrative treatment for colorectal patients involves intervention on three levels- biology, lifestyle, and conventional treatment. Adopting nutritional therapies, physical care modalities, and biobehavioral strategies can help in improving the condition and alleviating colorectal cancer symptoms.
Life in Remission
With advanced treatment options for colorectal cancer now available, the disease is being transformed from deadly to increasingly curable. But research reveals that colorectal cancer survivors have a questionable quality of life when compared to age-matched people without cancer. Although patients experienced symptoms and issues most prominently during the first three years following the treatment, they were affected by long-term symptoms and effects of colorectal cancer treatments. These effects include:
- Difficulty sleeping
- Fear of recurrence
- Negative body image
- Gastrointestinal problems
- Sensory neuropathy
- Sexual dysfunction
- Urinary incontinence
Colorectal cancer treatments such as chemotherapy and radiotherapy are not without side-effects or complications, even though they help subdue colorectal cancer and destroy the cells.
The side-effects of treatment for colorectal cancer patients are:
- Appetite loss
- Vomiting and nausea
- Mouth sores
- Hair loss
- Fatigue (due to low red blood cells count)
- Increases susceptibility to infections (due to low white blood cells count)
- Easy bruising and heavy bleeding (due to low platelet count)
- Skin irritation in the area which was subjected to radiation beams
- Slow healing of wounds
- Irritation in the rectum, which can affect bowel movements, diarrhea, and bloody stools
- Stool leakage
- Irritation in the bladder, which can cause a burning pain while urinating, or blood in the urine
- Issues of erection in men and vaginal irritation experienced by women
- Tissues on the treated area tend to stick to each other due to scarring or fibrosis
How can we help?
- Nourish yourself
When battling colorectal cancer, it can get difficult trying to keep up with the treatment procedures, recovering from the aftereffects of surgery, and colorectal cancer symptoms. Nourish yourself, so that you don’t succumb to the effects of colorectal cancer medication (drowsiness, lowered RBC, WBC, and platelet counts) and remain strong enough to stand on your feet with a clear head. Try to maintain a healthy weight, by eating frequent and small meals with high protein content and healthy fats throughout the day. Include vegetables and fruits in your meals, which can offer the body antioxidants powerful enough to fight colorectal cancer.
- Stay fit
Engage in light, but regular exercising to stay fit after a physically and mentally draining treatment session. Life looks better with a calm mind, and moderate exercises can make you feel better about your condition.
- Keep calm
Practice yoga to find your inner calm. Colorectal cancer can take a toll on your health and confidence but, when undergoing treatment, the chances of getting the condition cured is high. So, there’s nothing to worry about and stress over. Talking to a therapist, a colorectal cancer survivor, or your loved ones can help you to a great extent.
- Cancer-proof your home
Apart from medical treatment, what speeds up recovery from colorectal cancer symptoms is a sound and healthy environment. Cancer-proofing your home goes a long way in influencing the progress of colorectal cancer cure, and tiny steps such as radon-treating your surroundings and sanitizing your home with cancer-proof cleaning supplies can make your living space suitable for aiding colorectal cancer treatment.
- Get community support
Our extensive community excels in offering qualitative support to people battling colorectal cancer. Opting for our support services will guarantee you a refreshed mind, especially after having connected and spoken to people with whom you can very well relate and concur. The diversified cancer programs we provide are designed to make the journey of your colorectal cancer treatment smoother.
Check out our official website to learn more about what we do and how we can help you.