What Are The Types Of Colon Cancer
The vast majority of colon cancer is a type called adenocarcinoma. This is a cancer of the cells that line the inside surface of the colon. Rarer tumor types include:
- carcinoid tumors, which start in hormone-producing cells in the intestines
- gastrointestinal stromal tumors or other types of sarcoma that start in the blood vessels or connective tissue of the colon
- lymphoma, which is a cancer of the immune system that more commonly starts in the lymph nodes but can start in the colon
Is There A Test For Hereditary Colon Cancer
Gene testing can identify individuals who carry the more common gene mutations associated with FAP or HPNCC, such as those listed above. However, these tests may not identify all gene mutations that cause FAP or HNPCC. In some families, additional mutations may be present that cause the FAP or HNPCC, which cannot be detected by the commonly used gene tests.
The test for FAP syndrome involves examining DNA in blood cells called lymphocytes , looking for mutations in the APC gene. No treatment to reduce cancer risk is currently available for people with APC mutations that are associated with FAP. But for those who test positive, frequent surveillance can detect the cancer at an early, more treatable stage. Because of the early age at which this syndrome appears, the test may be offered to children under the age of 18 if they have a parent known to carry the mutated APCgene.
Researchers hope that an easier test, which is currently experimental, will become available for common use in three to five years. This new test looks for cancer cells with the APC mutation in a stool sample.
Genetic testing for HNPCC involves looking for mutations in four of the five genes identified that are associated with HNPCC – MLH1, MSH2, MSH6, and PMS2.
Individuals in families at high risk of genetic predisposition may consider testing. Genetic counselors can help individuals make decisions regarding testing.
Additional Resources for Information on Hereditary Colon Cancer
Looking For More Of An Introduction
If you would like more of an introduction, explore these related items. Please note that these links will take you to other sections on Cancer.Net:
ASCO Answers Fact Sheet:Read a 1-page fact sheet that offers an introduction to this type of cancer. This free fact sheet is available as a PDF, so it is easy to print.
ASCO Answers Guide: Get this free 48-page booklet that better helps you better understand this disease and treatment options. The booklet is available as a PDF, so it is easy to print.
The next section in this guide is Statistics. It helps explain how many people are diagnosed with colorectal cancer and general survival rates. Use the menu to choose a different section to read in this guide.
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Dont Wait For Symptoms Get Your Screening
Screening tests look for signs of cancer before it progresses to the point where symptoms may arise. Abdominal symptoms such as pain, bloating or rectal bleeding are often signs of an abnormal process in the left side of your colon. Right-sided colon cancers tend to be asymptomatic or cause these symptoms only when they are at an advanced stage and fairly large. Right-sided cancers are more likely to be diagnosed at a later stage and this alone makes for a poorer prognosis, Dr. Dakwar says.
The good news is that screening with colonoscopy can detect polyps and early cancers anywhere in the colon. Getting a colonoscopy screening on time, according to the recommended guidelines, can find and treat precancerous polyps and prevent cancer from forming. There is no other screening test that can substitute for a colonoscopy, says Dr. Dakwar.
What is on time for your colonoscopy? Most people at average risk should begin regular colon and rectal screening at age 45. But several factors mean you should begin sooner, such as being African American or having a family history of gastrointestinal cancer. Talk to your healthcare provider to learn when you need to schedule your screening.
Colon cancer screening
What Causes Colon Cancer And Am I At Risk
Colon cancer is the fourth most common type of cancer, in both males and females, in the United States. Every year, an estimated 104,000 cases of colon cancer will be diagnosed in the United States. African Americans, particularly African American men, are at an increased risk. The risk of colon cancer also goes up after age 50, but every year there are more cases reported in those under 50. Colon cancer tends to occur more in ages 55-74 with an average age at diagnosis being 67.
Certain factors put people at higher risk. Individuals with a personal or family history of colon cancer, polyps, or inherited colon cancer syndromes , as well as those with ulcerative colitis or Crohn’s disease, are all at higher risk and may require screening at an earlier age than the general population. A person with one first degree relative with colon cancer is 2 to 3 times as likely to develop colon cancer as someone who does not have an affected relative.
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How Do I Prepare For A Colonoscopy
Preparation for a colonoscopy involves cleansing of the bowel with a carefully defined laxative preparation. Since the most important determinant of a successful colonoscopy is the effectiveness of the preparation, ensuring that you closely adhere to the instructions you receive is crucial.
A typical prep includes a clear liquid diet for 24 to 48 hours prior to the examination and the administration of laxatives. These usually include some tablets and a substantial volume, usually 2 to 4 litres, of a salty solution. Mixing the solution with ginger ale or a lemony soda can render the solution more palatable. Liquids that are red or blue should be avoided, as the resulting discolouration of the stool may be misinterpreted as blood. Sometime after the initiation of this process, you will develop mild bowel cramping and increasingly liquid stools. Eventually, with a successful prep, the stools will consist of virtually clear liquid.
If your procedure is scheduled for the morning, the preparation is carried out the preceding day and evening. For afternoon examinations, a portion of the prep can be administered in the evening and the remainder in the morning. In all instances, the prep should be fully consumed no less than 4 hours prior to the procedure.
It is impossible to over-emphasize the importance of the prep. Be sure to understand the instructions and clarify any uncertainties with your doctor.
What Are The Signs And Symptoms Of Colorectal Cancer
Unfortunately, some colorectal cancers might be present without any signs or symptoms. For this reason, it is very important to have regular colorectal screenings to detect problems early. The best screening evaluation is a colonoscopy. Other screening options include fecal occult blood tests, fecal DNA tests, flexible sigmoidoscopy, barium enema, and CT colonography . The age at which such screening tests begin depends upon your risk factors, especially a family history of colon and rectal cancers.
Even if you do not have a family history of colorectal cancer or polyps, tell your doctor if you have any of the signs that could indicate a colorectal cancer, no matter what your age. Common signs of colorectal cancer include the following:
If you experience any of these signs or symptoms, it is important to see your doctor for evaluation. For a patient with colorectal cancer, early diagnosis and treatment can be life-saving.
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What Are The Symptoms Of Colorectal Cancer
Colorectal cancer does not always cause symptoms during the early stages of the disease. Polyps can grow in the colon wall for months or years without causing bleeding or pain. Symptoms are more likely to appear during the later stages of disease, after the cancer has grown or spread.
Typical colorectal cancer symptoms include:
- A change in bowel habits lasting more than a few days
- A persistent urge to have a bowel movement that doesnt go away after you have one
- Bleeding of the rectum
For People At Average Risk
Someone is at average risk if they are 50 to 74 years old with no first-degree relative who has been diagnosed with colorectal cancer.
If you are at average risk of getting colorectal cancer:
- you should get screened once every 2 years with the fecal immunochemical test
- you may also choose to get screened with flexible sigmoidoscopy every 10 years instead of FIT
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Hereditary Causes Of Colorectal Cancer
Having close relatives with colorectal cancer increases the risk of developing the disease and could direct or change the treatment for some patients. Up to 10% of people with colorectal cancer have an inherited genetic abnormality that is associated with developing the disease.
Two of the most common inherited conditions that influence your risk of disease include:
- Lynch syndrome is a condition that increases the risk of colorectal and other cancers including stomach, liver, ovarian, endometrial, brain, skin and small intestine cancers. The syndrome is also referred to as hereditary nonpolyposis colorectal cancer.
- Familial adenomatous polyposis involves developing multiple noncancerous polyps in the colon early in life that may later progress to colorectal cancer. This condition appears at a much earlier age than normally developing colorectal cancers.
Although hereditary factors account for less than 5% of colorectal cancers, your chances of having one of these conditions are higher if several of your close family members have been diagnosed.
If your family history suggests an increased risk of colorectal cancer, City of Hopes hereditary colorectal cancer multidisciplinary program offers genetic counseling and screening that can identify whether inherited conditions influence your risk and guide you to the best treatments.
What Are The Treatments For Colon Cancer
If you are diagnosed with colon cancer, your doctors will discuss treatment options with you. To make an informed choice, ask about the pros and cons of each option, potential side effects, and how effective the treatment is likely to be.
We understand how important quality of life is. We always try to preserve your ability to use the bathroom normally as well as your sexual health.
There are several ways to treat colon cancer depending on the stage and location of the disease. These methods are often used in combination, including:
- Surgery to remove the cancer. Colon cancer is treated with a segmental colectomy, which removes part of the colon. This is usually done using a minimally invasive procedure. For most people, the surgeon joins the two remaining ends to reconstruct the colon.
- Chemotherapy with drugs that shrink or kill colon cancer cells. This can be done before, during, or after surgery, or for some people, instead of surgery.
- Radiation using high-energy rays or particles to shrink or destroy cancer cells. This is more often used in advanced colon cancer that has spread and in rectal cancer.
- Targeted therapy that attacks genetic weaknesses in cancer cells. This treatment spares normal cells.
- Immunotherapy. This helps your bodys own immune system fight cancer.
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What Happens On The Day Of A Colonoscopy
Your colonoscopy may be carried out in a hospital or at an out-of-hospital clinic. The quality and safety of the procedure is the same regardless of the setting. Once you have registered, you will change into a hospital gown and an intravenous needle will be inserted. In the procedure room, you will be asked to lie on your left side. Supplemental oxygen will be administered through nasal prongs and you will be attached to equipment to monitor your heart rate, blood pressure and blood oxygen level. Once you are comfortable, your physician or an anaesthesiologist-assistant will administer sedative medication through the intravenous line. It is likely that you will fall asleep and have no recollection of the examination. While you are asleep, the colonoscopist will insert the colonoscope and proceed with the examination. An average examination takes 20 to 30 minutes. When it is completed, you will be transferred to a recovery area, where you will regain consciousness and be observed for up to an hour prior to discharge. During this period, you may have some mild cramping and will expel the residual gas from the procedure. Once you are sufficiently alert, you will be discharged in the care of your accompanying person.
What Are The Stages Of Colorectal Cancer
Colorectal cancer is described clinically by the stages at which it is discovered. The various stages of a colorectal cancer are determined by the depth of invasion through the wall of the intestine the involvement of the lymph nodes and the spread to other organs . Listed below is a description of the stages of colorectal cancer and the treatment for each stage. In most cases, treatment requires surgical removal of the affected part of the intestine. For some tumors, chemotherapy or for rectal cancers radiation are added to manage the disease.
Stage 0: For lesions that are stage 0 also known as carcinoma in situ the disease remains within the lining of the colon or rectum. Lesions are in the pre-cancerous stage and are not cancers. Therefore, removal of the lesion, either by polypectomy via colonoscopy or by surgery if the lesion is too large, may be all that is required for treatment.
Stage I: Stage I colorectal cancers have grown into the wall of the intestine but have not spread beyond its muscular coat or into close lymph nodes. The standard treatment of a stage I colon cancer is usually a colon resection alone, in which the affected part of the colon and its lymph nodes are removed. The type of surgery used to treat a rectal cancer is dependent upon its location, but includes a low anterior resection or an abdominoperineal resection.
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Any Age Any Gender Any Fitness Level
Screening is the No. 1 way to prevent or detect this disease early, when it’s most treatable. Learn about which colorectal cancer screening options are best for you based on your personal risk factors.
While anyone can develop colorectal cancer, a few conditions can increase risk.
- Inflammatory bowel diseases such as Crohns disease or ulcerative colitis
- A personal or family history of colorectal cancer or colorectal polyps
- A genetic syndrome such as familial adenomatous polyposis or hereditary non-polyposis colorectal cancer
- Black/African Americans and Ashkenazi Jews are at higher risk
How Can I Prevent Colon Cancer
Eating a low-fat diet high in fruits and vegetables and low in red meat, together with regular exercise and maintaining a healthy body weight may help prevent colon cancer. It is also important not to smoke, or to quit if you already smoke. Limiting alcohol may be helpful.
Chemoprevention is defined as the use of a chemical compound to prevent, inhibit, or reverse the formation of the cancer. There are ongoing studies looking at vitamins A, E, D, and C, folic acid, calcium, selenium, aspirin, cox-2 inhibitors, statin medications , and hormone replacement therapy as potential chemopreventive agents that may prevent or reverse the formation of polyps and colon cancer. These studies have been inconclusive so that specific recommendations cannot be made for the general population. Some of these agents continue to be tested in clinical trials.
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Common Palliative Care Issues
Abdominal pain can be the result of a partial or complete obstruction, peritoneal carcinomatosis, or intestinal perforation that leads to generalized peritonitis. Tenesmus may be the result of a locally advanced lesion encroaching on the pelvic nerves, leading to a neuropathic pain syndrome, especially in patients with rectal or low sigmoid cancers. Treatment of tenesmus may require combination of strong opioids with neuropathic agents, but there is evidence that in refractory cases neurolysis of the superior hypogastric nerve may alleviate symptoms.3
In metastatic disease, resection of the primary tumor is indicated in all patients with obstructive symptoms or other problems such as refractory anemia, tumor hemorrhage, or perforation. If the patient is not an appropriate surgical candidate, palliative radiation can be performed to control bleeding. In addition, if the patient is not a reasonable surgical candidate but has obstructive symptoms, consideration for a colonic stent by an experienced interventional gastroenterologist would be appropriate. In some cases, patients receive a stent instead of undergoing surgery, despite being a reasonable surgical candidate, if chemotherapy is scheduled to start soon, with the expectation that it will reduce the tumor burden. See Chapter 25 for more information on malignant bowel obstructions.
Freya A. Goumas, … Matthias Behrend, in, 2010
Whats The Outlook For People With Colon Cancer
It can be alarming and stressful to get a serious diagnosis like colon cancer. Fortunately, colon cancer is treatable, especially when detected early. In fact, according to the ACS, colon cancer thats diagnosed before it has spread past the colon and rectum has a . Additionally, these survival rates are based on data from 2010 to 2016. New cancer treatments have led to increasingly improved outcomes in more recent years.
However, colon cancer cases have also risen among younger people in recent years. According to the , while colon cancer deaths declined in older adults, deaths in people younger than 50 years old increased between 2008 and 2017.
|Colon cancer stageat diagnosis
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Should I Get Screened For Colon Cancer
Colon cancer can usually be cured if it is found early enough.
Memorial Sloan Ketterings guidelines recommend that you get screened for colon cancer beginning at age 45, if you have an average risk and no symptoms. If you are at a higher risk, you should have screenings more often, depending on your age as well as your personal and family medical history.
At MSK, a colonoscopy is the preferred screening method. This procedure detects polyps. These abnormal growths of tissue inside the colon lining can grow into cancer. A colonoscopy can also remove polyps before they become cancerous.