Colorectal Cancer: Overview, Types, Stages, Causes, Symptoms, Risk Factors, Diagnosis, Treatment, and Other

Colorectal Cancer

Colorectal cancer happens when cells in your large intestine and rectum grow uncontrollably. The treatment depends on the stage and types of colorectal cancer. Colorectal cancer starts in the large intestine or rectum, which are parts of your lower digestive system. According to the Centers for Disease Control and Prevention (CDC), colorectal cancer, also called colon cancer, is the third most common cancer in the United States when certain skin cancers are not counted. The American Cancer Society (ACS) estimates that about 1 in 23 men and 1 in 25 women will develop colorectal cancer in their lifetime. For more research you can also visit the World Health Organization. 

What is Colorectal Cancer?

 Colorectal cancer starts as a growth of cells in a part of the large intestine called the colon. The colon is the first and longest part of the large intestine, which is the last part of the digestive system. The digestive system breaks down food for the body to use. Colorectal cancer usually affects older adults, but it can happen at any age. It often begins as small cell clumps called polyps that form inside the colon. Polyps are usually not cancerous, but some can become colorectal cancer over time. Polyps often don’t cause symptoms, so doctors recommend regular screening tests to find polyps in the colon. Finding and removing polyps helps prevent colon cancer. If colon cancer develops, there are many treatments to help control it. Treatments include surgery, radiation therapy, and medicines like chemotherapy, targeted therapy, and immunotherapy. Colorectal cancer is sometimes called colon cancer. This term includes both colon cancer and rectal cancer, which starts in the rectum.  

What are the Stages of Colorectal Cancer?

Doctors use staging to determine how advanced colon cancer is. Knowing the stage is important because it helps doctors choose the best treatment plan and estimate your long-term outlook. Colorectal cancer stages range from 0-4, with stage 0 being the earliest and stage 4 the most advanced. Here are the stages:

  • Stage 0: Also called carcinoma in suit, abnormal cells are only in the inner lining of the colorectal rectum.
  • Stage 1: Cancer has grown into the lining (mucosa) of the colorectal or rectum and may have reached the muscles layer. It hasn’t spread to nearby lymph nodes or other body parts.
  • Stage 2: Cancer has spread to the walls of the colon or rectum or nearby tissues but hasn’t reached the lymph nodes.
  • Stage 3: Cancer has moved to the lymph nodes but not to other body parts.
  • Stage 4: Cancer has spread to distant organs, like the liver or lungs.

What are the Types of Colorectal Cancer?

You might be surprised to learn that there are different types of colorectal cancer. Various types of cells can become cancerous, and being called in different parts of the digestive tract can lead to colorectal cancer. The most common type of colorectal cancer starts from adenocarcinomas. Adenocarcinomas develop in the cells that make mucus in the colon or rectum. According to the American Cancer Society (ACS), adenocarcinomas, make up most colorectal cancer cases. Less commonly, colorectal cancer can be caused by other type of tumors, such as:

  • Lymphomas: These can form in the lymph nodes or start in the colon.
  • Carcinoids: These begin in the hormone making cells within the intestine.
  • Sarcomas: These form in the soft tissues like muscles in the colon.
  • Gastrointestinal Stromal Tumors: These can start as benign and then become cancerous. They usually form in the digestive tract but rarely in the colon.

What are the Causes of Colorectal Cancer?

Normally, cells in our body grow, divide, and eventually die in a controlled manner. Cancer can occur when cells start to grow and divide uncontrollably, not following their normal life cycle. The exact cause of colorectal cancer isn’t fully understood but certain factors can increase the risk according to the American Cancer Society (ACS). Cancer develops due to changes in DNA within cells. Some genes, called oncogenes, help cells survive, grow and divide. Others, like tumor suppressor genes, regulate cell division and death. Changes in DNA can affect these genes, leading to multiple alterations that many contribute to colorectal cancer. Polyps are growths that can form from inside the colon. While most polyps are not cancerous some types like adenomatous polyps can increase the risk of colorectal cancer. These polyps develop on the inner walls of the large intestine. If cancerous cells develop, they can spread from malignant tumors to other parts of the body through the bloodstream or lymphatic system. This process, known as metastasis, allows cancer cells to invade healthy tissues elsewhere in the body leading to a more serious and harder to treat condition.   

What are the Symptoms of Colorectal Cancer?

You may not notice any symptoms of colorectal cancer, especially in the early stages. If symptoms do appear in stage 0-2, they often include:

  • Constipation
  • Diarrhea
  • Changes in the stool color
  • Changes in stool shape, such as narrower stool
  • Blood in the stool
  • Rectal bleeding
  • Excessive gas
  • Abdominal cramps
  • Abdominal pain

Many of these symptoms can also be caused by less serious conditions. However, it’s important to see a doctor if you’ve had any of these symptoms persisting for more than a week or two. You and your doctor can discuss your symptoms and decide if screening for colorectal cancer is necessary. Early detection can significantly improve treatment outcomes.

Stage 3 or 4 Symptoms (late-stage symptoms):

Symptoms of colorectal cancer become more noticeable in stages 3 and 4. In addition to the previously mentioned symptoms, you might also experience:

  • Excessive fatigue
  • Unexplained weakness
  • Unintentional weight loss
  • Persistent changes in your stool lasting more than a month
  • Feeling that your bowels are not completely empty after a bowel movement
  • Vomiting

If colorectal cancer spreads to other parts of your body, you may also have:

  • Jaundice (yellowing of the eyes and skin)
  • Swelling in the hands and feet
  • Asthma
  • Chronic headaches
  • Difficulty breathing
  • Blurry vision
  • Bone fractures

If you experience any of these symptoms, especially if they persist or worsen over time, it’s important to consult with a doctor for evaluation and appropriate medical care. Early detection and treatment can improve outcomes for colon cancer.    

What are the Risk Factors of Colorectal Cancer?

Certain factors can increase your risk of developing colorectal cancer. Having one of these risk factors doesn’t guarantee you’ll get colon cancer, but it does raise likelihood compared to someone with no risk factors.

Risk Factors You Can’t Change:

Certain factors that increase your risk of developing colorectal cancer cannot be changed. These include:

  • Age (being over 50 years old)
  • Ethnicity (being African or Ashkenazi Jewish descent)
  • Family health history (having a family history of colorectal cancer)
  • Personal health history (having a prior history of colorectal polyps or certain bowel diseases)
  • Genetic syndrome (such as familial adenomatous polyposis, or FAP)
  • These factors are not within your control and can contribute to a higher risk of developing colorectal cancer.

Risk Factors You Can Avoid:

Other risk factors for colorectal cancer are avoidable meaning you can make changes to reduce your risk. These avoidable risk factors include:

By addressing these factors through lifestyle changes and healthy habits, you can lower your risk of developing colorectal cancer.  

What is the Diagnosis of Colorectal Cancer?

A physician will conduct a thorough physical examination and inquire about personal and family medical histories. They may also use the following diagnostic techniques to identify and determine the stages of cancer:

Colonoscopy:

Diagnosing a colonoscopy, a doctor inserts a long, flexible tube with a camera at one end into the rectum to examine the inside of the colon. Before the procedure a person may need to follow a special diet, like a clear liquid diet for 1-3 days. They will also need to cleans their colons using strong laxatives, a process called bowel prep. If polyps are found in the colon during the colonoscopy, a surgeon will remove them and send them to a pathologist for biopsy. During a biopsy the pathologist examines the polyps under a microscope to check for cancerous or precancerous cells. A flexible sigmoidoscopy is a similar procedure that allows a doctor to examine a smaller portion of the colorectal area. Unlike a colonoscopy it does not reach as far into the colon. A full colonoscopy may not be necessary if a sigmoidoscopy does not find polyps or if they are only in a small area.

Fecal Testing:

The (ACS) recommends yearly fecal testing. These tests are used to detect hidden blood in your stool. There are two main types:

  • Guaiac based fecal occult blood test (gFOBT)
  • Fecal immunochemical test (FIT)

These tests are important for early detection of colorectal cancer and are part of regular screening recommendations for adults.

Blood Test:

Your doctor may perform blood tests to understand the cause of your symptoms better. Liver functions tests and complete blood counts can help rule out other diseases and disorders. These tests are important diagnostic tools to assist in identifying potential health issues beyond colorectal cancer.

Sigmoidoscopy:

It is a minimally invasive procedure that allows your doctor to examine the sigmoid colon, which is the last section of your colon, for any abnormalities. This procedure also known as flexible sigmoidoscopy uses a flexible tube with a light. According to the United States Preventive Services Task Forces (USPSTF), it is recommended to have a flexible sigmoidoscopy every 5 years. Alternatively, it can be done every 10 years along with a yearly FIT (fecal immunochemical test) for colorectal cancer screening. The American Cancer Society (ACS) also recommends a flexible sigmoidoscopy every 5 years for screening purposes.

X-Rays:

Your doctor may order an X-rays using a contrast solution containing barium, a chemical element. This procedure involves inserting the barium solution into your bowels through a method called a barium enema. Once inside, the barium coats the lining of the colon, enhancing the quality of X-rays images taken during the procedures. This helps doctors visualize the structure and condition of the colon more clearly.

CT Scans:

CT scans provide detailed images of your colon that help your doctor diagnose conditions like colorectal cancer. When a CT scan is specifically used to examine the colon, it’s sometimes referred to as a virtual colonoscopy. This non-invasive procedure allows doctors to view the inside of the colon to detect abnormalities or signs of disease.

What is the Treatment of Colorectal Cancer?

The treatment of colorectal cancer depends on several factors. Your doctor will create a personalized treatment plan based on your overall health and the stage of your colorectal cancer.

Surgery:

In the early stage of colorectal cancer, surgery is often effective. If the cancerous polyp hasn’t spread beyond the inner lining of the bowel, your surgeon can usually remove it, resulting in a positive prognosis. If the cancers have spread into the bowel walls, your surgeon may need to remove a section of the colon or rectum, along with nearby lymph nodes. Depending on the extent of the surgery the surgeon may be able to reconnect the healthy parts of the colon and rectum. In cases where it isn’t feasible a colostomy may be necessary. A colostomy involves creating an opening in the abdominal wall to divert waste, and it can be either temporary or permanent.

Radiation:

Radiation therapy uses a strong beam of energy, similar to X-rays to target and kill cancer cells. It can be used before or after surgery to treat colorectal cancer. Radiation therapy is often combined with chemotherapy for more effective treatment.      

Chemotherapy:

Chemotherapy is a treatment that uses drugs to kill cancer cells. In colon cancer patients, chemotherapy is typically administered after surgery to eliminate any remaining cancer cells and to manage tumor growth. Common chemotherapy drugs used for colorectal cancer include:

  • Capecitabine (Xeloda)
  • Fluorouracil
  • Oxaliplatin (Eloxatin)
  • Irinotecan (Camptosar)

Chemotherapy can cause side effects, such as nausea and fatigue, which may require additional medications to manage.        

Other Medications:

Targeted therapies and immunotherapies might also be recommended for colorectal cancer treatment. The Food and Drug Administration (FDA) has approved several drugs for treating colorectal cancer, including:

  • Bevacizumab (Avastin)
  • Ramucirumab (Cyramza)
  • Ziv-aflibercept (Zaltrap)
  • Cetuximab (Erbitux)
  • Panitumumab (Vectibix)
  • Regorafenib (Stivarga)
  • Pembrolizumab (Keytruda)
  • Nivolumab (Opdivo)
  • Ipilimumab (Yervoy)

These drugs are used to treat metastatic, or late-stage colorectal cancer that hasn’t responded to other treatments and has spread to other parts of the body.

What is the Prevention of Colorectal Cancer?

Some risk factors for colorectal cancer, like family history and age, cannot be changed. However, you can prevent certain lifestyle factors that may contribute to colorectal cancer. Making changes can lower your overall risk of developing this disease. Here are steps you can take to reduce your risk:

  • Decrease the amount of red meat you eat
  • Avoid processed meats, such as hot dogs, and deli meats
  • Eat more plant based foods
  • Reduce dietary fat
  • Exercise daily
  • Lose weight, if recommended by your doctor
  • Quit smoking
  • Reduced alcohol consumption
  • Decrease psychological stress
  • Manage preexisting diabetes

Another important preventive measure is to get a colonoscopy or other cancer screening starting at age 45. Early detection can improve treatment outcomes.

What You Know About Cervical Cancer?

Cervical cancer is a serious health concern that affects women around the world. So in this article we’ll explore what cervical cancer is its causes, symptoms and the importance of prevention through vaccination and regular screening. It is a type of cancer that starts in the cells of the cervix, the lower part of uterus that connects to the vagina. Most cervical cancers are caused by the human papillomavirus (HPV), a common virus transmitted through sexual contact. The American Cancer Society estimates that doctors will diagnose around 13,170 new cases of cervical cancer by the end of 2019 in the United States. Additionally, more than 4200 women in the U.S. are expected to die from cervical cancer this year. Initially, the Centers for Disease Control and Prevention (CDC) recommended the vaccine for individuals aged 9-26 years. However, the CDC now advises that the vaccines is also available for all women and men aged 26-45 years who did not receive the vaccine as a preteen. Certain factors can make someone more likely to get it:

  • HPV infection
  • Smoking
  • Weakened immune system
  • Long term use of birth control pills
  • Having many children

What is the Types of Cervical Cancer?

Cervical cancer and cervical pre-cancers are classified by how they look in the lab with a microscope. The main types of cervical cancers are squamous cell carcinoma and adenocarcinoma. Most (up to 9 out of 10) cervical cancer are squamous cell carcinomas. These cancers develop from the cells in the exocervix. Squamous cell carcinoma most often begin in the transformation zone where to exocervix joins the endocervix. Most of other cervical cancers are adenocarcinomas. Adenocarcinomas are cancers that develop from glandular cells. Cervical adenocarcinoma develop from the mucus-producing gland cells of the endocervix. Less commonly, cervical cancers have features of both squamous cell carcinoma and adenocarcinomas. These are called adenosquamous carcinomas or mixed carcinomas. Although almost all cervical cancers are either squamous cell carcinomas or adenocarcinomas, other types of cancer also can develop in the cervix. These types, such as melanoma, sarcoma, and lymphoma, occur more commonly in other parts of the body.

What is the Symptoms of Cervical Cancer?

In the early stages of cervical cancer, a person may experience no symptoms at all. Therefore, it’s important for women to have regular cervical smear tests, or Pap tests. A Pap test is a preventive measure. It aims not to detect cancer but to reveal any cell changes that indicate the possible development of cancer so that a person can take early action to treat it. The most common symptoms of cervical cancer are:

  • Vaginal bleeding between periods
  • Bleeding after sexual intercourse
  • Menstrual bleeding that is longer or heavier than usual
  • Pain during intercourse
  • Bleeding after intercourse
  • Pelvic pain
  • A change in your vaginal discharge such as more discharge or it may have a strong or unusual color or smell
  • Vaginal bleeding after menopause

These symptoms can be caused by other conditions but if you are worried or symptoms persist, contact your doctor. This is importance of anyone with a cervix, whether you are straight, lesbian, gay bisexual or transgender.

What is the Stages of Cervical Cancer?

Determining the stage of cancer is crucial as it guides the choices of treatment that will be most effective. Staging is done to evaluate how far the cancer has spread and whether it has reached nearby structures or distant organs. The most common staging symptoms for cervical cancer is a 4 stages system.

  • Stage 0:Precancerous cell are present.
  • Stage 1:Cancer cells have grown from the surfaces into deeper tissues of the cervix, possibly reaching the uterus and nearby lymph nodes.
  • Stage 2:The cancer has spread beyond the cervix and uterus but hasn’t reached the walls of the pelvis or the lower part of the vagina. It may or may not affect nearby lymph nodes.
  • Stage 3:Cancer cells are found in the lower part of the vagina or the walls or the pelvis, possibly blocking the uterus. It may or may not affect nearby lymph nodes.
  • Stage 4:The cancer affects the bladder or rectum and has grown out of the pelvis. It may or may not involve the lymph nodes. In later stages, it spreads to distant organs like the liver, bones, lungs, and lymph nodes.

Regular screening and seeking medical attention for any symptoms can lead to early treatments, improving the chances of survival.

What is the Causes of Cervical Cancer?

Almost all causes of cervical cancer are caused by the persistent infection with some high-risk types of the human papillomavirus (HPV); this is the biggest risk factor for cervical cancer. The other main risk factor for cervical cancer is smoking. There is some evidence that women who have taken the contraceptive pill for five years or more are at increased risk of developing cervical cancer in people with HPV. The risk is small and taking the pills has also been shown to reduce to risk of other cancers such as ovarian and uterine. Other risk factors includes:

  • Smoking and passive smoking
  • A weakened immune system

If your mother was prescribed diethylstilbestrol (DES), an artificial form of the female hormone osteogenic during pregnancy (between 1939 and 1971). Around 8 out of 10 women will becomes infected with genital HPV at some time in their lives. Most women who have the HPV infection never get cervical cancer; only a few types of the HPV result in it. This results in an excessive buildup of cells, which eventually forms a lump, or tumor. Scientist are not completely sure why cells becomes cancerous. However, some risk factors might increase the risk of developing cervical cancer. These include:

  • HPV
  • Having many sexual partners or becoming sexually active early
  • Smoking
  • A weakened immune system
  • Birth control pills
  • Other sexually transmitted disease (STD)
  • Socio-economic status

What is the Diagnosis of Cervical Cancer?

Early diagnosed of cervical cancer significantly increased the chances of successful treatment. The American Cancer Society (ACS) provides the following guidelines for routine screening:

  • Under 25 years:Screening is not recommended by the ACS.
  • Ages 25-65 years:Individuals should undergo an HPV test every five years for cervical cancer.
  • Over 65 years:Screening is not recommended by the ACS for those who have had adequate screening in the past, unless they are at high risk of cervical cancer. Individuals who have had a hysterectomy with removal of the cervix do not require screening unless they have had precancerous lesions or cervical cancer in the past.

While these are the general screening recommendations, it’s important for individuals to consult with their doctor to determine their specific screening needs.

  • Cervical smear test
  • HPV DNA testing

If there are signs and symptoms of cervical cancer, or if the Pap test reveals abnormal cells, a doctor may recommends additional tests. These include:

  • Colposcopy
  • Examination under
  • Biopsy
  • Large loop excision of the transformation zone (LLETZ) or cone biopsy
  • Cone biopsy
  • LLETZ
  • Blood tests
  • CT scan
  • MRI
  • Pelvic ultrasound

What is the Risk Factors of Cervical Cancer?

Risk factors for cervical cancer include:

  • Smoking tobacco
  • Increasing number of sexual partners
  • Early sexual activity
  • Other sexually transmitted infections
  • A weakened immune system
  • Exposure to miscarriage prevention medicine

What is the Preventions of Cervical Cancer?

To reduce your risk of cervical cancer;

  • Ask your doctor about the HPV vaccine
  • Have routine Pap tests
  • Safe sex and cervical cancer
  • Cervical screening
  • Having fewer sexual parents
  • Delaying first sexual intercourse
  • Don’t smoke

What is the Treatments of Cervical Cancer?

Treatment for this cancer depends on several factors, such as the stages of the cancer, other health conditions you may have and your preferences.

Surgery:

So small cervical cancer that haven’t grown beyond the cervix are typically treated with surgery. The size of your cancer, its stage and whether you would like to consider becoming pregnant in the future will determine which operation is best for you. The options might include:

  • Surgery to cut away the cancer only
  • Surgery to remove the cervix, called a trachelectomy
  • Surgery to remove the cervix and uterus called a hysterectomy

Radiation Therapy:

Radiation therapy uses powerful energy beams to kill the cancer cells. The energy can come from X-rays, protons, or other sources. Radiation therapy is often combined with chemotherapy as the primary treatment for it that have grown beyond the cervix. It can also be used after surgery it there’s an increased risk that the cancer will come back. Radiation therapy can be given:

  • Externally, called external beam radiation therapy. A radiation beam is directed at the affected area of the body
  • Internally, called brachytherapy. A device filled with radioactive material is placed inside your vagina, usually for only a few minutes
  • Both externally and internally

Chemotherapy:

Chemotherapy uses strong medicines to kills the cancer. So that has spread beyond the cervix, low doses of chemotherapy are often combined with radiation therapy. This is because chemotherapy may enhance the effects of the radiation. Higher doses of chemotherapy might be recommended to help control symptoms of very advanced cancer. Chemotherapy may be used before surgery to reduce the size of the cancer.

Targeted Therapy:

Targeted therapy uses medications that attacks specific chemicals in the cancer cells. By blocking these chemicals, targeted treatments can cause cancer cells to die. Targeted therapy is usually combined with chemotherapy. It might be an option for advanced it.

Immunotherapy:

So it is a treatment with medications that helps your immune system kills the cancer cells. Because your immune system fights off disease by attacking germs and other cells that shouldn’t be in your body. Cancer cells survive by hiding from the immune system. It helps the immune system cells find and kill the cancer cells. It might be considered when the cancer is advanced and other treatments aren’t working.

Palliative Care:

It is a special type of health care that helps you feel better when you have a serious illness. If you have a cancer, palliative care can help relieve pain and other symptoms. A team that can include doctors, nurses, and other specially trained professional’s provider’s palliative care. A team goal is to improve quality of life for you and your family. You can have a palliative care at the same time as strong cancer treatments, such as surgery, chemotherapy, and radiation therapy. Using palliative care along with all other appropriate treatments can help people with cancer feel better and live longer.

FAQs:

Can colorectal cancer be cured?

Colorectal cancer is highly treatable and often curable when it is confined to the bowel. Surgery is the main treatment and curse for about 50% of patients. However, recurrence after surgery is a major issue and often leads to death.

How long can you live with colorectal cancer?

The current survival rates for colorectal cancer show that, overall about 65 out of every 100 people diagnosed with this type of cancer are expected to be doing well five years later. This statistic gives us an idea of the overall effectiveness of available treatments and how people with colorectal cancer are faring.

What naturally kills colorectal cancer cells?

Beans and legumes are considered superfoods in the fight against colorectal cancer. Black beans, in particular, increase levels of certain fatty acids that help protect against the growth of cancer cells.

Are eggs bad for colorectal cancer?

Testing on the link between egg consumption and colorectal cancer started in the 1980s. By the 1990s, 15 studies had been published, 10 showed a direct association between eating eggs and colorectal cancer while 5 found no association. By 2014, many more studies had been published, confirming that eggs indeed play a role in the development of colon cancer.

Are nuts bad for colon cancer?

The most recent study found that patients with stage III colon cancer who regularly ate at least two one-ounce servings of nuts a week had a significant reduction in cancer recurrence and death compared to patients who did not eat nuts.

What dry fruits help with colon cancer?

Prunes contain B-carboline alkaloids and phenolic substances. This dried fruit has a strong protective effect against stomach and colorectal cancer cell lines.

How many walnuts to eat per day?

A 2021 article on the effect of walnut consumption found that eating 30-60 grams of walnuts daily is beneficial for heart health. This amount is equal to 1-2 ounces or ¼ – ½ cup of walnuts.

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