Colon cancer

With the term Colon cancer or. Colon cancer are cancers that have localized in the colon. The malignant tumors mainly arise from the intestinal mucosa.

What is Colon Cancer?

Unfortunately, as with many other cancers, colorectal cancer lacks characteristic early symptoms. The disease is often completely asymptomatic, especially in the early stages.
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Malignant tumors in the area of ​​the large intestine are called colon cancer (colon carcinoma). The colon, in turn, begins in the area of ​​the right lower abdomen. There it joins the small intestine and finally ends at the anus.

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This form of cancer as a malignant growth of cells mainly develops from the lining of the intestine. In some cases, the degeneration of initially benign growths on the intestinal mucosa occurs. This disease usually only occurs after the age of 40. 90% of all those affected are older than 50 years. This cancer is relatively common in western industrialized countries.

Colon cancer is the second most common cancer in men and women. In Germany there are around 39,000 new male patients and 33,000 new female patients every year. Colon cancer rarely occurs in emerging and developing countries.

causes

There are many causes of colon cancer. It can be favored by various risk factors. There are inheritable defects in the genetic make-up that can increase the likelihood of colon cancer.

These include the following diseases: familial adenomatous polyposis, Gardner syndrome, Peutz-Jeghers syndrome and Lynch syndrome. Another risk factor is chronic bowel disease. This includes diseases such as ulcerative colitis and Crohn's disease. Both diseases are similar in terms of symptoms, complications, and treatments. They usually appear in childhood or adolescence.

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In addition, eating habits can have an influence. Obesity, a high-meat and high-fat diet, long-term smoking, regular and high alcohol consumption and a low-fiber diet increase the risk of developing colon cancer.

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Symptoms, ailments & signs

Unfortunately, as with many other cancers, colorectal cancer lacks characteristic early symptoms. The disease is often completely asymptomatic, especially in the early stages. The first signs of colon cancer may be changes in bowel habits.

Any sudden change in bowel movements in patients under the age of 40 should therefore be investigated more closely. There may be a switch between constipation and diarrhea. Frequent, foul-smelling or pencil-thin bowel movements can also be an indication of a malignant bowel disease.

In order to overcome the constriction, the intestinal muscles have to use significantly more force, which can lead to massive colicky bulging pain. In the course of the disease, blood regularly appears on or in the stool. The permanent blood loss leads to iron deficiency and anemia (anemia).

Less specific for colorectal cancer, but indicative of a general malignancy, are symptoms such as unwanted weight loss, night sweats, fever, decreased performance and general tiredness. In later stages of the disease and as the tumor grows, it can also be felt as a hardening in the abdomen.

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If the tumor has grown so large that it obstructs the intestinal lumen, the intestinal obstruction occurs. Doctors refer to this closure as an ileus. It manifests itself in stool retention, nausea and vomiting, a bloated stomach and cramp-like pain.

diagnosis

There are various methods available to doctors to diagnose colon cancer. Since around half of all growths are located in the rectum, the doctor can feel them with the help of a palpation examination.

For deeper areas, however, a colonoscopy is required. However, a colonoscopy is necessary to examine the entire colon. With this method, the doctor can also take a tissue sample from regions suspected of being cancerous at the same time. This is then analyzed under the microscope.

Special X-ray examinations with a colonic contrast enema are also possible. Early detection is crucial for the successful course of the disease. 95% of all patients survive the next five years if they were diagnosed with this cancer in the early stages. If the colon cancer is well advanced, the chances of a cure are greatly reduced.

Complications

Partial removal of the intestine may be appropriate depending on the location and size of the tumor. In these cases the respective ends of the intestine are sewn together. The utilization of food and the regulation of bowel movements can subsequently be problematic.

In individual cases it may be necessary to create an artificial anus. The associated psychological consequences for the patient usually subside after the stoma is moved back. In addition, there are general operational risks (thrombosis, pulmonary embolism and postoperative wound healing disorders).

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The most common complications during chemotherapy are severe malaise with vomiting, dizziness and temporary hair loss. Depending on the tumor classification and location of the tumor, pre- or postoperative irradiation of the tumor may be suitable. Many patients experience the following complications in the course of radiation therapy: diarrhea, skin irritation, abdominal pain and an increased susceptibility to urinary tract infections.

If treatment for the disease is not treated or if therapy is started too late, the tumor will grow further and form distant metastases in the liver and lungs. If the tumor grows aggressively, it can break through the intestinal walls, so that intestinal contents leak into the abdomen and cause inflammation there. A cure is no longer possible at this stage of the disease.

When should you go to the doctor?

Characteristic for a tumor infestation of the colon is usually a long phase of no symptoms in the initial stage. Most patients only suffer from unspecific pain. For this reason, doctors only recognize growths in the last section of the digestive tract thanks to routine checks. If the symptoms are massive, the colon cancer is usually already well advanced.

Nevertheless, there are some warning signs for early detection that prevent the spread of cancerous ulcers through a timely consultation with a doctor. Only a colonoscopy can give you absolute certainty about the condition of the colon. This method determines very reliably whether there are any growths in the large intestine.

Typical warning signs that require a doctor to conduct a close examination are regular deposits of blood on the stool. A dark discoloration in particular indicates an origin in the inner area of ​​the intestine. Cancerous ulcers impair bowel function and provoke occasional alternations from diarrhea and constipation with no plausible explanation for those affected.

Bottlenecks also favor the formation of very thin pencil stools. Excessive mucus deposits with relatively little bowel movement in the morning hours indicate disease in the rectum. General indications of involvement of the large intestine are pain a few hours before going to the toilet.

However, isolated abdominal pain and cramps are not a specific symptom of cancer. Nevertheless, it is advisable to seek an examination by a specialist in the case of regular, mild illnesses. Familial accumulations of colon cancer, especially before the age of 45, should definitely be brought up by patients at the presentation.

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Treatment & Therapy

Colon cancer is usually treated surgically. The aim of the surgical procedure is to completely remove the tumor. Furthermore, the treatment depends on the extent and type of cancer.

Metastases must also be eliminated if necessary. At an advanced stage, the operation is often supplemented by radiation therapy and chemotherapy. Before the surgical procedure, these treatment methods are used to shrink the growths.

This makes the operation easier. After the operation, chemotherapy and radiation therapy are used to kill any remaining cancer cells. Radiation therapy only affects the local area of ​​the radiation field. Chemotherapy also detects diseased cells in the whole organism. It is also combined with newly developed preparations that allow a better quality of life.

In this way, the pain is efficiently relieved, the mobility is maintained for a longer period of time and the cancer can stabilize for a while with this form of therapy. Patients with colon cancer not only feel better physically, but also improve their mental state.

Outlook & forecast

Colon cancer is one of the types of cancer whose prognosis is initially quite good, but unfortunately the disease is often discovered late. This naturally worsens the chances of a complete cure and a subsequent cancer-free life.

If colon cancer is found in stage I or II, the chances are often good that it can be completely or at least largely removed surgically. The patient may need chemotherapy afterwards because there is a risk that the colon cancer has already spread. However, if it does not and can be completely removed, then a patient can hope for a cure.

Colon cancer discovered later, however, no longer has such a prognosis. Often it has already spread to other organs and can only be removed surgically in parts or not at all. Then the prognosis depends on the result of chemotherapy and its success in turn on a number of other factors such as the general health of the patient, the individual tolerance of the chemotherapy or age.

Colon cancer also influences the absorption of nutrients, so malnutrition can quickly occur with this type of cancer. Furthermore, it may be necessary to create an artificial anus after an operation. Although this is reversed, this can be accompanied by adjustment disorders due to a weakened sphincter muscle.

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prevention

The risk of developing colon cancer can be reduced by eating a healthy diet. A fiber-rich diet in particular can prevent various types of colon and stomach cancers. Furthermore, a life with a lot of exercise and sport is advisable. In old age, however, early detection is essential as a preventive measure. This improves the prognosis significantly. So men and women from the age of 50 should go for colon cancer screening. From the age of 55, a colonoscopy is recommended every 10 years to detect any colon cancer at an early stage.

Aftercare

Colon cancer diagnosis poses some challenges after completing treatment. The body regenerates. Those affected have to find their way back to everyday life. If necessary, doctors can order rehabilitation measures or provide help with social and psychological ailments. The treatment also sometimes results in secondary symptoms such as incontinence and indigestion.

In addition to eliminating the acute signs, follow-up care also has a preventive character. It must be prevented that cancer cells form again, metastases or a tumor appears elsewhere in the large intestine. Depending on the intensity of the infestation, various follow-up examinations have been established.

If the prognosis is favorable, doctors will perform a colonoscopy in addition to a physical exam. If the chances of recovery deteriorate, a number of additional checks are added. Among other things, the determination of the tumor marker CEA provides clarity about the progress.

An ultrasound of the abdomen and chest x-rays are also regularly arranged. The higher the likelihood of relapse, the more frequent follow-up visits will be. If the progression is unfavorable, a six-month cycle is indicated.

You can do that yourself

In addition to medical treatments, patients with colon cancer have everyday opportunities to alleviate symptoms caused by the disease itself or the therapies. It is important that self-help measures are always discussed with the treating doctor.

It is crucial that the rest of the intestine in the body after the operation is supported in its function and is not exposed to any avoidable stress. This is achieved by avoiding overly lavish meals, poorly digestible foods or foods that cause gas. Food rich in fiber is also suitable to support the intestine in its natural digestive activity. In this context, it is also important to drink enough fluids in the intestine.

Patients who have lost a lot of weight due to the intestinal disease and the therapy can regain weight and strength through special food. Self-help groups for cancer patients, relaxation methods or yoga are ideal for mental regeneration. Exercise in the fresh air or meeting friends also help create a positive mood and thus a better quality of life.

Ostomartists can do a lot to improve their wellbeing by taking care of their artificial anus as instructed by the ostomist. It is also helpful to learn through discussions with experts, such as a psycho-oncologist or stoma therapist, to consciously accept the stoma and not grapple with the restriction on a daily basis.