Colorectal cancer, colorectal carcinoma or colon carcinoma is a cancer of the intestine. Specifically of the colon or rectum, more rarely in the small intestine or anal area. Typical early symptoms are blood in the stool and pain in the bowel area. Without treatment, the disease is usually fatal.
What is colorectal cancer?
Colorectal cancer can develop in any of the three areas of the intestine. These include the colon, small intestine and anal area. The colon itself additionally consists of the rectum or rectal, the appendix and the colon. Thereby, the colorectal cancer or tumor can arise from the intestinal mucosa. Most frequently, colorectal cancer occurs in the colon (colon carcinoma) or rectum (rectal carcinoma). Tumors form rather rarely in the small intestine and in the anal region. Colorectal cancer continues to occur mostly in older people over the age of 40. The higher the age, the higher the risk of developing colorectal cancer. Annually, however, only about 0.045 percent of the population in Germany develops these malignant intestinal tumors.
Causes
The causes of colorectal cancer can generally be classified into three factors. 1. familial or hereditary causes.
2. chronic intestinal diseases
3. diet
4. lifestyle
Hereditary and genetic causes:
Among the hereditary causes of colorectal cancer, genetic defects, i.e. errors in the hereditary makeup, are the most important. Certain risk syndromes play a decisive role: Gardner syndrome, familial adenomatous polyposis (FAP), Lynch syndrome and Peutz-Jeghers syndrome. These heritable risk factors are also called hereditary predisposition. Chronic bowel disease:
Chronic bowel diseases primarily include Crohn’s disease and ulcerative colitis. These diseases can occur at a young age and develop into chronic intestinal diseases. Particular characteristics of this are usually constant diarrhea and blood in the stool
Diet:
Similarly, a diet high in fats and low in fiber can promote the development of colorectal cancer. A high-salt cost (e.g., salted meat, salt sticks, smoked foods) is also partly responsible for colorectal cancer. Lifestyle:
In addition to a poor diet, a poor lifestyle often accompanies it. Thus, especially lack of exercise, smoking and obesity are causal for the development of tumors and especially colorectal cancer.
Symptoms, complaints and signs
In the early stages, colorectal cancer causes only very nonspecific symptoms that are usually not associated with the digestive tract. These include unexplained weight loss, pale skin, decreased performance, and severe fatigue. Occasionally, mild fever occurs, and affected individuals often complain of increased night sweats. If the tumor spreads to the intestine, visible blood inclusions become visible in the stool: bright red blood inclusions usually originate from the rectum, a tumor in the upper part of the intestine is noticeable by dark to blackish blood inclusions. A conspicuous pallor of the skin may indicate anemia due to a prolonged loss of blood. Other warning signs are an alternation between constipation and diarrhea, frequent urge to defecate, and flatulence, which may be accompanied by involuntary defecation. A purulent, foul odor of the stool is often noticeable, and mucoid stool admixtures are also possible. Repeated cramping abdominal pain, prolonged loss of appetite, frequent nausea and increased bloating must also be considered as bowel cancer. Depending on the location of the tumor, pain may occur during defecation; if the rectum is narrowed, the stool is often pencil-thin in shape. A very large tumor may be noticeable as a palpable induration in the abdomen; in advanced stages, a tumor can cause complete bowel obstruction.
Course
Colonoscopy of the colon for colorectal cancer.
© Juan Gärtner – Fotolia.com.
The course of colorectal cancer depends on whether it is detected early or not. The earlier colorectal cancer is treated, the better the prognosis. From this point of view, the chance of cure depends on the stage of the tumor disease. If metastases have already formed or other organs have already been affected by the cancer, the prospect of a full recovery worsens.Complications that can occur in the course of colorectal cancer are: Anemia, internal bleeding, pain during bowel movements (intestinal obstruction), intestinal perforation and peritonitis. For the last three conditions, surgery must be performed immediately.
Complications
Colorectal cancer does not always have to lead to complications. With timely diagnosis of the disease and appropriate treatment, some patients can be cured. However, there are typical complications that cannot be excluded in this disease. These include the so-called Illeus. Illeus is an obstruction of the intestine caused by the tumor. It is also possible for the intestine to rupture. As a result, a serious inflammation of the peritoneum, also called peritonitis, may occur. In the worst case, this condition can have a fatal outcome and must therefore be treated immediately with intensive care. These two complications typically occur in later-stage colorectal cancer. Another possible complication of this disease is spread to nearby organs. Colorectal cancer can affect the vagina, bladder or liver, among other organs. In some cases, a vital blood vessel is squeezed. As a result, the entire intestine may die or other vital organs may become severely limited in function. In a late stage of colorectal cancer, metastasis to the liver may occur. Subsequently, this leads to failure of this organ. This also results in complications such as clotting disorders, clouding of consciousness and edema. Infestation of the lungs is also possible. This manifests itself as a bloody cough and shortness of breath. Colorectal cancer can also spread via the lymph. Typically, the lymph nodes of the aorta, groin or pelvis are affected. These lymph nodes cause severe pain and subsequently weaken the patient’s immune system.
When should you go to the doctor?
A doctor should be consulted if blood is passed unabated after several bowel movements. If pain occurs in the abdomen that cannot be explained and is perceived as unusual, further examination should take place. If the pain increases or spreads, a visit to the doctor is necessary. If everyday tasks can no longer be performed due to the discomfort, the cause should be clarified. Consultation with a physician is necessary before taking a pain-relieving medication in order to avoid additional risks. If the discomfort occurs even though a healthy and easily digestible diet has been consumed for several days and sufficient fluids have been consumed, it is considered unusual and must be investigated. Stinging and pulling sensations in the abdomen, numbness as well as growths should be clarified by a doctor. Persistent diarrhea, flatulence or a permanent feeling of fullness as well as pressure should also be examined by a doctor. If the affected person suffers from an unexplained lack of energy, malaise or general physical weakness that lasts for several days or weeks, a visit to the doctor is recommended. A doctor should also be consulted if intolerances of habitual foods occur or if a changed and unexplainable feeling of inner restlessness sets in. If there are intestinal diseases in the past or within the family, regular control and preventive examinations should take place in principle.
Treatment and therapy
The therapy or treatment of colorectal cancer is usually carried out, depending on the stage of the cancer, by a combination of chemotherapy, radiotherapy and surgery. In this process, surgery is intended to shrink or remove the intestinal crest. This is followed by radiotherapy or chemotherapy. Its main purpose is to kill the remaining cancer cells. Radiation therapy is administered locally, and chemotherapy also fights metastases throughout the body. If the colorectal cancer is very advanced, a cure is usually no longer possible. Nevertheless, modern treatment methods, especially within chemotherapy, and drugs can increase or prolong the chances of survival. Likewise, the general quality of life should be improved. The drugs used in colorectal cancer therapy, as well as chemotherapy, can also have severe side effects. The main undesirable side effects are hair loss, diarrhea and loss of appetite.However, these side effects disappear quickly after successful therapy. Other modern treatment methods are: Laser therapy and heat therapy. You can find out more about this from your attending physician.
Outlook and prognosis
The prognosis for colorectal cancer is more favorable the earlier the disease is detected. If small tumors can be surgically removed before they affect adjacent lymph nodes or form daughter tumors (metastases) in more distant organs, a long-term cure can be achieved with a high probability. The success of an operation depends strongly on the location and aggressiveness of the tumor, the qualities of the operating physician and the general condition of the patient. Even after successful surgery, there is a risk of recurrence, especially within the first five years, but this can be detected early through regular follow-up examinations. As colorectal cancer progresses, the chances of cure decrease: lymph node involvement lowers the 5-year survival rate to about 50 percent, and the spread of the tumor to other organs further worsens the prospects. If the liver or lungs are affected, the daughter tumors can often be removed surgically, which improves the prognosis. If surgery is not possible, chemotherapy occasionally succeeds in containing or slowing the growth of the metastases: This can often increase life expectancy by several months. If these measures show no effect, the chances of a complete cure are considered low – in this case, treatment is primarily aimed at pain relief and the best possible preservation of quality of life.
Prevention
If no hereditary or genetic diseases are present, colorectal cancer can be prevented quite well. Mainly, prevention should focus on a healthy lifestyle with plenty of exercise and sports, as well as a healthy diet rich in fiber. High-fat food, smoking, a lot of alcohol and little exercise should be avoided.
Follow-up
After colorectal cancer treatment is completed, the body needs time to fully recover. Colorectal cancer aftercare is concerned with immediately initiating new measures for therapy in the event of any new tumor formation. In this context, information about therapeutic approaches is essential. These are both surgical and chemotherapeutic. If necessary, blood tests to determine the carcinoembryonic antigen, or CEA value, will be arranged. This is a reference value for the transformation of healthy body cells into tumor cells. It is important to completely monitor the regeneration process. This is the only way to detect tumor relapse or metastasis. For a new recovery procedure, the patient must be in a state of health that permits medical care. Follow-up care includes regular check-ups with the doctor. The number of them depends on the severity and therapeutic success of the previous cancer. In some cases, it may not be possible to completely remove the tissue overgrowth. In this case, during the medical check-up, special attention is paid to the tumor region, the degree of formation and the severity. In most cases, the tumor will recur within two years. If this time period is exceeded and there is no sign of recurrent colorectal cancer, the probability of this also decreases. Follow-up care is then discontinued accordingly. For early detection, however, it is recommended to undergo regular colonoscopies.
What you can do yourself
Even though the diagnosis of colorectal cancer is bad news for most of those affected, it does not mean that there are no ways to maintain quality of life and help shape the healing process yourself. Scientific studies show that the right diet can help to positively influence the chances of recovery. For example, the spice turmeric has been shown to be effective against tumor cells. The addition of black pepper increases the bioavailability of turmeric by a factor of two thousand. In addition, the consumption of green leafy vegetables is beneficial for healing, as the chlorophyll they contain can destroy tumor cells and cause the cancer to shrink. In addition, the antioxidants contained in soft fruits have been scientifically confirmed to significantly slow cancer growth. In the course of conventional medical measures such as chemotherapy, radiation and surgery, the intestinal flora is massively damaged.The development and rehabilitation of the intestinal flora can be positively supported by the addition of beneficial microorganisms, such as those found in sauerkraut, vegetable juices, kefir and fermented cereals. Strengthening the immune system is the most important factor in the recovery process. Here, not only nutrition is important, but also exercise depending on age and health condition. Positive thoughts, as well as the inner conviction that one can defy the disease, determine the chances and course of healing.
