Colorectal Cancer (Colon Carcinoma): Symptoms, Complaints, Signs

The following symptoms and complaints may indicate colon cancer (colorectal cancer):

  • Rectal bleeding or blood/mucus in the stool – visible or occult (hidden).
  • Weight loss* (weight loss)
  • Fatigue* (chronic fatigue)
  • Unclear abdominal pain* (abdominal pain) – abdominal pain.
  • Meteorism (intestinal cramps)
  • Stool irregularities* / change in stool consistency – alternation of constipation (constipation) and diarrhea (diarrhea; here due tobacterial decomposition) = paradoxical diarrhea.
  • Increasing lumen narrowing (constriction) of the intestine to complete obstruction (→ possibly pencil stool in rectal cancer / rectal cancer).
  • Iron deficiency anemia* (anemia).

* Note: Approximately 50% of all patients with colon cancer report the above symptoms at baseline without rectal bleeding. Further notes

  • Tumors in the left colon (large intestine), particularly in the rectosigmoid (portion of the colon between the rectum (rectum) and the sigmoid/S colon), more rapidly produce symptoms such as fecal retention, meteorism, and paradoxical diarrhea because large amounts of water and electrolytes are reabsorbed in this segment of the intestine. In timely colon sections, on the other hand, the stool is still relatively thin and can thus pass intestinal stenosis (intestinal narrowing) well.
  • The above symptoms and complaints usually occur only when the tumor is already advanced. Accordingly, early detection of colorectal cancer is of particular importance.

Tumor localization

  • Approximately 70% of colorectal carcinomas are located in the rectum (rectal cancer; rectal carcinoma) and sigmoid colon (sigmoid carcinoma; synonyms: called sigmoid loop, sigmoid colon, or sigmoid; fourth and final part of the human colon).
  • Approximately 30% of colorectal carcinomas are located in descending frequency in the ascending colon (part of the colon located between the caecum/blind intestine and the right colonic flexure (flexura coli dextra; bend at the colon)) and the remaining intestinal segments.

Risk assessment for inflammatory bowel disease (IBD) or colorectal cancer (CRC) (in patients <50 years of age) [2}

Common features of CED and CRC) are rectal bleeding, abdominal pain (abdominal pain; abdominal pain), diarrhea (diarrhea), weight loss, and iron deficiency anemia. According to one study, 10 parameters are considered significantly associated with CED or CRC:

  • Rectal bleeding (positive predictive value (PPV): 1%).
  • Altered bowel habits (PPV: 1%).
  • Diarrhea (diarrhea)
  • Increased inflammatory markers
  • Thrombocytosis (abnormal increase in platelets (thrombocytes)).
  • Abdominal pain
  • Low mean cell volume (MCV)
  • Low hemoglobin
  • Increased leukocyte count (white blood cells)
  • Increased liver enzymes

Constellations

  • Altered bowel habits + low hemoglobin (PPV: 9.6%).
  • Diarrhea + thrombocytosis (PPV: 6.9%).
  • Rectal bleeding + thrombocytosis (PPV: 5.3%).
  • Rectal bleeding + increased inflammatory parameters (PPV: 5.2%).

Authors recommend:

Detection of recurrence (recurrence of disease) – recurrence symptoms

During the regular follow-up examination within the follow-up period of maximum five years, recurrences were detected (discovered/uncovered) as follows:

Almost all of the recurrent patients detected during follow-up (95%) had no symptoms! The following symptoms and complaints were reported by the recurrence patients:

  • Abdominal pain (abdominal pain) (57.7%).
  • Changes in defecation (42.3%).
  • Weight loss (23.1%)