Diagnosis | Colon Cancer

Diagnosis

Basically, the basis of any clinical diagnosis is the conversation with the patient (anamnesis), in which numerous things are learned. The questions vary depending on the symptoms present. For example, if there is a suspicion of intestinal cancer, the doctor might ask the following: In addition, a blood sample would be taken to check the laboratory values.

Colorectal cancer does not show any specific changes in the usual laboratory parameters, but it can, for example, lead to anaemia in the context of the disease. The next step is the essential digital-rectal examination, i.e. the physician inserts his finger into the anal canal in order to palpate possible abnormalities. About 10% of all carcinomas of the intestine and rectum are palpable in this way, so this examination is essential even if it is usually not entirely comfortable for the patient.

The next examination step is usually a colonoscopy, in which the entire colon is observed by means of a rectally inserted tube with a camera and can be examined for tumorous changes. The examination usually takes place under short anaesthesia. As intestinal cancer almost always develops from so-called adenomas (tumours of the mucous membrane) and the risk of adenoma development increases significantly, especially from the age of 50, the health insurance company will cover the costs of two control colonoscopies at intervals of 10 years from the age of 55 onwards, during which such adenomas are searched for.

If an adenoma is found, it is removed during colonoscopy using a small loop and then histologically examined to determine whether it is already in the preliminary stage or even a manifest form of colon cancer and, if so, whether all suspicious parts could be removed during the removal. If the colonoscopy reveals the presence of a carcinoma (most common form of intestinal cancer), further examinations follow. These include ultrasound (sonography) and computed tomography (CT) of the upper abdomen and an X-ray of the chest (thorax) in order to detect or exclude metastases.

Furthermore, so-called tumour markers in the blood are determined. They are used in particular to assess the course of treatment after a therapy. – Stool changes

  • Blood admixtures to the stool
  • Pain
  • Reduced performance and fatigue
  • Unwanted weight loss
  • Colorectal cancer relatives
  • The presence of risk factors such as smoking and unbalanced diet and previous illnesses

Several methods can be used to test for the presence of colorectal cancer relatively quickly.

First and foremost, the digital-rectal examination, with which about 15% of the tumours can already be palpated (for this purpose, the examiner inserts a lubricating gel-coated pointer finder into the patient’s anus). There are two chemical tests to detect blood in the stool. However, they cannot determine whether this comes from a tumour or another source of bleeding.

At best, therefore, they give an indication of the need for further examination. These two tests are called iFOBT and guaiac test (also known as Haemoccult). The iFOBT has now proven to be the more accurate and clearer one.

Tumor markers are certain proteins in the blood that are generally present in everyone, but are significantly elevated in certain cancers. They are never used for absolute certainty of diagnosis when cancer is suspected, but are only useful for monitoring the progress of the disease. They can indicate a recurrence (a recurrence of cancer) after the first case of cancer by regular check-ups. The so-called CEA (carcinoembryonic antigen), secondarily also the CA 19-9 and CA 50, is particularly groundbreaking for intestinal cancer. The better known enzyme value of LDH (lactate dehydrogenase) can be increased in fast growing tumours, as it stands for cell decay.