Colon Cancer: Stages, Treatment, Symptoms, Prevention and Survival Rate

Colon cancer better known in the name of colorectal or bowel cancer that signifies the growth of cancer cells in parts like colon, rectum or appendix. This cancer is widely common in both male and female resulting in more about 655,000 death in a year.

Generally, people above 40 are vulnerable to colon cancer. Strangely, around 70 to 80 per cent of the colon cancer has its growth without involving any major risk factor. The disease is indeed dreadful and murderous with least chances of survival if diagnosed at the last stage.

Colon cancer can be divided into various types. The most common variation of colon cancer that originates from the glands is Adenocarcinomas that results in 90 to 95 percent of the total colon cancer patients over the world.

• Leiomyosarcomas: It is a type of colon cancer that initiates in the muscles of the colon. This is rare and comprises of 2or 3 percent of the total colon cancer.
• Lymphomas: These are sort of colon cancer that is diagnosed to initiate in the rectum and not in the colon. This is said to have evolved in a different part of the body and got spread to the colon.
• Melanomas: These are nearly similar to Lymphomas as it occupies the same characteristics of getting started at a different area or organ in the body and end up spreading to the colon.
• Neuroendocrine tumours: These are colon cancers that include two different types namely aggressive and indolent.

A lot of people who develop colon cancer do not experience any major symptom in the initial stages of the condition. Moreover, even when the symptoms become noticeable, they usually vary depending on the size and location of cancer in the intestine. However, there are certain signs and symptoms that are associated with colon cancer. Those are:

• Diarrhoea
• Constipation
• Weakness and Fatigue
• Pain in abdomen, cramps, gas and/or bloating
• Changes in the consistency of stools
• Persistent urge to pass stool even after emptying the bowel
• Presence of blood in stools
• Weight loss
• Anaemia
• Irritable bowel syndrome

Some of the symptoms that become noticeable in Stage 3 or 4 of colon cancer are:

• Difficulty in breathing
• Blurry vision
• Vomiting
• Jaundice
• Swelling in hands or feet
• Chronic headaches
• Bone fractures

Medical researchers are not sure about what contributes to colon cancer. They are still studying the factors that lead to this condition. It is believed that a number of risk factors act alone or in synergy to increase an individual's risk of colon cancer. Some of the causes that may lead to colon cancer are:

• Polyps:

  Colon cancer usually originates from precancerous polyps, a type of abnormal tissue growth, that develops in the large intestine.

  Polyps are of two types:

  • Adenomas: These polyps look very similar to the inner lining of the large intestine. However, these appear differently under a microscope. These polyps can become cancerous.
  • Hyperplastic polyps: These polyps are usually benign and rarely progress into colon cancer.

  Some of these polyps may grow into malignant colon cancer if a surgeon does not remove them during the initial phases of treatment.

  It is recommended that these polyps should be removed by a surgeon during the initial phase of treatment. If left untreated, these polyps may grow further into malignant colon cancer. In worse cases, the cancerous cells invade healthy cells throughout the body (metastasis).

• Genetic mutation:

  Genetic mutation is believed to be one of the causes of colon cancer. The predisposition to cancer is greater in individuals who have a family member or close relative diagnosed with colon cancer before 60 years of age.

  The risk increases if more than one relative or family member develops this cancer. Although the occurrence of genetic mutation doesn't necessarily mean a person will develop colon cancer, it certainly raises the risk of this condition.

  Some of the other inherited conditions that may possibly raise the risk of colon cancer include:

  • Juvenile polyposis syndrome
  • Attenuated familial adenomatous polyposis
  • Peutz–Jeghers syndrome
  • Familial adenomatous polyposis (FAP)
  • Turcot syndrome, which is another variant of FAP
  • Gardner syndrome, which is a different type of FAP
  • MYH associated polyposis
  • Lynch syndrome, or hereditary nonpolyposis colorectal cancer
  • Muir–Torre syndrome, which is a variant of Lynch syndrome
• Medical conditions:

  A number of medical conditions and treatments are associated with an increased risk of colon cancer. These include:

  • Ulcerative colitis
  • Crohn's disease
  • Diabetes
  • Acromegaly
  • Radiation therapy for other cancer

The following factors are associated with an increased risk of colon or colorectal cancer:

• Older age
• Alcohol abuse
• Smoking
• Sedentary lifestyle
• Low intake of fibre
• High intake of processed foods or red meats
• Obesity or excess body weight
• Type 2 diabetes
• Family history of colon cancer
• Inflammatory conditions such as ulcerative colitis, Crohn's disease etc
• History of radiation therapy

A physician will begin by asking questions related to the symptoms. He may ask you to share your and your family's medical history. He may perform a physical test to look for lumps or polyps.

A physician may also ask you to undergo the following procedures/tests:

• Colonoscopy: The procedure involves inserting a long tube with a small, attached camera inside your colon and rectum. The physician may take a sample of tissue which will be used for detailed lab analysis.
• X-ray: The X-ray test uses a radioactive contrast solution that contains the metallic element barium. The solution will be inserted in the bowels through the use of an enema. The solution is used to coat the lining of the colon to help improve the quality of images.
• CT scan: This technique, also known as virtual colonoscopy, allows the physician to get a detailed view of your colon.

Following diagnosis, the physician will ascertain the stage of the colon cancer according to the size and spread of the tumour and cancer cells.

When the doctor is sure that the patient has cancerous growth, the next step is to evaluate the stage of colon cancer on of the patient. There are four stages of colon cancer.

• Stage I: The 1st stage indicates the growth of cancer in the superficial lining of the colon but has not crossed the colon or the rectum walls.
• Stage II: Stage II signifies that cancer has been successful in passing through the colon walls but did not spread to the lymph nodes situated nearby.
• Stage III: Stage III situation is when cancer has emerged through the lymph nodes and is quickly spreading throughout the body.
• Stage IV: Stage IV or the last stage of colon cancer is when cancer has spread and affected other organs like lungs and the liver.

Some of the treatment options for colon cancer are:

• Surgery :

  During the initial stages of colon cancer, surgery may be performed to remove the cancerous polyps. If cancer has spread into the walls of the bowel, the surgeon may perform colectomy. It is a procedure that involves the removal of the part of the colon affected by cancer.

  Depending on how much of colon is removed during colectomy, the surgeon will determine if it is possible to reattach the remaining portion of the large intestine to the rectum. In case that is not possible, then the surgeon will perform a colostomy. This is a procedure that involves creating a stoma (an opening in the wall of the abdomen) to facilitate the removal of waste.

  Some of the other surgical procedures for colon cancer include:

  • Endoscopy: The procedure is performed to remove some small and localized cancers.
  • Laparoscopic surgery: In this surgery, several small incisions are made in the abdomen to take out large polyps.
  • Palliative surgery: The surgery is mainly performed to provide relief from the symptoms of end-stage or advanced cancers.
• Chemotherapy:

  Chemotherapy is a common treatment for different types of cancer. The treatment involves the administration of drugs to kill cancer cells by disrupting their cell division process. In colon cancer, chemotherapy is usually performed after surgery to eliminate remaining cancer cells. The procedure is associated with certain side effects such as fatigue, nausea, vomiting and hair loss.

• Radiation Therapy:

  The treatment uses a powerful beam of high energy gamma rays to target and kills cancer cells. The therapy is performed alongside chemotherapy before and after surgery. For colon cancer, doctors usually do not administer radiation therapy until the later stages.

On being diagnosed at the primary stage, colon cancer is treated with minimal surgery. In such cases, side effects are limited to drug related effects post the surgery.

However, in case of patients who undergo chemotherapy or radiation therapy, side effects are huge. Side effects of chemotherapy include severe mouth sores, sudden hair loss, drastic fall of appetite, diarrhoea, fatigue and increase in vulnerability to infection and experiencing easy bleeding and bruising.

Treatment for the different stage of colon cancer varies in accordance with the severity of the condition. But some of the factors remain indifferent for patients on completion of their treatment procedure. A low diet is to be maintained for at least 6 weeks post the treatment.

You should take small meals many times a day rather than having 3 major meals. Fluid intake should be more, have 3 to 4 litres of water in a day. Strictly avoid caffeine. A routine diet and disciplined life habits should be a mandatory factor to look after.

Recovery is entirely dependent on the stage of colon cancer a person is suffering from. For patients with a small touch of cancer, it gets cured with the execution of a minimal surgery. However, on the other hand, the last stage of colon cancer demands chemotherapy or radiation therapy and thus takes a huge amount of time to recover.

Research speaks around 50% of the patient experiencing the last stage of colon cancer gets cured. Previously, people would survive for around 8 to 10 weeks while now advanced medical research and innovation enables a person to live up to 30 weeks and about 10% of the total patient at last stage have chances for complete recovery.

Some of the possible complications of colon cancer include:

• Blockage of the large intestine resulting in bowel obstruction
• Recurrence of cancer in the colon
• Metastasis (uncontrolled spread of cancer in the body)
• Second primary colon cancer

The cost of the treatment of colon cancer varies according to the patient’s condition and the stage of cancer they are experiencing. For surgery in case of patients with stage I colon cancer, cost of treatment is hugely less than patients at the last stage of colon cancer. Thus the range starts from 2.5 lakhs to 20 lakhs that includes several sessions of chemotherapies and radiation therapies.

For patients diagnosed with the first stage of colon cancer, complete recovery can be achieved. The constant growth in medical science has undoubtedly enhanced the survival rate of people with colon cancer.

Previously, a person at the last stage of colon cancer could survive up to 7 to 8 weeks whereas, nowadays a person can live up to 30 weeks with treatment. On the other hand, proper medical treatment results in survival rates up to 50% for patients with colon cancer.

There is no silver bullet to prevent colon cancer. However, there are certain measures that an individual can take to reduce the likelihood of colon cancer. Those measures are:

• Maintain a healthy weight
• Engage in physical activity and exercise daily
• Quit smoking
• Limit stress
• Manage blood glucose levels
• Limit intake of alcohol or quit consumption if possible
• Consume a balanced diet that includes vegetables, fruits, nuts, seeds and whole grains
• Eat more fibre rich foods
• Reduce the intake of fats, red meat, and processed foods

An effective preventive strategy for people above 50 years is to get the following tests done:

• Faecal testing at least once in 2 years
• Colonoscopy or sigmoidoscopy every 10 years

Besides medical treatment for colon cancer, natural products even result in producing amazing treatment fighting against the growth of colon cancer. National Cancer Institute releases a Factsheet on the utility of garlic in preventing colon cancer.

Thus, more consumption of garlic acts as an antidote to colon cancer. Intake of red meat should be avoided. Use of olive oil and foods rich in selenium are more preferable during this time. Last but not the least, plenty of antioxidant in green vegetables, fruits, herbs and diet are of huge help.