Colorectal Cancer

COLORECTAL CANCER magnified

Last Updated December 20th, 2021

Overview

Cancers can arise in practically any part of the body when cells begin to grow out of control. Cancer appearing in the terminal portions of the gastrointestinal tract is known as colorectal cancer. In other words, this is cancer of the colon or the rectum. ‘Colon’ is another name for the large intestine and its main function is to absorb water and minerals from solid wastes as they pass through it. It is a muscular tube between 5 to 6 feet long.

Anatomically it is divided into a number of sections. These sections are the caecum, ascending colon, transverse colon, descending colon and sigmoid colon. Finally, the colon is succeeded by the rectum and the anal canal. Solid waste is stored in the rectum until it can be eliminated through the anus. Colorectal cancer is one of the most common forms of cancer and it can take varied forms.

Definition

COLORECTAL CANCER locationColorectal cancer is a broad term for any cancer that originates in the large intestine or the rectum.

Depending on the specific location, the disease may be known either as colon cancer (bowel cancer) or rectal cancer.

Usually, it begins in the form of a benign growth in the inner mucosal lining of the colorectal region.

From here, it can invade the other layers and even the muscular wall of the organ.

Following this, it can extend into blood vessels or lymphatic channels. Once this takes place, it is possible for cancer to spread or metastasize to other parts of the body.

Causes

The colon and rectum are both composed of multiple layers of tissue. The innermost layer is known as the mucosa and the thin muscular component of this is known as the muscularis mucosa. Next comes a fibrous layer called the submucosa. This is surrounded by a thick layer of muscle known as the muscularis propria. Finally, the colon (but not the rectum) is sheathed by the subserosa and serosa which are composed of connective tissue.

Usually, cancer first arises in the innermost layer or the mucosa. Sometimes, pre-cancerous changes, or dysplasia, are observed in the cells of this area. This can eventually give rise to cancer. Otherwise, cancer may have its origin in a form of abnormal growth called a polyp. Polyps can be of different types and they do not all necessarily have the tendency to transform into a malignant state. Adenomatous polyps, for instance, are known to turn cancerous. However, the more common hyperplastic polyp is less likely to do so. Often, the origin of colorectal cancer can be linked to age or lifestyle factors. Genetic factors also have a role to play.

COLORECTAL CANCER magnifiedRisk factors include:

  • Being obese or overweight.
  • Being male is associated with a higher risk of developing colorectal cancer.
  • Having a family history of colorectal cancer.
  • Being older than 60 years of age is associated with a heightened risk.
  • Having had breast cancer is also linked with an increased likelihood of developing colorectal cancer.
  • Diet that is high in fat and deficient in fiber. Eating a lot of red meats or processed meats is also a risk factor.
  • Alcohol abuse.
  • Smoking.
  • Sedentary lifestyle.
  • Having inflammatory bowel diseases such as ulcerative colitis or Crohn’s disease.
  • Having hereditary diseases such as familial adenomatous polyposis.

Symptoms 

In the initial stages of the disease, the patient may not experience noticeable symptoms. Possible signs and indications include:

  • Bleeding from the rectum.
  • Blood in the stools or darkened stools.
  • Pain in the abdominal area or the rectal area.
  • Changes in normal bowel habits. The patient may have persistent diarrhea or constipation.
  • Excessive Flatulence.
  • Weight loss.
  • Fatigue.
  • Nausea and/or vomiting.

Types of Colorectal Cancer

The following are the various recognized types of colorectal cancer:

  • Adenocarcinoma: This is by far the most common type, accounting for as much as 95% of diagnosed cases. This form originates in the cells of intestinal glands.
  • Primary colorectal lymphoma: This is a rather rare type and tends to arise in the caecum. It is a form of non-Hodgkin lymphoma. In other words, it arises in the lymphatic system and affects lymphocyte cells. Men are affected twice as often as women.
  • Gastrointestinal carcinoid tumor: The neuroendocrine cells of the gastrointestinal tract regulate the secretion of digestive juices and also control the passage of food through the organs. Such cells share the features of both neurons and endocrine cells. This form of cancer affects the neuroendocrine cells of the colorectal region by causing the formation of tumors. The tumors, like the cells they have originated from, are also known to secrete hormone-like substances although this may not always be in quantities capable of causing significant symptoms. This type of cancer accounts for only about 1% of colorectal malignancies. It is a slow-growing type.
  • Gastrointestinal stromal tumor: This form of cancer originates in a certain type of cell belonging to the autonomic nervous system. These cells are responsible for providing the electrical impulses that cause the muscles of the gastrointestinal tract to contract and relax. This is a form of sarcoma or cancer that arises in the connective tissue.
  • Melanoma: This type of cancer arises in certain types of pigment-forming cells known as melanocytes. Usually, such cells are present in the skin but they are also found in other areas including the mucosal tissues of the gastrointestinal tract.
  • Leiomyosarcoma: This rare form is associated with a high likelihood of metastasis. Hence, early detection and commencement of treatment ensure a better outlook. This tends to affect the connective tissues, particularly the smooth muscles. Leiomyosarcoma only constitutes about 0.1% of colorectal cancers.
  • Squamous cell carcinoma: This form of cancer arises in the squamous cells present in the lining of the bowels. This is a highly uncommon cancer.

Cancer Grading and Stages

COLORECTAL CANCERThe severity of colorectal cancer is graded on a scale of 1 to 4 depending on the extent to which the malignant cells differ from normal tissue. G1 indicates that the cancer cells closely resemble healthy tissue. G4, at the other extreme of the scale, indicates that the cancer cells show highly abnormal features. Grades 1 and 2 are considered the lower grades while 3 and 4 are considered high grades.

Combining this information with the cancer stage helps determine treatment approaches and overall outlook. The TNM system developed by the American Joint Committee on Cancer is a scheme commonly used to determine the stage of colorectal cancer. The criteria for this include the degree of invasion of various layers of the colorectal area, whether cancer has extended locally in the area and whether it has spread to more distant parts of the body. This information is obtained by collating the results of imaging tests and biopsies as well as the findings of any surgeries that may have been conducted.

Clinical Complications

The list below outlines some complications associated with colorectal cancer:

  • The cancer can spread to distant organs and tissues within the body. This makes it especially difficult to treat and shortens life expectancy.
  • The formation of scar tissue can create obstructions in the bowels or rectum.
  • The cancer can recur even after treatment.
  • Colorectal cancer can be a terminal illness. In other words, it is capable of being fatal.

Diagnosis

Diagnosing colorectal cancer involves the following procedures:

  • Physical examination of the patient may reveal a mass in the abdominal area.
  • Complete blood count test to check for anemia.
  • Fecal occult blood test detects the presence of blood in the stools.
  • Colonoscopy or sigmoidoscopy involves the insertion of a flexible tube tipped with a camera. This is an effective test for detecting cancer in the colon or rectum.
  • Diagnostic imaging helps assess the condition of the bowels or rectum and determine the extent of spread of the cancer. This can also help reveal the extent of damage to other organs. Involvement of distant organs such as the brain may be revealed by imaging methods such as magnetic resonance imaging (MRI) and computerized tomography (CT).
  • A sample of affected tissue is examined beneath a microscope in order to determine the specific type of cancer.
  • Assessing the grade and stage of the cancer.

Treatment and Prevention

Treatment of colorectal cancer:

  • Surgery: This includes removing the cancer cells and some surrounding tissues as well. Other surgical methods include laparoscopy surgery, colostomy if cancer has spread to the rectum, and radiofrequency ablation (Cryoablation).
  • Radiation Therapy: This includes the use of high energy gamma rays pinpointed at the cancer cells to destroy them.
  • Chemotherapy: Chemotherapy drugs such as Fluorouracil or Capecitabine is directly supplied into the bloodstream which travels to the site of cancer cells and destroys them.

Low FODMAP diet for colon cancer

FODMAPs are a group of fermentable carbohydrates. They are known to cause many problems such as gas, bloating, constipation, diarrhea, and stomach pain. Studies show that restricted low consumption of FODMAPs drastically reduces the symptoms mentioned above.

FODMAP stands for

  • F – Fermentable.
  • O – Oligosaccharides. Dietary sources of oligosaccharide are wheat, rye, legumes, pulses, and various sources of fruits and vegetables.
  • D – Disaccharides. Dietary source of disaccharides is milk, yyogurt and soft cheese.
  • M – Monosaccharides. Dietary sources of monosaccharide are honey, agave nectar, and various sources of fruits and vegetables.
  • A – and
  • P – Polysaccharides. Dietary sources of polysaccharides are various sources of fruits and vegetables, and certain sweeteners such as sugar-free gum.

A typical Western diet is rich in red meat such as chorizo, dairy products such as buttermilk, custard, gelato, kefir etc. It also includes processed and artificially sweetened foods such as sausages, pasta, pastries, muffins, cakes etc. These foods come under the category of a high FODMAP diet and may increase the chances of developing colon cancer. A low FODMAP diet can be prescribed to reduce the symptoms of colon cancer. A low FODMAP diet consists of an increased intake of whole grains such as buckwheat, corn, millets etc. Dairy products such as butter, margarine, sorbet etc and meat such as beef, lamb, chicken etc. may increase the risk of colon cancer.

Following a low FODMAP diet consisting of whole grains and dietary fibers makes the gut healthier. Consuming dairy products up to 400g per day reduces the chances of developing colon cancer. Limiting red meat consumption to 500g per week can reduce the chances of developing colon cancer.

Prevention of colorectal cancer:

  • Consume a low-fat, high-fiber diet that includes at least 5 servings of fruits and vegetables per day.
  • Avoid red meat, processed meats, and cured meats.
  • If you are above 40, it is advised to go for full body check-ups and get regularly screened for colorectal cancer (especially if you have a family history or other risk- factors).
  • Refrain from unhealthy habits such as smoking and drinking alcohol.
  • Add calcium, vitamin D, and folate supplements.
  • Exercise often and make sure that you have a healthy BMI.

TL;DR?

Facts

  • Colorectal cancer is one of the most widespread cancers in the USA, with as many as 135,430 cases diagnosed in the year 2017 alone.
  • One out of every 22 men will be detected with colorectal cancer. In women, this ratio is 1 in 24.

Facts

  • Regular screening can help in preventing 33% of deaths due to colorectal cancer in the USA. Experts believe that the 5 year survival rate can be made 90% with early detection.
  • Obesity increases the likelihood of developing colorectal cancer by 30%. It also diminishes the chances of a swift and healthy recovery.

Facts

  • If you suffer from any one of these conditions – Diabetes, Crohn’s Disease, IBD, or Lynch Syndrome, you are more likely to suffer from colorectal cancer.

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Dos and Don'ts

Dos
  • If you have been diagnosed with colorectal cancer, it is advisable that you maintain a detailed record of your health. This includes medications and the onset of symptoms.
  • Choose low-fat foods and also limit your carbohydrate intake.
  • Wear adult diapers, pads, or panty liners if you are experiencing frequent diarrhea post chemo sessions.
Don'ts
  • Consume meats. Especially, one must refrain from eating cured and processed meats.
  • Lead a sedentary life. Go for walks as it will build up your immunity and prevent cancer from coming back.
  • Add stress or anxiety in your life. Practice meditation, join a support group and indulge in your favorite hobbies that will help you relax.

 

 

 

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Coconut sugar: What is it and is it healthier than table sugar? In the long list of things that the wonderful coconut gives us, coconut sugar is another remarkable addition.…
Barium-enema
Barium Enema Barium enema is also known as colon x-ray. Here, the patient is asked to consume small amount of…
PROGESTERONE_test
Progesterone test The progesterone test is a blood test used to determine the level of hormone progesterone in the blood…
Rubella IgM test
Rubella IgM Test The Rubella IgM test is a blood test that is performed to diagnose the presence of the rubella…
blood ketone test
Blood Ketone (D3HB) Test The Blood Ketone Test measures and monitors the levels of ketone in the blood which is usually performed…
alcohol toxic
7 startling facts that will make you quit alcohol today Does drinking really make you friendly and happy? How many calories does a can of cold beer add…
dance health benefits
5 unbelievable effects of dance on your overall health! You enjoy dancing, but did you know what else it does to your body? Dancing is not only…
Jack in the box fast food
Jack In the Box : The perils of surging fast food culture in the USA Jack in the Box - How a culture of fast-food can clog your arteries, weaken your heart, fatten…
Oil of Oregano: The one-stop essential oil you’ve been looking for Are you plagued by a weak immune system? High body inflammation accompanied by pain and infections? Why not…
Psyllium Husk: More than just an effective natural laxative Psyllium husk, or isabgol, is a popular natural laxative . But did you in addition to regulating bowels,…
Tart Cherry: The healthiest excuse for taking that second serving of pie Tart cherry has been traditionally used in delectable desserts such as pies. Recent studies have revealed that its…
Hydroquinone: Is it the best topical treatment for hyperpigmentation? Darkening of the skin due to high melanin levels is called hyperpigmentation.  Hydroquinone interferes with melanin production thus treating…
Inhale oxygen, exhale worries: The top breathing exercises and how to perform them Performing the breathing exercise is like becoming mindful of how you breathe.  Here is a list of breathing…
Atkins diet weight loss
Atkins Diet: The right steps to carb control that can help you lose those pounds fast The Atkins diet is a high fat, low-carb diet with proven weight loss benefits that is flexible enough…
LFT-test
Liver Function Test – LFT LFT or Liver Function Test is a blood test used to determine the levels of hepatic enzymes which…
Hysteroscopy_procedure
Hysteroscopy Hysteroscopy is a minimally invasive tool to help specialists view the uterus to diagnose and even treat several…
Strep throat pain
Anti-Streptolysin-O Test The ASO or Anti-Streptolysin-O is a blood test designed to check for the presence of streptococcus bacterial infection…
vdrl test syphilis
VDRL Test The VDRL test is a blood test that is used to diagnose sexually transmitted or venereal diseases, primarily…
HSV-1_IGG
Herpes Simplex Virus I (HSV)-IgG Test Herpes simplex virus I(HSV)-IgG is an Immunoglobulin protein that acts as an antibody & stays in the blood…
woman with abdominal pain holding ovulation calendar
Ovulation – facts to know about ovulation Learn how and when ovulation occurs, demystify common misconceptions, identify symptoms, methods of detection and right period for…
Optavia diet
The features of an Optavia diet The Optavia diet endorses pre-packaged meals and snacks called "fuelings" that are tasty, low in calorie, and incorporates…
GM Diet: The fastest way to lose weight or yet another hoax diet? General Motors started this trend of extreme dieting for 7 straight days to ensure its employees were able…
Kava: Is it the healthy substitute for alcohol you have been waiting for? Native to the beautiful South Pacific islands, Kava is a famous beverage rooted in the local culture. It…
Love tea, hate tannins? Rooibos tea is just what you need The market is brimming with a multitude of herbal teas. But what makes rooibos tea (or red bush)…
How seitan proved to be a blessing in disguise for vegans worldwide Can only meat-eaters enjoy delicious juicy steaks and burgers? With seitan, the best meat substitute available today,even vegans…
How can berberine supplements help you live longer and healthier? Berberine is a turmeric look-alike herbal extract that is credited with numerous health benefits ranging from diabetes cure…
How accurate is the hair follicle drug test? Hair follicle drug test is one of the best ways to identify drug use in professional circles. But…
Bubble Tea: Bubbling with nutrition or a hidden sugar mine? The tapioca pearls present in the tea looks like bubbles and hence the name bubble tea became popular.…
Balneotherapy jacuzzi
5 things you didn’t know about balneotherapy and how you can do it at home Sauna baths have been popular since a long time. But how much more beneficial can balneotherapy be as…
GGt test
GGT – Gamma-Glutamyl Transferase Test GGT or gammaglutamyl transferase test is a liver function test that is used to detect the extent of…
CT-scan-machine
CT – Computed Tomography Scan CT scan or computed tomography scan is an diagnostic imaging technique where cross-sectional images of body are obtained…
blood elements analysis
Blood Element Analysis Test A blood element analysis is a blood test performed to measure the level of toxic elements such as…
antihepatitis core antigent
Anti-Hepatitis B Core Antigen (AHBc) Total Anti-hepatitis B core antigen (AHBC ) is a blood examination and the only serological marker of infectious blood…
antiHEV IgM test
Anti hepatitis E virus (Anti HEV) IgM Test Anti HEV IgM test determines the level of the IgM antibodies in the blood, The disease is often…
complement c4 test
Anemia Profile Anemia Profile test (Basic) is a blood screening test that measures the levels of important components of the…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
acne removal tips
Anatomy of acne: 7 instant steps to kiss those zits goodbye Blackheads, whiteheads, or pimples-call them what you may. Acne is never good news.Did you know some of the…
improve digestion weight loss
Power up your gut: 8 proven steps on how to improve your digestion Did you know you have a colony of bacteria in your gut that help you in digesting food?…
Horny Goat Weed: Can it improve libido in human beings too? This plant got its name as Horny Goat Weed when one of the goats feeding on the plant…
Rick Simpson’s Oil: The truths and controversies of this cannabis product Rick Simpson's Oil is an extract from the much-controversial plant, Cannabis. What is the actual truth behind the…
Erythritol: A healthy sugar substitute or yet another marketing ploy? Erythritol is a popular choice of a healthy alternative sweetening agent in foods. But how healthy can a…
Oxalates: How healthy greens can sometimes be bad news for your kidneys Oxalates are compounds present in a majority of healthy foods. However, at times an overconsumption of these could…
fructosamine test
Fructosamine Test A fructosamine test measures blood sugar glucose content. Fructosamine level can indicate blood sugar level in past 2-3…
sodium blood test
Blood Sodium Test A blood sodium test measures the amount of sodium (an important electrolyte) in your body. It is also…
pilonidal sinus
Pilonidal sinus Pilonidal sinus is more common in young men than women. Learn about treatment options, surgical management, risks, and…
hidden benefits walking
9 benefits of walking we bet you didn’t know! Did you know walking can be the miracle pill for eternal youth? Everyone knows walking is good for…
aspartame or sugar
Aspartame – Hidden truths about this storm in a teacup Aspartame, the artificial sweetener, has gone under the scanner on several occasions for allegedly doing more harm than…
gallbladder diet tomato
Gallbladder surgery :Tips on post-operative care and diet What to eat post a gallbladder surgery? What are the key things to avoid if you had a…