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

Last Updated: Aug 03, 2021

What is colon cancer?

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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.

Types of colon cancer

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.

What are the symptoms of colon cancer?

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

What causes colon cancer?

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

Can you survive colon cancer?

Even though it is a murderous disease, the overall survival rate in colon cancer is quite high. Depending upon the stage and affected area, the chances of survival are:

  • Stage 0 - 2: The initial stage of colon cancer shows a successful survival rate in the colon, rectum, and anus.
  • Stage 3: Chances of survival are low as compared to early stages, although with proper medication and treatment one can survive colon cancer in stage three.
  • Stage 4: This is the final stage of cancer and most of the cases failed to survive at this stage. The survival rate is quite rare and unstable.

NOTE: These statistics are merely a concentrated result based on controlled environment studies. It includes the different patients with different survival rates, so the accuracy of these statistics can be questioned.

Can you have colon cancer for years and not know it?

Yes, since cancer is a slow-growing disease usually located in the lower abdomen region. Most of the time it is hard for a patient to detect the signs at the early stages of colon cancer. Patients generally seek medical attention when the symptoms affect the personal life. At that point, most of the cases have already developed a life-threatening situation that lowers down the survival rate of an individual.

To avoid critical conditions like this, it is advisable for the general public to seek routine checkups and tests. Here is the list of test one can be suggested to keep an eye on your colon:

  • Colonoscopy
  • Stool assessment
  • Blood test

How long can you live with untreated colon cancer?

Lifeline in any cancer is dependent upon its level/stage. For instance, at the initial stages of cancer, it is hard to detect the signs. This leads to a case where it is mostly left untreated until the case becomes severe or affects individual personal life. The time span can be from six months to 10 years, depending on the individual immunity system.

On the other hand, as the stage turns into its advanced form, the patient life span tent to get shorter even after proper treatment and medication. This happens because every cancer needs early detection and treatment or the chances of survival will slide down with the delay in treatment!

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What are the risk factors of colon 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

Is dying from colon cancer painful?

Depending upon the severity of the case, colon cancer can create an end number of problems including:

  • Sharp pain in the lower abdomen region.
  • Abdomen discomfort during bowel movements.
  • Weight loss.
  • Anemia.
  • Blood in stool.
  • Passing excessive gas.

At the initial stages, the symptoms can be cured and treated with medical attention, if not the patient is provided with suitable drugs to ease out the pain. Especially when the patient's chances of survival are low.

In terms of mental health, it is always painful to know about your death. Psychiatrists and counselors always advise you to communicate and express your feelings to cope with the depression associated with the situation.

Does colon cancer make your stomach big?

Yes, one of the symptoms of advanced colon cancer is ascites. Ascites are a condition where the stomach starts swelling due to build-up fluid in the abdomen. Stomach swell during colon cancer because of these reasons:

  • Cancer cells irritate the lining of the abdomen which makes it produce extra fluids.
  • Lymph glands in the abdomen get blocked and are not able to drain boldly fluid properly.
  • Cancer cells have spread to the liver and started to pressure nearby blood vessels, which creates an imbalance in the production of fluids.
  • The liver can’t make enough blood proteins to flush out fluid, so it started to leak out of veins into the abdominal cavity.

The symptoms don’t have any self-care solution, one has to seek a medical emergency to get the fluid released from the body.

Is Colon Cancer aggressive or slow-growing?

Cancer occurs when the immune system cannot handle the abnormality of the damaged cells. The abnormal cells later started to develop into lumps and clusters called a tumor or cancer. Since cancer is hard to detect by our own immune system, the growth of cancer cells merely depends on how much it has been damaged.

In the case of colon cancer, the tissue cells contain less genetic damage, making it a slow-growing disease. It can grow so slow that in some cases it takes up to 10 years to show its initial symptoms to the patient.

How is colon cancer diagnosed?

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.

Can blood tests detect colon cancer?

Blood tests might help your doctor to identify surface symptoms, but it is not recommended to use them to detect colon cancer.

Although here is the list of test that doctors perform around the globe to detect colon cancer and its adversity:

  • Colonoscopy:

    Mostly used to check your large intestine and rectum. The process takes place with an instrument called a colonoscopy. A long and flexible tube attached with a tiny camera at the tip of the tube allows the doctor to have a clear view inside the colon.

  • Biopsy:

    In this process, the examiner will take a specimen of the colon tissues and run some tests to identify the root cause of the distress.

  • Chest X-ray, MRI (magnetic resonance imaging), CT (computed tomography), and Ultrasound
  • ( In adverse cases):

    In some cases, the patient feels the same pain and discomfort in other organs too. This happens because cancer cells travel through your bloodstream and infect other organs. To ensure successful treatment, doctor's run these tests to get a detailed analysis of the case and provide effective treatment accordingly.

What are the stages of colon cancer?

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.

How is colon cancer treated?

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.

Are there any side effects of colon cancer treatment?

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.

What are the post-treatment guidelines?

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.

How long does it take to recover?

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.

What are the complications of colon cancer?

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

What is the price of the treatment in India?

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.

What are colon cancer survival rates?

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.

How to prevent 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

What are the alternatives to the treatment?

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.

References

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Written ByDr. Jagdish Shinde MD - Radiothrapy,MBBSOncology
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