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Showing posts with label rectum. Show all posts
Showing posts with label rectum. Show all posts

Sunday, September 2, 2007

A Simple Guide to Colorectal Cancer


A Simple Guide to Colorectal Cancer
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What is Colorectal Cancer?
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is one of the commonest cancer among males and females in the world. Colorectal cancer is cancer that starts in the large intestine (colon) or the rectum (end of the colon). Colorectal cancer can be effectively treated if detected early.

What is the cause of Colorectal Cancer?
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Colorectal cancer occurs when cells from the intestinal wall grow and spread uncontrollably.
It may begin as polyps (growths) in the large intestine and rectum. Polyps should be monitored regularly and removed upon detection to prevent them from developing into cancer.

Who are at risk of Colorectal Cancer?
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As with most cancers, the risk of developing colorectal cancer increases with age.
People at high risk include those with:
1. family history of personal history of endometrial, ovarian or breast cancer
3. personal history or family history of gastrointestinal polyps
4. history of inflammatory bowel disease such as chronic ulcerative colitis or Crohn's disease.
5. Cancer elsewhere in the body
6. Certain genetic syndromes also increase the risk of developing colon cancer.

What you eat may play a role in your risk of colon cancer.
Colon cancer may be associated with a high-fat, low-fiber diet and red meat.
However, some studies found that the risk does not drop if you switch to a high-fiber diet, so the cause of the link is not yet clear.

What are the Symptoms of Colorectal Cancer?
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In its early stages, the cancer usually has no symptoms, which is why regular screening is important to see if it could be present.
The most common symptom of colorectal cancer, especially if it is located in the lower part of the large intestine, is changes in bowel habits. For some, it may be an increase in the number of bowel visits to the toilet, and for others, it may be constipation. Still others may complain of constipation with overflow diarrhoea, i.e., difficulty in passing motion but stools flow out without any control.
Other symptoms include
bloody or black stools from bleeding of the tumour (blood appears black on digestion in the intestines),
fatigue, appetite and weight loss of unknown cause,
Unexplained anemia
abdominal pains, cramps or bloating in the lower abdomen
Intestinal obstruction
Narrow stools
With proper screening, colon cancer can be detected BEFORE the development of symptoms, when it is most curable.

What are the signs of Colorectal Cancer?
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The physical exam rarely shows any problems, although an abdominal mass may be felt in late cases.
A rectal exam may reveal a mass in patients with rectal cancer, but not colon cancer.

How do you Screen for Colorectal Cancer?
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People over the age of 50 years are advised to screen for colorectal cancer, even if they have no symptoms.
A Faecal Occult Blood Test (FOBT>) is recommended once every year.
If the results are positive, other tests like a sigmoidoscopy, barium enema and colonoscopy may be required.
A complete blood count may reveal show signs of anemia with low iron levels.

What is the treatment of Colorectal Cancer?
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Surgery:
is the main treatment.
In surgery, the part of the large intestine containing the cancer is removed.
In some cases, the two ends of the colon can be rejoined.
Sometimes an opening called a stoma has to be left in the abdominal for the removal of waste. This opening may be temporary or permanent.
Radiation Therapy:
destroy the cancer cells with minimal damage to surrounding tissue. It is used to prevent recurrence of the cancer and for pain relief. Side effects include skin irritation,nausea,vomiting and lethargy.
Chemotherapy:
is used to kill the cancer cells in the colon and rectum as well as to prevent a recurrence.
Side effects may be quite severe with loss of hair, weight, appetite, nausea, vomiting, rashes.

Which treatment is used depends on the staging of the cancer using additional tests.
Staging of the Cancer:
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Stage 0: Very early cancer on the innermost layer of the intestine
Stage I: Cancer is in the inner layers of the colon
Stage II: Cancer has spread through the muscle wall of the colon
Stage III: Cancer has spread to the lymph nodes
Stage IV: Cancer that has spread to other organs

Stage 0 colon cancer may be treated by removing the cancer cells, often during a colonoscopy.
For stages I, II, and III cancer, more extensive surgery is needed to remove the part of the colon that is cancerous.
There is some debate as to whether patients with stage II colorectal cancer should receive chemotherapy after surgery. You should discuss this with your oncologist.
Almost all patients with stage III colorectal cancer should receive chemotherapy after surgery for approximately 6 - 8 months. The chemotherapy drug 5-fluorouracil given has been shown to increase the chance of a cure in certain patients.
Chemotherapy is also used to treat patients with stage IV colon cancer.

Irinotecan, oxaliplatin, and 5-fluorouracil are commonly used drugs. You may receive just one type, or a combination of the drugs. Capecitabine is a chemotherapy drug taken by mouth, and is similar to 5-fluroruracil.

For patients with stage IV disease that has spread to the liver, various treatments directed specifically at the liver can be used. This may include cutting out the cancer, burning it (ablation), or freezing it (cryotherapy). Chemotherapy or radiation can sometimes be delivered directly into the liver.
While radiation therapy is occasionally used in patients with colon cancer, it is usually used in combination with chemotherapy for patients with stage III rectal cancer.

What is the Prognosis(outcome) of Colorectal Cancer?
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How well a patient does depends on many things, including the stage of the cancer.
In general, when treated at an early stage, more than 90% of patients survive at least 5 years after their diagnosis.
However, only about 40% of colorectal cancer
is found at an early stage.
The 5-year survival rate drops
considerably once the cancer has spread.
If the patient's colon cancer does not come back (recur) within 5 years, it is considered as cured.
Stage I, II, and III
cancers are considered potentially curable.
Stage IV cancer is not curable
in most cases.

How to prevent Colorectal Cancer?
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Prevention of Colorectal Cancer involve:
1. early and regular screening,
2. lifestyle changes:
Maintain a balanced diet low in animal or saturated fat
such as butter, coconut oil, ghee and lard.
Diets high in total fat, protein, calories and meat, and low in calcium are associated with an increased incidence of colorectal cancer.
Increase your intake to at least 2 servings of fruits and vegetables each day. Studies have shown that very low intake of fruits and vegetables is associated with an increased risk of colorectal cancer.
Quit smoking. Cigarette smoke contains many chemicals that promote the development of many types of cancers.
Increase physical activity.
Physical activity promotes general health and reduces your risk of colorectal cancer.
Maintain your BMI within the healthy range of 18.5 to 22.9 (kg/m2).

The death rate for colorectal cancer has dropped in the last 15 years.
This may be due to increased awareness and screening by colonoscopy.
Colorectal cancer can almost always be caught in its earliest and most curable stages by colonoscopy.
Almost all men and women age 50
and older should have a colonoscopy.

Other types of colorectal cancer such as lymphoma, carcinoid tumors, melanoma, and sarcomas are rare. The colorectal cancer referred to in this article refers to Colorectal carcinoma.

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