Colorectal Cancer
Colorectal Cancer

What is colorectal cancer?

Colorectal cancer is a cancer that starts in the colon or the rectum. These cancers can also be named colon cancer or rectal cancer, depending on where they start. Colon cancer and rectal cancer are often grouped together because they have many features in common.

It is a multifactorial disease process, with etiology encompassing genetic factors, environmental exposures (including diet), and inflammatory conditions of the digestive tract.

Types of cancer in the colon and rectum

  • Adenocarcinomas: is the most common colorectal cancer 95%. These cancers start in cells that form glands that make mucus to lubricate the inside of the colon and rectum. When doctors talk about colorectal cancer, they are almost always talking about this type.

Other, less common types of tumors can also start in the colon and rectum. These include:

  • Carcinoid tumors start from specialized hormone-making cells in the intestine. They are discussed inGastrointestinal Carcinoid Tumors.
  • Gastrointestinal stromal tumors (GISTs) start from specialized cells in the wall of the colon called the interstitial cells of Cajal. Some are non-cancerous (benign). These tumors can be found anywhere in the digestive tract, but it is unusual to find them in the colon. They are discussed in Gastrointestinal Stromal Tumor (GIST).
  • Lymphomas are cancers of immune system cells that typically start in lymph nodes, but they can also start in the colon, rectum, or other organs. Information on lymphomas of the digestive system is included in Non-Hodgkin Lymphoma.
  • Sarcomas can start in blood vessels, muscle layers, or other connective tissues in the wall of the colon and rectum. Sarcomas of the colon or rectum are rare. They are discussed in Sarcoma - Adult Soft Tissue Cancer.

What are the signs and symptoms of colorectal cancer?

Colon cancer is now often detected during screening procedures. Other common clinical presentations include the following:

  • Iron-deficiency anemia.
  • Rectal bleeding or blood in stool.
  • Abdominal discomfort, such as cramps, gas or pain.
  • Change in bowel habits, including diarrhea or constipation or a change in the consistency of your stool that lasts longer than four weeks.
  • Intestinal obstruction or perforation.
  • Feeling that your bowel doesn’t empty completely.

Physical findings may include the following:

  • Early disease: Nonspecific findings (fatigue or weakness, weight loss) or none at all.
  • More advanced disease: Abdominal tenderness, macroscopic rectal bleeding, palpable abdominal mass, hepatomegaly, and ascites.

What are the causes of colorectal cancer?

It's not known exactly what causes bowel cancer, but there are a number of things that can increase your risk. These include:

  • Age: almost 9 in 10 cases of bowel cancer occur in people aged 60 or over.
  • Diet: a diet high in red or processed meats and low in fiber can increase your risk.
  • Weight: colorectal cancer is more common in people who are overweight or obese.
  • Exercise: being inactive increases your risk of getting bowel cancer.
  • Smoking: a high smoking intake may increase your chances of getting bowel cancer.
  • Family history: having a close relative (mother or father, brother or sister) who developed colorectal cancer under the age of 50 puts you at risk.
  • People with crohn’s disease or ulcerative colitis: more than 10 years have an increased risk of colorectal cancer.

When to see a doctor?

If you notice any symptoms of colon cancer, such as blood in your stool or a persistent change in bowel habits, make an appointment with your doctor.

Talk to your doctor about when you should begin screening for colon cancer, usually they start at 50. Your doctor may recommend more frequent or earlier screening if you have other risk factors, such as a family history of the disease.

How colorectal cancer are diagnosed?

A.    Laboratory studies cannot tell you if you have colon cancer. But your doctor may test your blood for clues about your overall health:

  • Complete blood count.
  • Chemistries and liver functions tests.
  • Serum carcinoembryonic antigen.

B.    Imaging studies that may facilitate staging include the following:

  • Chest radiography.
  • Chest computed tomography.
  • Abdominal barium study.
  • Abdominal/pelvic CT.
  • Contrast ultrasonography of the abdomen and liver.
  • Abdominal/pelvic MRI.
  • Positron emission tomography, including fusion PET-CT scan.

C.    Other procedures that may be warranted include the following:

  • Colonoscopy.
  • Sigmoidoscopy.
  • Biopsy of suspicious lesions.
  • Double-contrast barium enema.

The stages of colon cancer are:

  • Stage I: Your cancer has grown through the superficial lining (mucosa) of the colon or rectum but hasn't spread beyond the colon wall or rectum.
  • Stage II: Your cancer has grown into or through the wall of the colon or rectum but hasn't spread to nearby lymph nodes.
  • Stage III: Your cancer has invaded nearby lymph nodes but isn't affecting other parts of your body yet.
  • Stage IV: Your cancer has spread to distant sites, such as other organs — for instance, to your liver or lung.

What are the treatments for colorectal cancer?

Colorectal cancer can be treated using a combination of different treatments, depending on where the cancer is in your bowel and how far it has spread.

The main treatments are:

  • Surgery: the cancerous section of bowel is removed; it's the most effective way of curing bowel cancer and in many cases is all you need.
  • Chemotherapy: where medication is used to kill cancer cells.
  • Radiotherapy: where radiation is used to kill cancer cells.
  • Biological treatments: a newer type of medication that increases the effectiveness of chemotherapy and prevents the cancer spreading.

As with most types of cancer, the chance of a complete cure depends on how far it has advanced by the time it's diagnosed. If the cancer is confined to the bowel, surgery is usually able to completely remove it.

Keyhole or robotic surgery is being used more often, which allows surgery to be performed with less pain and a quicker recovery.

Lifestyle changes to reduce your risk

You can take steps to reduce your risk of colon cancer by making changes in your everyday life. Take steps to:

  • Eat a variety of fruits, vegetables and whole grains: Fruits, vegetables and whole grains contain vitamins, minerals, fiber and antioxidants, which may play a role in cancer prevention.
  • Stop smoking: Talk to your doctor about ways to quit that may work for you.
  • Exercise most days of the week: Try to get at least 30 minutes of exercise on most days. If you've been inactive, start slowly and build up gradually to 30 minutes. Also, talk to your doctor before starting any exercise program.
  • Maintain a healthy weight: If you are at a healthy weight, work to maintain your weight by combining a healthy diet with daily exercise. If you need to lose weight, ask your doctor about healthy ways to achieve your goal. Aim to lose weight slowly by increasing the amount of exercise you get and reducing the number of calories you eat.

Does my Insurance Policy cover colorectal cancer treatment?

Yes. According to CCHI unified Policy terms and conditions, health insurance policies in Saudi Arabia cover the treatment of colorectal cancer.

Please Click Here to access the Unified CCHI Policy Wordings.


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