WHAT YOU SHOULD
KNOW
This type of cancer strikes approximately 1 American in
20 at some point in life. It can appear in either the colon or
rectum, which together form the large bowel (also known as the
large intestine). The colon occupies the upper 5 or 6 feet of
the large bowel, and the rectum, the last 6 to 8 inches. In
this part of the digestive tract, the last residues of digested
food are stripped of liquid and formed into stool.
Colorectal cancer often starts as a harmless polyp---a
mass of noncancerous tissue---which over time turns cancerous.
Like all cancers, the disease is the result of unrestrained
multiplication of cells. Normal cells divide in a planned way,
creating more cells only when needed. Cancerous cells grow and
divide without control or order, often making excess tissue
that becomes a tumor. Cancer cells may grow into nearby healthy
tissue, or they may break away from the tumor and travel
through the blood stream or lymphatic system to other parts of
the body.
Causes
Scientists still do not know exactly what triggers colon
cancer. However, they do know several factors that make it more
likely:
-
Age: The disease takes a long time to develop, and
rarely appears in anyone under age 50.
-
Family History: If a parent, sister, or brother has
had colon cancer, you're more likely to get it
too.
-
Polyps: A condition called polyposis, in which
hundreds of polyps develop in the large intestine, will
almost certainly lead to cancer if left
untreated.
-
Inflammatory Bowel Diseases: Conditions such as
ulcerative colitis and Crohn's disease increase the chances
that a cancer will develop.
-
High-Fat, Low-Fiber Diet: The fiber found in foods
such as cereals, fruits, and vegetables appears to have a
protective effect. Excessive fat intake, on the other hand,
seems to promote large bowel cancer.
Signs/Symptoms
There are usually no symptoms during the early stages of
this disease. Early detection depends on regular rectal exams,
fecal occult blood tests, and examinations with a sigmoidoscope
or colonoscope. During later stages, warning signs
include:
-
Black or bloody bowel
movements
-
Cramping abdominal
pain
-
A full-feeling
(bloating)
-
Diarrhea
-
Constipation
-
Pencil-thin bowel
movements
-
Unexplained weight
loss
-
Rectal pain
-
Constant
fatigue
Care
To find out how far the cancer has advanced, your doctor
will probably order x-rays, ultrasound, and other imaging
tests. The results of the tests will help you and your doctor
choose a treatment plan.
Although surgery is the usual treatment for large bowel
cancer, several other treatments may also be employed. The
major treatment options are:
-
Surgery: This is often the only treatment you'll
need if the cancer is found early enough. Depending on the
stage of the cancer, all or part of the colon or rectum may
have to be removed. You may also need to have some lymph
nodes taken out to help prevent the cancer from spreading.
After the diseased parts of the bowel have been removed,
the surgeon may be able to hook together the remaining
healthy sections. If this proves impossible, you may need a
colostomy---an opening to the bowel through the wall of the
abdomen.
-
Chemotherapy: Often called "chemo," this type of
therapy uses drugs to kill new tumor cells or shrink lymph
nodes that contain cancer cells. It is often used as a
safety measure to eliminate any cancer cells missed during
surgery.
-
Many different chemo
medicines are available. They may be taken as a pill, as a
shot, or in an IV. You will probably need frequent blood
tests to determine how your body is doing and how much
chemo you need. The drugs can produce many side effects,
and may leave you susceptible to infection for a
while.
-
Radiation: X-rays or gamma rays can kill cancer and
help prevent it from spreading. They can also be effective
in reducing pain, controlling bleeding, and shrinking
cancerous tumors. Doctors often use this type of therapy to
shrink tumors before colon surgery, and sometimes use it
afterwards for extra insurance. Radiation and chemotherapy
are often used together.
-
Biologic Therapy (also called biotherapy or
immunotherapy): This type of treatment relies on special
drugs that boost the immune system to help your body fight
growing cancer cells. Certain drugs may also make cancer
cells weaker and easier to kill. The medications are
usually given through an IV. They may cause flu-like
symptoms.
Risks
If the cancer is not treated, it is certain to spread.
All forms of treatment have unpleasant side effects, and in the
end, may still fail to halt the spread. Nevertheless, some form
of treatment is your only chance of a
cure.
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