Colon cancer is a common and deadly form of cancer that develops from polyps in the colon and rectum. Risk factors include age, family history, smoking, alcohol, and poor diet. Symptoms are often not obvious until the cancer has advanced, making regular screening important. Treatment options vary depending on the stage of the cancer.
Colon cancer is characterized by malignant tumors of the colon, rectum and/or appendix. It is the third most common form of cancer and a leading cause of cancer death, second only to lung cancer. In the United States, there is a seven percent chance that a given person will develop colon cancer in their lifetime. Colon cancer develops from adenomatous or glandular polyps in the colon and rectum.
People with a personal or hereditary history of bowel cancer or polyps are at increased risk for the disease, and the likelihood of developing colon cancer increases with age. Additionally, behavioral factors may increase the risk of colon cancer. Cigarette smoking, heavy drinking and lack of exercise are all risk factors, along with a diet high in red meat and low in fruits, vegetables, fish and poultry.
The early symptoms of colon cancer are often not very obvious; they can include blood in the stool, anemia, fatigue, and weight loss. Local symptoms such as changes in bowel habits or, in extreme cases, bowel obstruction, are usually not present until large tumors form. Sometimes a large tumor can be felt across the abdomen and can also affect the bladder or vagina, leading to bloody urine or unusual vaginal discharge. In advanced cases of colon cancer, the cancer metastasizes to the liver, causing an enlarged liver, jaundice, and abdominal pain. Blood clots are another late stage symptom.
Early diagnosis is key to surviving this cancer. The disease can take years to develop and, if caught early enough, can be treated surgically quite easily. If the cancer has metastasized, extensive surgical treatment and chemotherapy are typically required, and recovery is much less likely. Because colon cancer doesn’t present with obvious symptoms until it’s somewhat advanced, regular screening is recommended for people at risk.
The most common screening methods in the United States are the fecal occult blood test (FOBT), which checks for blood in the stool that is not visible, and endoscopy, in which a lighted probe is inserted into the rectum and colon to check for abnormalities. There are two types of endoscopy; sigmoidoscopy examines the colon and lower rectum and is usually done in combination with FOBT, while colonoscopy examines the entire colon and rectum. If polyps are found during a colonoscopy, they can be removed right away.
There are two methods of describing the stages of colon cancer. The earlier version, known as Dukes’ system, was developed in 1932 and divides the disease into four stages, A through D. In A, the tumor is confined to the intestinal wall. In B, it has grown beyond the intestinal wall. In C, lymph nodes are affected and D is characterized by distant metathesis. The TNM system describes the severity of the disease by assigning different numbers to tumors (0-4), lymph nodes (0-2), and metastases (0-1), with higher numbers indicating a more advanced stage of cancer.
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