Colorectal Cancer: Causes, Symptoms, and Treatments

Introduction: Colon Cancer Fact File 

Colon or colorectal cancer is usually malignant tumours which arise from inner walls of colon (large intestines) or from an individual’s rectum. Colon and rectum cancers in combination are the third most prevalent tumour globally with cancer of the colon being more prevalent in high-risk populations (Stoppler, 2017). In addition cancer of the colon is considered the second greatest cause of all deaths that occur as a result of cancer. Cancer of the rectum and colon begins as a growth which is known as a polyp on the tissue lining of the rectum or the colon. Most of these polyps either remain benign or eventually turn cancerous (Stoppler, 2017). However, if these polyps are removed at the early stages they are stopped from turning cancerous which means that individuals must make regular clinical visits for early detection and removal of polyps. There are risk factors beyond human control which ultimately causes one to get colorectal cancer. The factors that increase the risk of colon cancer include colon polyps, family history, history of ovarian or breast cancer, advanced age (50 years), inflammatory bowel diseases among others.

Epidemiology of Colon Cancer 

Colon cancer causes to a great extent mortality as well as morbidity across the globe as it represents about nine percent of total incidences of cancer. Moreover, cancer of the rectum and colon is ranked in the third position in cancer types in addition to being the fourth most killer globally (Haggar, & Boushey, 2009). Additionally, colorectal cancer affects both and women alike with new cases totalling to a million documented in the year 2002 which is the latest international estimates. The countries which have high incidences of colorectal cancer are Australia, New Zealand, the United States, Canada and some regions in Europe. However, countries that are classified as low-risk zones include South America, India China and parts of Africa (Haggar, & Boushey, 2009). In 2005, the United States recorded 40,800 and 108,100 people got diagnosed with rectum and colon cancers in that order. In addition, it was estimated that in 2008, 148,900 new cases would be found and as a result, 49,900 would succumb to death (Haggar & Boushey, 2009). Statistics further reveal that prevalence of colon cancer is more in developed countries than it is in developing countries. While United States range is 40 per 100,000 it is 5 per 100,000 in parts of Asia and Africa. Mortality rates attributed to colorectal cancer is usually half the total incidences. In 2002, almost 530,000 deaths occurred which is a representative of about 8 percent of all cancer deaths. Estimates show that at least 394,000 people succumb to colorectal cancer annually which makes colorectal cancer the fourth killer disease (Haggar & Boushey, 2009). In the United States almost 49, 960 people would die in 2008. Survival rates for individuals who are diagnosed with cancer of the colon and rectum are highly dependent upon the stage in which the cancer is in.

Financial Costs of Colon Cancer 

Estimation of the costs which are associated with colorectal cancer is very vital or the purposes of assessing the burden of disease as well as for evaluations in economic terms of various health programs as well as policies for detection, prevention or treatment of cancer. There is need to conduct cross-national comparisons studies in order to determine disparities as well as understand the economic implications of health care programs and policies (Yabroff et al., 2013). Colorectal cancer financial costs include direct nonmedical costs such as the patients time which is spent in receiving care as well as direct medical costs indirect medical costs mean that the patients and caregivers waste a lot of time which would have otherwise been used productively for economic gains (Yabroff et al., 2013). These kinds of costs are hard to quantify as compared to the direct medical costs of chemotherapy, drugs and other forms of treatment. Governments across the globe invest heavily in the healthcare institutions in order to manage and treat colorectal cancer. This money which is pumped into the healthcare institutions may run into millions of dollars annually as more and more Americans become prone to colorectal cancer. In addition, the social costs incurred by such governments through missed days at work and occupancy of hospital beds runs into billions of dollars annually.

How Colon Cancer Affects Various Body Systems 

Colon cancer in spite of it occurring in the tissues lining the colon and the rectum may have effects on other body systems to a great extent. Colon cancer symptoms which include discomfort in the bowel movements can bring problems to the digestive system derailing the digestion of food in the stomach (Mishra et al., 2013). Furthermore, a person who has colon cancer occasionally feels tired and weak which by extension seems to affect every aspect of the body system from the muscles to the limbs. In addition, the colon of cancer can metastasize into other body parts say the lungs and the liver especially at the advanced stages hence affecting the endocrine and respiratory body systems (Mishra et al., 2013). More so colon cancer prevents the absorption of water and nutrients into the body causing weight loss, anaemia, fatigue, and other related effects. As a result of this other parts of the body, systems feel the effects of cancer of the colon.

Aetiology of Cancer of the Colon 

Cancer of the colon tends to occur in a sporadic manner and is usually inherited in about 5-10 percent of all cases. Populations that move from areas with low risk say Japan to areas with high risk say the United States are likely to have increased incidences of getting colon cancer. This is usually the case with the first generation of the migrants. Another factor which is attributed to an increase in chances of getting colon cancer is diet. A research which was conducted by the AICR (American Institute for Cancer Research) and WCR (World Cancer Research) made findings that indicated that appropriate diet can go a long way in preventing colorectal cancer (Labianca, et al., 2010). In addition, smoking is related to adenomas in the rectum and colon viewed to be cancer symptoms and indicators. More so bowel inflammatory diseases such as Crohn’s disease and ulcerative colitis are said to increase the prevalence of cancer of the colon (Labianca et al., 2010). Furthermore, diabetes, high blood pressure, hypertriglyceridemia and other metabolic syndromes increase the risk of getting colon cancer, especially among men. Genetic factors also tend to have a hand in increasing prevalence of cancer of the colon in individuals. This is usually contributed to polyposis and nonpolyposis syndrome associated with loss of familial adenomatous polyposis responsible for colorectal cancer.

Prognosis of Colon Cancer 

Cancer of the colon can be detected once an individual shows signs or when screening results the presence of colon cancer. Colon cancer in its early stages does not have symptoms and the signs are usually not specific such as weight loss, tiredness, abdominal discomfort among others. It is, therefore, important for individuals to go for regular screening tests in order to get early prognosis to avoid the spread of the tumours. Currently, the main diagnosis method is endoscopy and may be performed through colonoscope or sigmoidoscope. However, some patients present some difficulties since it may be difficult to study them with a colonoscope which is attributed to anatomical reasons.

So as to deal with such difficulties the specialists combine barium enema with colonoscopy of the left side which shows the front part of the colon. More so, for individuals at a higher risk and with multiple adenomas, a barium enema with double contrast is combined with a colonoscopy to give more accurate results. Moreover CT colonography and virtual colonoscopy though not yet standardized could be useful in helping the specialists locate the tumour with more precision. These procedures are quite helpful especially when dealing with patients who are scheduled for laparoscopic resections. This is so since they help in the detection of polyps and colonic lesions when colonoscopy alone is not able to see through the whole colon especially if there is an obstructive tumour.

Future Outlook of Colon Cancer 

Doctors in the country are conducting numerous researches and clinical trials on advanced methods of detection, prevention, screening and treatment of colon cancer. Researchers are looking for new ways of checking colorectal cancer and polyps through the effectiveness of virtual colonoscopy which is a colon’s CT scan. More so there is the use of testing in genetics used for checking stool specimens to detect colorectal cancer cells (Cancer Compass, n.d). Furthermore, research is being conducted on drugs which may be useful in preventing the onset of colon cancer. Consequently, these researchers are exploring the use of celecoxib, aspirin and other drugs mainly on people who are considered to have a high chance of getting colon cancer (Cancer Compass, n.d). In addition, research is being further conducted in order to get advanced treatment options such as biological therapy, chemotherapy as well as combinations of various cancer treatment methods that are already available. Biological therapy as per the research will use the body’s immunity to fight cancer as the researchers continue to research on the use of monoclonal antibodies treatment soon after chemotherapy or surgery. These monoclonal antibodies are substances which are produced in the laboratory which has the ability to bind onto cancer cells and eventually help kill those cancer cells (Cancer Compass, n.d). Ultimately these research efforts will go a long way in managing colon cancer and reducing its adverse effects on human health.

In conclusion cancer of the colon is cancer which affects colon or rectum through the growth of polyps which when left unmanaged can turn cancerous. Colon cancer as per the statistics is the second cause of cancer deaths globally. Various risk factors have been linked to higher prevalence of colorectal cancer such as the history of ovarian and breast cancer and obesity. Early detection of cancer cells is very important in managing and treating colon cancer and since its symptoms are usually general symptoms, one is advised to go for regular screening. Treatment options available include chemotherapy, colonoscopy, and surgery through research is still being conducted to come up with better treatment and management strategies. With such efforts, it is hoped that colon cancer will be kept at bay and many unnecessary deaths prevented from occurring.

References

Cancer Compass (n.d ). Future Research: Colon Cancer . Retrieved from: https://www.cancercompass.com/colon-cancer-information/future-research.htm . 

Haggar, F. A. & Boushey, R. P. (2009). Colorectal cancer epidemiology: incidence, mortality, survival and risk factors. Clin Colon Rectal Surg 22(4), 191-197. doi. 10.1055/s-0029-1242458.

Labianca, R. et al. (2010). Primary colon cancer: ESMO clinical and practice guidelines for diagnosis, adjuvant treatment and follow-up. European Society for Medical Oncology, Suppl 5 , v70-7. doi: 10.1093/annonc/mdq168 . 

Mishra, J. et al. (2013). Prospective of colon cancer treatments and scope for combinational approach to enhanced cancer cell apoptosis. Critical Reviews in Oncology /Haematology , 86(3), 232-250. doi: 10.1016/j.critrevonc.2012.09.014.

Stoppler, M. C. (2017). Colon Cancer (Colorectal Cancer) . Retrieved from http://www.medicinenet.com/colorectal_cancer_pictures_slideshow/article.htm.

Yabroff, K.R, Borowski, L. &Lipscomb, J. (2013). Economic studies in colorectal cancer: challenges in measuring and comparing costs. Journal of National Cancer Institute of Monographs, 2013(46); 62-78. doi.https://doi.org/10.1093/jncimonographs/lgt001