Colon cancer primarily affects the epithelial lining of its walls.
The anatomical structure of the large intestine, which is the final section of the gastrointestinal tract( starting from the ileocecal flap dividing the small and large intestine and ending with the anus) is represented by five sections:
- with the Cecum ending in a process appendicitis.
- An ascending colon located on the right side of the abdomen.
- The transverse colon passing transversely to the left side of the abdomen.
- The descending colon, extending the transverse colon and descending down the left side of the abdomen.
- Sigmoid colon located in the pelvic cavity.
- Relatively short rectum, ending with anal opening.
Definition and statistics
Colon cancer, referred to as colorectal cancer, is a malignant tumor that develops from epithelial tissues lining the walls of any of its five divisions.
Photo of colon cancer
Since in the medical literature the colon is often called the large intestine, we will immediately say that both of these concepts are synonymous and interchangeable.
The medical statistics show a steady progression of this formidable disease: on a global scale, 500,000 new patients( generally residents of industrially developed countries) become ill with colon cancer each year.
The lowest incidence( five per 100 000 population) in Africa, the median( 33 out of 100 000 people) in the southern and eastern regions of Europe, the highest( 52 per 100 000 inhabitants) in North America and the western regions of Europe.
In the structure of male oncology, colon cancer ranks third( after prostate cancer and lung cancer), in the structure of the female - the second( yielding to breast cancer).Men are exposed to this ailment 1.5 times more often than women.
A person of any age( including a child) can get cancer of the large intestine, but most often it affects people of the older age group: in people over 60 years old it is observed in 28% of cases, in patients older than 70 years - in 18% .
It is interesting that in people whose age exceeds 80 years, the incidence rate of colon cancer falls sharply to the values typical for young patients.
Classification
By nature of growth, large intestinal cancers are divided into:
- exophytic forms growing in the lumen of the affected bowel;
- endophytic forms developing in the thickness of the intestinal wall;
- saucer-shaped forms combining the features of both of the above forms.
Cancer is represented by a variety of types depending on the location of the pathological process and the cellular structure of the tumor tissue.
When localized in the colon, a malignant tumor can be represented by:
- adenocarcinoma( its incidence is more than 80%);
- mucosal adenocarcinoma;
- by an undifferentiable neoplasm;
- by mucocellular carcinoma;
- unclassifiable cancer.
In colorectal cancer, colorectal cancer is represented by all of the above types, characteristic of the colon, as well as:
- squamous;
- basal cell;
- ferruginous squamous cell carcinoma.
Reasons for the development of
The following risk factors contribute to the development of colon cancer:
- Age over 50 years.
- The presence of inflammatory diseases of the colon( ulcerative colitis, Crohn's disease).
- Hereditary predisposition( the presence of a similar pathology in close relatives increases the risk of developing colon cancer several times).About a quarter of all cases of colorectal cancer is due precisely to the genetic factor.
- Ethnicity. Cancers of the colon are most susceptible to immigrants from the eastern region of Europe, who are of Jewish origin.
- Incorrect food, reduced to eating foods poor in fiber, but containing a large amount of fats and refined carbohydrates, the abuse of meat dishes and yeast bread.
- Insufficient level of physical activity, which causes a decrease in intestinal motility and the development of constipation.
- Addiction to alcohol and tobacco.
- Polyposis of the large intestine. The polyp, localized on the walls of the colon, may eventually degenerate into a malignant tumor.
Clinical manifestations of
Cancer of the large intestine at the very onset of development is completely asymptomatic and can only be detected by accident, during a clinical examination or during intestinal procedures performed in connection with another of its diseases( presumed or already identified).
Symptoms of colon cancer in the early stages of
As the malignancy grows, the following first signs develop:
- Abdominal pain( abdominal pain syndrome), characterized by a different nature and intensity depending on the localization of the tumor process. They can be cramped, aching, pressing.
- Constant discomfort in the abdomen, accompanied by rumbling and increased gas production.
- Irregular stools characterized by alternating diarrhea and constipation.
- Constant belching, frequent nausea and vomiting.
- Heaviness and a feeling of fullness of the stomach.
General Symptoms of
General symptoms that develop in advanced stages of colon cancer indicate a disruption in the functioning of other internal organs and systems.
It is characterized by:
- The presence of anemia due to bleeding and impaired absorption of iron and vitamin B12, necessary for the formation of hemoglobin and erythrocytes.
- Pale and dry skin, brittle hair, brittle nails.
- Decreased performance, accompanied by severe weakness, dizziness and headaches.
- Loss of appetite.
- Sharp weight loss.
Signs in women and men
In men, more often( approximately 60% of cases) develops cancer of the rectum, in women( 57%) - cancer of different parts of the colon. There are no specific signs in the clinical course of colon cancer in representatives of different sexes.
Stages and their survival prognosis
In colon cancer, the five-year survival rate of patients is directly dependent on the stage of its detection:
- In stage 1, characterized by small tumor sizes that do not leave the mucosa and submucosa of the intestinal wall and have not yet spread to the lymph nodes, the survival rateis 95%.
- In stage 2, when a malignant growth that begins to germinate in the muscle layer affects more than half of the intestine( with a single penetration into the lymph nodes), the survival rate is 75%.
- In stage 3, characterized by the germination of the tumor into the serous membrane or its metastasis in a series of regional lymph nodes, only half of the patients survive.
- At stage 4, when the pathological process spread to the tissues of nearby organs and the process of distant metastasis began, the survival prognosis does not exceed 10%.
Metastasis
The colon tumor most often metastasizes in:
- Liver , which most( 75%) of the incoming blood receives from the portal vein, fed by internal organs( including the intestine).This circumstance promotes metastasis. Colorectal cancer metastasized to the liver, manifests itself as exhaustion, vomiting, nausea, jaundice, development of ascites( accumulation of fluid in the abdominal cavity), pain and itching.
- Peritoneum is a thin connective tissue film lining the inner surface of the abdominal cavity and covering all internal organs. After the malignant tumor sprouts through the tissues of the intestinal wall, it affects the peritoneum, forming foci that gradually spread to its neighboring areas, simultaneously affecting the neighboring organs covered by it.
- Lightweight. Colon cancer metastasized into this organ, manifested by a constant cough, pain in the chest, shortness of breath, hemoptysis.
Complications of
Along with metastasis, colon cancer produces a number of complications that result in:
- Complete intestinal obstruction( due to overlap of its lumen with tumor tissues).
- By perforation of the intestinal walls, coupled with the formation of holes through which cancer cells and intestinal contents can enter the abdominal cavity.
- The formation of pathological communication between intestinal loops and adjacent organs.
- Compression of internal organs.
- Difficulty of urination.
- Recurrence of a malignant tumor.
Diagnosis
Early detection of colon cancer is complicated by the absence of characteristic symptoms at the very beginning of the development of the tumor process.
Endoscopic methods
Endoscopic methods include procedures:
- Recto-manoscopy. The object of research with the help of a sigmoidoscope is the rectum and the lower parts of the sigmoid colon. Introduced through the anus, a gel-pliable flexible tube equipped with a powerful optic capable of repeatedly enlarging the resulting image allows revealing the presence of the most insignificant pathological changes in the mucous lining of the intestine.
- Colonoscopy. Colonoscopy is performed using a colonoscope, which also has an optical system and a video camera connected to the monitor. The ability to manipulate the device allows the doctor not only to detect the presence of pathology, but also to remove polyps, and also to take material for biopsy. Colonoscopy helps to examine the condition of the entire large intestine.
Radiographic
X-ray methods are represented by the procedures:
- Barium enema. Before the procedure, the patient is given an enema containing a suspension of barium sulfate, followed by a series of X-ray photographs. Barium suspension, a uniform layer covering the walls of the intestine, creates in the picture a "filling defect", which makes it possible to detect the presence of polyps or cancerous tumors.
- Computed tomography. This method, used when it is necessary to detect metastases, makes it possible to perform multiple layer-by-layer photographs of the organ under investigation using X-rays.
- Magnetic resonance imaging. The MRI procedure is also designed for layered visualization of the tissues under investigation, but only through electromagnetic radiation. The absence of ionizing radiation makes it safer.
- Chest X-ray. The procedure is indispensable for the detection of metastases in the lungs.
- Positron emission tomography. Given the high demand for cancer cells in sugar, the PET procedure uses sugar labeled with radioactive substances. The accumulation of these substances in a specific area of the body indicates the presence of a cancer tumor in it. With the help of a special camera, the doctor can determine the location of its location and dimensions.
Genetic testing of
This type of examination aimed at revealing in the genetic code of the sick genes responsible for the degeneration of healthy cells into cancer cells is carried out with close relatives suffering from colorectal cancer.
Laboratory methods
Laboratory tests for cancer of the intestine in a patient include:
- Study of feces for latent blood.
- General and biochemical blood test.
- Perform a biopsy.
Ultrasound examination
Ultrasonic procedure using ultrasonic waves to obtain a volumetric image of internal organs, allows to detect the tumor, determine its size and establish the presence of distant metastases.
What kind of markers do they identify?
In case of colon cancer, the level of:
- of a cancer embryonic antigen may be increased;
- cancer marker CA 242 , produced by cancer cells that have affected the tissues of the pancreas and colon;
- antigen CA 19-9 , revealing tumors of the gastrointestinal tract and pancreas;
- of the specific tumor marker CA 72-4 , appearing in the blood for tumors of the ovaries, colon and gastric carcinoma.
Test for colon cancer and how much does it cost?
A person who has found an alarming symptomatology at home can test their feces for hidden blood.
To do this, just go to the pharmacy, get a test for colon cancer and perform a number of simple manipulations, guided by the manufacturer's recommendations.
Treatment of
- The leading method for treating colon cancer is surgery. Most often, patients undergo radical surgery: partial hemicolectomy or colectomy. The operation can be open( performed through the incision of the abdominal wall) or laparoscopic, carried out through several small incisions into which manipulators and a miniature video system are introduced. When lymph nodes are affected, lymphadenectomy is performed.
- No less important method of treatment is the chemotherapy - the use of drugs that inhibit the division of cancer cells, resulting in the tumor decreases in size, stops its rapid growth or decreases the likelihood of its metastasis to other organs. Chemotherapy can be used before surgery, after it, and as a primary treatment for inoperable forms of cancer.
- Radiotherapy , consisting of the use of X-rays to destroy cancer cells, is the third therapeutic method for treating colon cancer.
Used in the pre-operative period, it can lead to a significant reduction of the cancerous tumor. When treating an operated patient, radiation therapy destroys the atypical cells that remain after the operation, preventing a relapse of the malignant neoplasm.
In what cases is the colostomy output?
Colostomy is called an artificially created hole with a portion of the colon withdrawn into it, intended for the removal of gases and feces.
Indication for colostomy with rectal cancer is:
- Removal of the most part of the large intestine affected by the tumor.
- The high risk of complications that can occur when stitching the ends of the colon after an operation to remove its fragment.
- Impossibility of tumor removal. In this case, the colostomy is superimposed to restore the patency of the intestine in order to remove gases and feces.
- Presence of complications accompanying the tumor process( fistula, suppuration).
- Germination of the tumor in adjacent organs.
- The presence of severe inflammation in the large intestine after radiation therapy.
Colostomy may be temporary or permanent. In the first variant, after a certain period of time, another operation is performed, during which the ends of the intestine are sewn and close the hole made in the skin.
Patients who have undergone colostomy, are forced to use the kalopriemnikami kalopriememnikami - special containers for collecting stool.
Diet
Abundant with vegetable fiber, a therapeutic diet for colon cancer should:
- promote the cleansing of the body;
- to prevent the occurrence of constipation;
- significantly accelerate the removal of toxic substances from the patient's body.
In colorectal cancer from the diet should completely eliminate foods containing large amounts of protein and fats, replacing them with dishes high in vitamins A and C, complex carbohydrates and plant fibers.
All these substances are found in vegetables( potatoes, cabbage, tomatoes), cereals( brown rice, wheat and corn flakes) and fruits( avocados, citrus fruits, bananas).
Completely abandoning the yeast bread, the patient should prefer its whole-grain or cut-off varieties.
Prevention
Specific prevention of colon cancer is not available.
The following actions can reduce the risk of its development:
- Persons at risk should have an annual examination for colon cancer.
- People over the age of forty are advised to undergo a procedure each year for finger examination of the rectum.
- Patients over 50 years of age should perform a colonoscopy or proctosigmoidoscopy every two years, and a test for occult blood once a year.
- Regular exercise and constant body weight control are also useful.
Can I get a disability group?
To obtain a disability in colon cancer, the patient should receive a medical and social expert opinion.
Before her, the patient needs to undergo:
- chest X-ray;
- liver ultrasound;
- radiograph of the intestine;
- biopsy;
- medical examination of a number of specialists( including oncologist, therapist, neurologist, etc.
In some cases, the patient is examined under in-patient conditions
In addition, the patient must pass:
- urine and blood samples for general and biochemical analysis,
- feces samplesfor receiving a coprogram and examining them for dysbiosis.
Video on prevention and diagnosis of colon cancer: