Colorectal Cancer: Preventable, Treatable, and Beatable
As March is colorectal cancer awareness month, we can use this month to raise awareness about colorectal cancer and take actions towards preventing it. Colorectal cancer is the third most common cancer in the world and there are increasing number of patients in Asia and South East Asia. In Thailand itself, the number is increasing both in women and men. Many colorectal cancers can be prevented through regular screening. Screening can find precancerous polyps, abnormal growths in the colon or rectum, so that they can be removed before they turn into cancer. Screening is crucial because when found early, colorectal cancer is highly treatable. Early stages of colorectal cancer usually presents no symptoms, as it tends to appear as the cancer progresses.
Risk factorsResearchers have found several risk factors that might increase a person’s chance of developing colorectal cancer.
- Diet that is high in red meats and fatty meats
- Diet that is high in processed meats (sausages, bacon, and ham)
- Low fiber diet
- Physical inactivity
- Heavy alcohol consumption
- Genetic – family history of colorectal cancer and polyps
Signs and symptomsMany people with colorectal cancer experience no symptoms in the early stages of the disease. Signs and symptoms of colorectal cancer include:
- A change in bowel habits, such as diarrhea, constipation, or narrowing of the stool, that lasts for more than a few days
- Abdominal pain – the pain characteristic depends on the size and location of the tumor
Tests to diagnose colorectal cancer
- Radiography with contrast barium enema
- Blood test for carcinoembryonic antigen (CEA)
- Other investigations such as chest x-ray, CT-scan, MRI, EUS
TreatmentThe type of treatment your doctor recommends will depend largely on the stage of your cancer.
- Stage 0 – Cancers have not grown beyond the inner lining of the colon, surgery to take out the cancer is often the only treatment needed.
- Stage I and II – Cancers have grown deeper into the muscle layer of the colon wall, but they have not spread outside the colon wall itself or into the nearby lymph nodes. Surgery to remove the section of the colon containing the cancer along with nearby lymph nodes may be the only treatment needed. However, your doctor may recommend adjuvant chemotherapy (chemo after surgery) if the cancer has a higher risk of recurring. Genome testing will also be done.
- Stage III – Cancers have spread to nearby lymph nodes, but they did not spread to other parts of the body. Treatment includes surgery to remove the section of the colon with the cancer along with nearby lymph nodes, followed by adjuvant chemotherapy or targeted therapy. Genome testing will also be done. Radiotherapy may be needed in patients with cancer in both colon and anus.
- Stage IV – Cancers have spread from the colon to distant organs and tissues. Colon cancer most often spreads to the liver, but it can also spread to other places like the lungs, brain, peritoneum (the lining of the abdominal cavity), or to distant lymph nodes. Chemotherapy and radiotherapy may be given before surgery. If the tumors shrink, the doctor might be able to remove the tumors.