Bowel or colon cancer is a type of cancer that starts in the large intestine. This cancer usually starts as a growth on the inner lining of the colon. These growths are called polyps. Some types of polyps can turn into cancer over time (usually it takes years), but not all polyps will become cancer. You can find more information below.

What is bowel cancer?

Bowel cancer , also known as colon cancer , is a general term for cancer that begins in the large intestine. Depending on where the cancer started, it is sometimes called rectal cancer or colorectal cancer.

Bowel cancer symptoms include blood in the stool, an unexplained change in your bowel habits, such as prolonged diarrhea or constipation , and unexplained weight loss.

Most bowel cancers develop from small spots on the intestinal lining or growths inside the colon or rectum that look like cherry stems. These are called polyps. Not all polyps become cancerous. If the polyps are removed, the risk of bowel cancer is significantly reduced.

Bowel cancer can be treated using a combination of surgery, chemotherapy, radiotherapy, and in some cases, biological therapy. As with most types of cancer, the chances of a complete cure depend on how far the cancer has progressed when diagnosed.

What is the incidence?

Colon cancer is the third most common cancer in men after lung and prostate cancer, and second in women after breast cancer. Bowel cancer mortality rate also seems to be quite high. Approximately 1700 die among 4000 people who are diagnosed with bowel cancer each year.

Men are affected more often than women. Of those affected, 38% were aged 50 to 69 at the time of diagnosis, and 55% were over 70 years of age. Bowel cancer is particularly common in western industrialized countries, while it is rarely diagnosed in Asia and Latin America.

What causes bowel cancer?

There are many reasons why people develop bowel cancer. However, it is difficult to give a cause, but for most people, their age and eating habits contribute to the development of bowel cancer.

The risk is higher for people who have a family history of bowel cancer or polyps, have inflammatory bowel disease such as Crohn’s disease and ulcerative colitis , or have had polyps in the gut before. People with the Lynch syndrome genetic disorder are also at risk for bowel or colon cancer.

Bowel cancer usually takes many years to develop. It starts as a small growth called a polyp on the inner wall of the intestine. It can grow there for a long time before undergoing changes to become cancerous and then spread to other parts of the body.

Who is at risk?

The primary risk factor for bowel cancer is the age of the person concerned. Nine out of ten affected people are 55 years or older. Therefore, preventive medical check-ups from this age are particularly useful, for example if they have the following factors:

  • Having a family member with colon cancer
  • Bowel cancer development in family members under the age of 50
  • Family members have other types of cancer
  • Inflammatory bowel diseases such as ulcerative colitis or Crohn’s disease
  • genetic predisposition
  • People with weakened immune systems
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In addition, a number of risk factors associated with personal lifestyle believed to increase the likelihood of colon cancer include:

  • Smoking
  • high alcohol consumption
  • lack of exercise
  • Eating habits that contain red meat, sausage, animal fats and very little fiber
  • Being overweight or obese

What are the symptoms of bowel cancer?

  1. Do you have diarrhea and constipation problems?
  2. Do you have blood in your stool?

These symptoms, typical of bowel or colon cancer, usually occur when the tumor reaches a certain size. In the early stages, colon cancer often goes undetected because it shows almost no symptoms.

Blood in the stool can be a sign of cancer. But sometimes the blood is microscopically small and invisible to the naked eye. It can only be seen through certain tests.

Other signs of a possible cancer tumor are changes in bowel habits. Experiencing constipation, diarrhea, or both can be a sign of colon cancer, especially if it persists for a long time.

If the tumor has grown, it narrows the bowel, the stool may become thin like a pencil and smell bad . Despite the narrowing, the bowel will try to empty itself. This is why cramps and abdominal pain are often the result.

As with all cancers, this cancer weakens the entire body . This is usually manifested by symptoms such as decreased performance, weakness and fatigue .

Loss of appetite and mild fever may also accompany the symptoms. If people lose weight unintentionally and for no apparent reason, this can also indicate cancer.

Detailed indications

  • Changes in stool habits
  • Constipation and diarrhea
  • Bad-smelling stools and a feeling of bloating even after defecation
  • Blood in, on, or in the stool, black stools (tar stools)
  • Thin stool due to narrowing by intestinal tumor
  • Right stomach pain, intestinal cramps
  • Abdominal hardening
  • For small bowel cancer: Abdominal pain, nausea, vomiting, diarrhea and constipation

Associated symptoms include:

  • Sudden unexplained weight loss in a short time
  • Weakness, poor performance, fatigue, malaise, loss of appetite
  • swollen lymph nodes
  • Mild fever and night sweats
  • Anemia (tumor anemia)

If a person has any of these symptoms, it does not mean they have cancer. However, these complaints should be taken seriously and clarified. In general, people over the age of 40 are recommended to carefully observe changes in their stool habits.

If these persist for more than three weeks for no apparent reason, they should be examined for causes. The earlier that bowel or colon cancer is diagnosed, the better the chance of cure.

How is bowel cancer diagnosed?

Bowel cancer can develop without early warning signs. Cancer can grow as a polyp in the lining of the gut for several years before it becomes cancerous and spreads to other parts of the body. Usually, a very small amount of blood leaks from these growths and a bowel movement occurs without any symptoms being noticed.

Screening involves testing for bowel cancer in people who do not have obvious symptoms of the disease. The aim is to find any polyps or to start treatment as soon as possible, if any. Early diagnosis saves lives.

There is the stool occult blood test (FOBT) which is a bowel cancer screening test, which is mainly used to detect blood in the stool as a symptom, not colon cancer.

Bowel cancer screening using a FOBT is a simple, non-invasive process that can be done in the privacy of your own home. Although no screening test is 100% accurate, the FOBT is currently the best researched screening test for bowel cancer.

Completing a FOBT every two years can reduce the risk of dying from bowel cancer by 15 to 25%. People with symptoms of bowel cancer or a family history of bowel cancer should consult their doctor as soon as possible.

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If your doctor suspects you have bowel cancer or your FOBT test is positive, you will be sent for a colonoscopy to take a close look at your rectum and intestine with a thin, tube-like instrument and a lens for viewing.

During a colonoscopy , the doctor may also remove polyps or tissue samples, which are checked under a microscope for signs of cancer.

Other testing tools

Other tests may also be required, these include:

  • Physical examination: An examination of the body to check for signs of general health, including checking for signs of illness such as lumps or anything else that looks unusual. A history of the patient’s health habits, past illnesses, and treatments will also be taken.
  • Rectal exam: The doctor or nurse inserts a lubricated, gloved finger into the rectum to feel for lumps or anything else that looks unusual.
  • Barium enema: A series of X-ray (X-ray) examinations of the lower gastrointestinal tract that show any swelling or lumps . A liquid containing barium (a silver-white metallic compound) is inserted into the rectum. Barium coats the lower gastrointestinal tract and X-rays are taken.
  • Computerized tomography or magnetic resonance imaging scan: CT scans produce three-dimensional pictures of several organs at once and can be used to examine the intestines. An MRI scan creates detailed cross-sectional pictures of the body and can show the size of any tumors.
  • PET scan: A small amount of radioactive glucose is injected into the body. Cancer cells appear brighter when scanned.
  • Ultrasound: A test that uses echoing sound waves when something dense, such as a tumor, is found. This test can see if the cancer has spread.
  • Biopsy: In a biopsy, cells or tissue are removed so they can be viewed under a microscope by a pathologist to check for signs of cancer.

How is bowel cancer treated?

The goal of treating any bowel cancer is to completely remove or destroy the tumor. The success of treatment depends on how far the cancer has progressed. At an early stage, there is a good chance for a tumor to be completely removed and completely healed.

In general, the treatment of colon cancer depends on the location, size, and type of the tumor. It is also important in the treatment whether the cancer has already metastasized. A combination of methods is also possible if treatment success can be increased.

Surgical treatment

Surgery is the most important treatment method for colon cancer, both in the rectum, in other colon regions, and in the small intestine. The surgeon cuts the affected part of the intestine and a safety distance of a few centimeters and sews the ends together. It also removes the surrounding lymph nodes.

The common method for this is open surgery, in which a surgeon completely exposes access to the bowel. Alternatively, keyhole surgery (laparoscopy), which is associated only with a small incision in the abdominal wall, is increasingly used.

If small malignant rectal tumors are at an early stage, it is possible to remove them from the anus . If the tumor is too close to the exit of the bowel, the sphincter and the entire rectum may need to be removed. The surgeon will then make an artificial bowel outlet .

If possible, the doctor tries to avoid an artificial bowel outlet during bowel surgery. However, an artificial bowel exit may be temporarily necessary so that the bowel can heal more easily.

chemotherapy treatment

Chemotherapy is treatment with cancer drugs (cytostatics) that are expected to inhibit or completely kill cancer cells In types of colon cancer, such as bowel cancer, rectal cancer, and small bowel cancer, chemotherapy is used for a variety of reasons:

  • As a supportive treatment (adjuvant chemotherapy): It is used after surgery to destroy residual cancer cells that lurk elsewhere in the body, which can then lead to horny tumors, and also to reduce the risk of recurrence.
  • As preparatory therapy for surgery (neoadjuvant therapy): The goal of neoadjuvant therapy is to provide the operation with a better starting position with chemotherapy. To this end, large tumors should be reduced so that later surgery is possible.
  • To inhibit tumor growth and alleviate symptoms (palliative therapy ) : first for an advanced tumor that is no longer operable, second for those who do not want to have surgery, and third for existing malignant tumors, palliative treatment should keep the tumor as small as possible because it should slow the course of the disease. The aim is to alleviate symptoms in order to prolong the lives of those affected and maintain their quality of life for a long time.
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With the use of new active ingredients and modern treatment concepts, the frequency and severity of side effects has decreased. Additionally, undesirable effects can often be well treated with medication.

radiotherapy treatment

Radiation therapy is used to destroy cancer cells in certain parts of the body For people with bowel cancer, radiation prior to surgery can reduce the size of the tumor and make it easier for the surgeon to remove it later.

This treatment is often combined with chemotherapy. After surgery, it may be appropriate to continue the combination therapy to prevent the tumor from returning to the same area.

Doctors may also consider radiation therapy if malignant tumors have formed. In bone metastases, radiation should relieve pain and eliminate the risk of fracture.

If small and few liver metastases occur, they can be destroyed by treatment similar to radiation therapy, radiofrequency ablation.

targeted therapies

While targeted therapies directly target cancer cells, chemotherapy acts like a cell poison and attacks not only tumor cells but also healthy tissues. This also creates many side effects.

The active ingredients in targeted therapy fight specific growth factors, preventing blood flow to the tumor or preventing signal transmission between tumor cells.

Other treatment methods

Other treatment methods may include:

  • Pain management: Cancer may be associated with pain, for example when the tumor presses on surrounding tissue and nerves. Surgery is accompanied by pain. Patients should not ignore pain, but should talk to their treating physician about available treatment options. Otherwise, a kind of pain memory may develop. The pain may become independent and persist even if the cause has been removed.
  • Psychosocial care: Cancer often turns life upside down. Diagnosis and subsequent treatments can be very stressful for those affected and their relatives. In addition to this difficult life situation and psychological adjustment disorders, many patients suffer from depression and anxiety disorders. It is estimated that about one-third of cancer patients seek professional help. Therefore, it is normal for them to want to receive psychosocial care, and they should.

Aftercare

The frequency with which those affected go for follow-up examinations depends on the stage at which their cancer is being treated. Doctors usually recommend having a checkup every six months for the first two years after surgery . The risk of recurrence is highest during this time.

Even if the disease is likely to improve and experts rate the risk of recurrence as low, they may recommend regular colonoscopy if they fear that a second tumor may develop independently of the first.

People with more advanced colon cancer are usually under close medical supervision . However, the type and timing of controls depend on the individual disease state.

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