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Colorectal Cancer: Symptoms, causes, prevention and treatment

Team AckoJun 23, 2024

According to the World Health Organization (WHO) GLOBOCAN database, Colorectal Cancer is the third most deadly and most commonly diagnosed cancer that affects more males than females. Also, early-onset Colorectal Cancer has become a global health challenge because of its alarming rise over the past two decades. Its symptoms in the early stages are hard to detect. That is why most people are diagnosed with CRC in the later stages. This article will help you understand the A to Z of Colorectal Cancer which includes types stages, signs, causes, risk factors, treatments, and prevention methods.

Colorectal

Contents

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What is Colorectal Cancer?

Cancer that occurs in the colon is known as Colon Cancer, whereas if it develops in the rectum, then it is called Rectal Cancer. Together they are named Colorectal Cancer. This type of cancer develops when small, noncancerous clumps (known as polyps) form in the colon or rectum. These cells grow abnormally and can invade other parts of the body. Treatment works great if the cancer is diagnosed in the early stage. 

Types of Colorectal Cancer

The different types of cancer in the colon and rectum are as follows.

  • Adenocarcinoma: It starts in the lining of internal organs.

  • Lymphoma: It occurs in a lymph node. Also, it can happen in the colon or rectum.

  • Gastrointestinal stromal tumours (GIST): It begins in the muscle tissue of the digestive tract.

  • Carcinoids: It is slow-growing and starts in special hormone-producing cells in the intestine.

Colorectal Cancer symptoms

Many people might not experience any signs in the early stage. However, according to the cancer’s location and size, people might notice the following symptoms.

  • Weakness and fatigue

  • Persistent abdominal discomforts such as fullness, cramps, bloating, or gas

  • Decreased appetite

  • Vomiting

  • Jaundice

  • A feeling that you have not emptied the bowels completely

  • Rectal bleeding, blood in the stool, dark stools 

  • Constipation, diarrhoea, or change in the consistency of the stool 

  • Unexplained weight loss

These signs also resemble other health diseases such as inflammatory bowel disease, infections, and haemorrhoids (piles). It is vital to check with the doctor if the signs are not subsiding. 

What causes Colorectal Cancer?

The most common cause is the development of benign (noncancerous) cells called polyps. These cells grow uncontrollably and become cancerous. Apart from this, traits such as food habits, lifestyle, and ageing can also result in this cancer. 

Other causes are as follows. 

  • Hereditary: Individuals with a family history of this type of cancer are most likely to inherit it.

  • Health issues: Diabetes and Inflammatory Bowel Diseases such as Ulcerative Colitis and Crohn’s Disease, and those who have undergone radiation therapy for previous cancers are prone to this cancer.

Risk factors

Following is the rundown of the risk factors for Colorectal Cancer.

  • A sedentary lifestyle

  • Obesity

  • Older age (people above 50 years)

  • Alcohol consumption

  • Consuming a high-fat and low-fibre diet  

  • Tobacco use

  • Smoking

Different stages of Colorectal Cancer

There are five stages of cancer that indicate its size and how much it has invaded the body. 

Stage 0: It is also called carcinoma situ, and in this stage, cancer just begins to form in the inner layer of the colon. 

Stage 1: Cancer grows in the next layer of the colon.

Stage 2: Cancer spreads in the outer layers of the colon.

Stage 3: Cancer reaches the lymph nodes but has not reached the other organs.

Stage 4: In this stage, cancer spreads to other organs of the body.

How is Colon Cancer screened and diagnosed?

The following are the commonly recommended screening options.

  • Colonoscopy: Here, a flexible tube (with a camera) is used to examine the entire colon and rectum. Before starting this process, the individual is given a sedative.  

  • Sigmoidoscopy: This process is performed without sedation. In this procedure, a flexible sigmoidoscope is inserted through the anus to view the inside rectum and lower colon.

  • Double-contrast barium enema: Here, an x-ray is used to see if there is any abnormal growth in the colon. In this process, an enema is given, and then air is blown into the rectum to expand and view the colon. 

  • FIT (Fecal Immunochemical Test): It is used to see the hidden blood in the stool. The stool is collected and sent to the lab for examination.

  • Stool DNA test: This test detects the sections of abnormal DNA and hidden blood products in the stool.

  • Guaiac-based fecal occult blood test (gFOBT): This test is also used to screen for any hidden blood in the stool.

  • CT colonography (virtual colonoscopy): It uses a CT scan to produce multiple images of the colon. 

If, during screening tests, a doctor finds that something is not normal with the colon, then the following tests are recommended for diagnosis. 

  • Biopsy:In this procedure, some cells are taken from the body and sent to a lab to be tested.

  • Imaging tests: (ultrasound, X-rays, MRI scan, angiography, PET scan, and CT scan)

  • Proctoscopy: It uses the tool proctoscope to examine the anus and rectum.

  • Blood tests: (Complete blood count (CBC), Circulating tumour cell tests, Tumour markers, and Blood protein testing)

Treatment options for Colorectal Cancer

As Colorectal Cancer has different stages, the treatment is given accordingly. Moreover, a skilled doctor considers various factors such as age, lifestyle, and other health conditions (if any) to determine the right treatment option for the individual. Depending upon the patient’s case, the doctor might choose from the following options. 

Surgery

This treatment is given at the early stage of Colon Cancer, in which the surgeon removes the cancerous cells (polyps). This type of surgery is known as polypectomy

If cancer spreads in the nearby area of the colon, then a colectomy is performed. In this process, the surgeon takes out the part of the colon and the surrounding area where the cancer has spread. 

When cancer reaches the bowel walls, the surgeon removes the lymph nodes and the portion of the colon or rectum. This surgery is known as colostomy

Depending on where the cancer is, the surgeon performs different surgeries, such as endoscopy, laparoscopic surgery, and palliative surgery.

Chemotherapy

A surgeon recommends this treatment to kill cancer cells or control tumour growth. In some cases, chemotherapy is done before surgery to shrink a tumour and after the surgery to destroy the lingering cancerous cells. If cancer has invaded other organs, then also chemotherapy is recommended.

The treatment involves the use of drugs such as capecitabine (Xeloda), oxaliplatin (Eloxatin), fluorouracil, and irinotecan (Camptosar). The side effects of chemotherapy include fatigue, hair loss, nausea, and vomiting. These side effects are then controlled with other medications. 

Radiation therapy

In this therapy, high-energy gamma rays are used to target and kill cancerous cells. It is not a common treatment for Colon Cancer. However, radiation therapy can be used before or after surgery or to ease the signs of advanced Colon Cancer that result in pain, bleeding, or internal blockage. Sometimes doctors use it along with chemotherapy to help control cancer. 

Oncologists suggest external or internal radiation therapy depending on the individual’s case. Radiation treatment has some side effects, such as diarrhoea, mild skin changes, weight loss, nausea, loss of appetite, vomiting, and fatigue. Many of these side effects usually disappear in a few weeks once the treatment is finished.

Drugs to treat Colon Cancer

The Food and Drug Administration (FDA) also recommends targeted therapies and immunotherapies and has approved the following drugs. Please consult a doctor before taking any medication/drugs.

  1. Cetuximab (Erbitux)

  2. Bevacizumab (Avastin)

  3. Nivolumab (Opdivo)

  4. Panitumumab (Vectibix)

  5. Ramucirumab (Cyramza)

  6. Ipilimumab (Yervoy)

  7. Regorafenib (Stivarga)

  8. Ziv-Aflibercept (Zaltrap)

  9. Pembrolizumab (Keytruda)

How to prevent Colorectal Cancer

The following tips can reduce the risk of developing this type of cancer.

  • Maintain a healthy weight, as being overweight can lead to Colon or Rectal Cancer

  • Stop smoking and limit alcohol

  • Stay physically active (brisk walking, moderate workouts, dancing, etc.)

  • Get enough vitamin D and calcium (nuts, low-fat dairy, beans, fortified plant-based milk, tuna, and eggs)

  • Consume a diet rich in fibre and whole grains (fruits, veggies, whole-grain cereals, etc.)

  • Limit red meat and processed meat intake

Frequently asked questions (FAQs)

Here is the rundown of the commonly asked questions about Colorectal Cancer.

Is Colorectal Cancer curable?

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It is treatable and often curable.

What decreases the risk of Colorectal Cancer?

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Maintaining a healthy weight, increasing physical activity, limiting alcohol intake, and avoiding smoking and tobacco use can decrease the risk of Colon or Rectal Cancer.

Does Colon Cancer spread fast?

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It depends on the factors such as age and overall health of the individual. Usually, it does not spread fast, but one should consider timely medical attention if one encounters the symptoms.

Can you live a long life after Colon Cancer?

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Colon Cancer is treatable, and the majority of people can live normal lives after the treatment.

When to visit a doctor?

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You should visit a doctor if you see blood in the stool and a change in bowel movement. Make sure to seek help at the earliest if you are above 50 years.

References

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. It is based on several secondary sources on the internet. As this content piece is not vetted by a medical professional, please consult a doctor before making any health-related decisions.

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