Causes and Risk Factors of Colon and Rectal Cancer

Causes and risk factors 

Age : – About 90 percent of people diagnosed with colon cancer are older than 50. Colon cancer can occur in younger people, but it occurs much less frequently.

A personal history of colorectal cancer or polyps : – If you’ve already had colon cancer or adenomatous polyps, you have a greater risk of colon cancer in the future.

Inflammatory intestinal conditions : – Long-standing inflammatory diseases of the colon, such as ulcerative colitis and Crohn’s disease, can increase your risk of colon cancer.

Inherited disorders that affect the colon : – Genetic syndromes passed through generations of your family can increase your risk of colon cancer. These syndromes cause only about 5 percent of all colon cancers. One genetic syndrome called familial adenomatous polyposis (FAP) is a rare disorder that causes you to develop thousands of polyps in the lining of your colon and rectum.

When to seek medical advice

If you notice any symptoms of colon cancer, such as blood in your stool or a persistent change in bowel habits, see your doctor as soon as possible. Keep in mind that colorectal cancer can occur in younger as well as older people. If you’re at high risk, don’t wait until symptoms appear. See your doctor for regular screenings.

Talk to your doctor about when you should begin screening for colon cancer. Guidelines generally recommend colon cancer screenings begin at age 50. Your doctor may recommend more frequent or earlier screening if you have other risk factors, such as a family history of the disease.

Tests and diagnosis

Screening

Most colon cancers develop from adenomatous polyps. Screening can detect polyps before they become cancerous. Screening may also detect colon cancer in its early stages when there is a good chance for cure.

You may be embarrassed by the screening procedures, worried about discomfort or afraid of the results. Discuss your screening options and your concerns with your doctor. Most procedures are only moderately uncomfortable, and working with a doctor you like and trust can help ease your embarrassment…

Diagnosis 

If your doctor suspects you may have colon cancer based on your signs and symptoms, he or she may recommend colonoscopy to look for colon cancer. Colonoscopy allows your doctor to look for polyps or unusual areas in your colon. Your doctor can also remove a sample of tissue from your colon to look for cancer cells. In some cases, barium enema or flexible sigmoidoscopy may be used to diagnose colon cancer.

Treatments 

The type of treatment your doctor recommends will depend largely on the stage of your cancer. The three primary treatment options are: surgery, chemotherapy and radiation.

• Surgery :Surgery is the mainstay of treatment and involves in block removal of diseased segment with adequate margins, surrounding tissue and lymph nodes. The names given to such resections are right hemicolectomy, transverse colectomy, left hemicolectomy, sigmoid colectomy, and subtotal colectomy
• Polypectomy : If the cancer is found in a polyp (a small piece of bulging tissue), the polyp is often removed during a colonoscopy.
• Local excision : If the cancer is found on the inside surface of the rectum and has not spread into the wall of the rectum, the cancer and a small amount of surrounding healthy tissue is removed.
• Resection : If the cancer has spread into the wall of the rectum, the section of the rectum with cancer and nearby healthy tissue is removed. Sometimes the tissue between the rectum and the abdominal wall is also removed. The lymph nodes near the rectum are removed and checked under a microscope for signs of cancer.
• Pelvic exenteration : If the cancer has spread to other organs near the rectum, the lower colon, rectum, and bladder are removed.

Low Cost Colon Cancer Treatment in India

Diagnostic tests for colorectalcancer are usually done when:

• the symptoms of colorectal cancer are present

• the doctor suspects colorectal cancer after talking with a person about their health and completing a physical examination

• screening tests suggest a problem with the colon or rectum

Many of the same tests used to initially diagnose cancer are also used to determine the stage (how far the cancer has progressed). Your doctor may also order other tests to check your general health and to help plan your treatment. Tests may include the following.

Medical history and physical examination The medical history is a record of present symptoms, risk factors and all the medical events and problems a person has had in the past. The medical history of a person's family may also help the doctor to diagnose colorectal cancer. In taking a medical history, the doctor will ask questions about: a personal history of polyps in the colon or rectum inflammatory bowel disease colorectal cancer a family history of colorectal cancer familial adenomatous polyposis hereditary non-polyposis colorectal carcinoma (also known as Lynch syndrome) signs and symptoms Tumour marker tests Tumour markers are substances – usually proteins – in the blood that may indicate the presence of colorectal cancer. Tumour marker tests are used to check a person's response to cancer treatment, but they can also be used to diagnose colorectal cance Colonoscopy A colonoscopy is a procedure that lets the doctor look at the lining of the colon using a flexible tube with a light and lens on the end (an endoscope). A colonoscopy is preferred over a flexible sigmoidoscopy because the entire colon can be checked for polyps or abnormal areas. A colonoscopy is done in a hospital on an outpatient basis. The doctor gently inserts the colonoscope (a type of endoscope) through the anus and slowly moves it into the rectum and colon. The colon is inflated with air to stretch out the lining so the doctor can look at the entire surface. This can be uncomfortable, so drugs are given to help the person relax during the procedure. Biopsy During a biopsy, tissues or cells are removed from the body so they can be tested in a laboratory. The pathology report from the laboratory will confirm whether or not cancer cells are present in the sample and may also identify the type of cancer. A biopsy is the only definite way to diagnose colorectal cancer. Biopsies of polyps or abnormal areas are taken during a sigmoidoscopy or colonoscopy. A biopsy sample will allow the doctor to find out the type of colorectal cancer and the grade. Biopsy results may also show how far the cancer has grown through the wall of the colon or rectum. Computed tomography (CT) scan A CT scan uses special x-ray equipment to make 3-dimensional and cross-sectional images of organs, tissues, bones and blood vessels inside the body. A computer turns the images into detailed pictures. It is used to: check if the cancer has spread to other organs in the abdomen or pelvis (small areas of spread [microscopic spread] may not be detected by CT scan) check if the cancer has spread to the lymph nodes in the abdomen check how far the tumour has grown into the wall of the colon or, especially, the rectum CT-guided needle biopsy CT scans may also be used to help guide a needle to perform a biopsy (CT-guided needle biopsy) to check for cancer cells in a tumour in the colon or a suspected area of metastasis (cancer spread outside of the colon or rectum). Virtual colonoscopy Virtual colonoscopy uses a CT scan to create images of the colon without having to insert an endoscope through the rectum. A virtual colonoscopy is less invasive and more comfortable than a regular colonoscopy. Studies are continuing to examine the effectiveness of this test.  Ultrasound  Ultrasound uses high-frequency sound waves to make images of structures in the body. Endorectal ultrasound (EUS or ERUS) uses a special instrument (transducer) that is inserted into the rectum. It is used to see: how far a tumour has grown into the rectal wall if the tumour has spread to nearby organs or lymph nodes Abdominal ultrasound may be done to see if the cancer has spread to other organs in the abdomen, such as the liver. Pelvic ultrasound may be done if doctors suspect that the cancer has spread to the urinary tract. An ultrasound may also be used during abdominal surgery. The surgeon can place the transducer directly on the liver to check for metastases. Positron emission tomography (PET) scan A PET scan uses radioactive materials (radiopharmaceuticals) to detect changes in the metabolic activity of body tissues. A computer analyzes the radioactive patterns and makes 3-dimensional colour images of the area being scanned. PET scans are not routinely used to diagnose colorectal cancer. They are more commonly used to help stage and check for recurrent disease if a person's CEA level starts to rise following treatment. PET scans are not readily available at all centres. For more information visit:          http://www.medworldindia.com                           https://www.facebook.com/medworld.india Please scan and email your medical reports  to us at care@medworldindia.com and we shall get you a Free Medical Opinion from India’s Best Doctors. Call Us : +91-9811058159 Mail Us : care@medworldindia.com

Tests used to screen for Colorectal Cancer

The tests used to screen for colorectal cancer are described below:

Colonoscopy. This test allows the doctor to look inside the entire rectum and colon while a patient is sedated. A flexible, lighted tube called a colonoscope is inserted into the rectum and the entire colon to look for polyps or cancer. During this procedure, a doctor can remove polyps or other tissue for examination (see biopsy in theDiagnosis section). This is the only screening test that allows the removal of polyps, which can also prevent colorectal cancer.

Computed tomography (CT or CAT) colonography. CT colonography, sometimes called virtual colonoscopy, is a screening method being studied in some centers. It requires interpretation by a skilled radiologist, a doctor who specializes in obtaining and interpreting medical images, to be used to the best advantage. However, it may be an alternative for people who cannot have a standard colonoscopy due to the risk of anesthesia, which is medication to block the awareness of pain, or if a person has a blockage in the colon that prevents a full examination.

Sigmoidoscopy. A sigmoidoscope is a flexible, lighted tube, and it is inserted into the rectum and lower colon to check for polyps, cancer, and other abnormalities. During this procedure, a doctor can remove polyps or other tissue for later examination. The doctor cannot check the upper part of the colon, the ascending and transverse colon, with this test. If polyps or cancer is found using this test, a colonoscopy to view the entire colon is recommended.

Fecal occult blood test (FOBT). This is a test used to find blood in the feces, or stool, which can be a sign of polyps or cancer. A positive FOBT test, meaning that blood is found in the feces, can be from causes other than a colon polyp or cancer, including bleeding in the stomach or upper GI tract and even ingestion of rare meat or other foods. There are two types of tests: guaiac and immunochemical. Polyps and cancers do not bleed continually, so the FOBT must be done on several stool samples each year and should be repeated yearly. Even then, the reduction in deaths from colorectal cancer is fairly small at around 30% if done yearly and 18% if done every other year.

Double contrast barium enema (DCBE). For patients who cannot have a colonoscopy, an enema containing barium is given, which helps the outline of the colon and rectum stand out on x-rays. A series of x-rays is then taken of the colon and rectum. In general practice, most doctors would recommend other screening tests because a barium enema is less likely to detect precancerous polyps than a colonoscopy, sigmoidoscopy, or CT colonography.

Stool DNA tests. This test analyzes the DNA from a person’s stool sample to look for cancer. It uses changes in the DNA that occur in polyps and cancers to determine whether a colonoscopy should be done.

Screening Recommendations

Different organizations have made different recommendations for colorectal cancer screening. Two sets of recommendations are described below. Talk with your doctor about the best test and time between tests based on your health history and personal cancer risk.

The following tests detect both polyps and cancer:

• Flexible sigmoidoscopy, every five years
• Colonoscopy, every 10 years
• DCBE, every five years
• CT colonography, every five years

These tests primarily detect cancer:

• Guaiac-based FOBT, every year
• Fecal immunochemical test, every year
• Stool DNA test, as often as your doctor recommends
  
  
  
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Major factors that may increase your risk of Colon Cancer

Causes and risk factors of colon and rectal cancer

Age : – About 90 percent of people diagnosed with colon cancer are older than 50. Colon cancer can occur in younger people, but it occurs much less frequently.

A personal history of colorectal cancer or polyps : – If you’ve already had colon cancer or adenomatous polyps, you have a greater risk of colon cancer in the future.

Inflammatory intestinal conditions : – Long-standing inflammatory diseases of the colon, such as ulcerative colitis and Crohn’s disease, can increase your risk of colon cancer.

Inherited disorders that affect the colon : – Genetic syndromes passed through generations of your family can increase your risk of colon cancer. These syndromes cause only about 5 percent of all colon cancers. One genetic syndrome called familial adenomatous polyposis (FAP) is a rare disorder that causes you to develop thousands of polyps in the lining of your colon and rectum.

When   to seek medical advice

If you notice any symptoms of colon cancer, such as blood in your stool or a persistent change in bowel habits, see your doctor as soon as possible. Keep in mind that colorectal cancer can occur in younger as well as older people. If you’re at high risk, don’t wait until symptoms appear. See your doctor for regular screenings.

Talk to your doctor about when you should begin screening for colon cancer. Guidelines generally recommend colon cancer screenings begin at age 50. Your doctor may recommend more frequent or earlier screening if you have other risk factors, such as a family history of the disease.

Testsand diagnosis

Screening

Most colon cancers develop from adenomatous polyps. Screening can detect polyps before they become cancerous. Screening may also detect colon cancer in its early stages when there is a good chance for cure.

You may be embarrassed by the screening procedures, worried about discomfort or afraid of the results. Discuss your screening options and your concerns with your doctor. Most procedures are only moderately uncomfortable, and working with a doctor you like and trust can help ease your embarrassment…

Diagnosis 

If your doctor suspects you may have colon cancer based on your signs and symptoms, he or she may recommend colonoscopy to look for colon cancer. Colonoscopy allows your doctor to look for polyps or unusual areas in your colon. Your doctor can also remove a sample of tissue from your colon to look for cancer cells. In some cases, barium enema or flexible sigmoidoscopy may be used to diagnose colon cancer.

Treatments 

The type of treatment your doctor recommends will depend largely on the stage of your cancer. The three primary treatment options are: surgery, chemotherapy and radiation.

• Surgery :Surgery is the mainstay of treatment and involves in block removal of diseased segment with adequate margins, surrounding tissue and lymph nodes. The names given to such resections are right hemicolectomy, transverse colectomy, left hemicolectomy, sigmoid colectomy, and subtotal colectomy:
• Polypectomy : If the cancer is found in a polyp (a small piece of bulging tissue), the polyp is often removed during a colonoscopy.
• Local excision : If the cancer is found on the inside surface of the rectum and has not spread into the wall of the rectum, the cancer and a small amount of surrounding healthy tissue is removed.
• Resection : If the cancer has spread into the wall of the rectum, the section of the rectum with cancer and nearby healthy tissue is removed. Sometimes the tissue between the rectum and the abdominal wall is also removed. The lymph nodes near the rectum are removed and checked under a microscope for signs of cancer.
• Pelvic exenteration : If the cancer has spread to other organs near the rectum, the lower colon, rectum, and bladder are removed.
  
  
  

Most Advanced Laparoscopic Surgery to Treat Colon Cancer

Colon cancer is cancer of the large intestine (colon), the lower part of your digestive system. Rectal cancer is cancer of the last several inches of the colon. Together, they're often referred to as colorectal cancers. Most cases of colon cancer begin as small, noncancerous (benign) clumps of cells called adenomatous polyps. Over time some of these polyps become colon cancers.

These are the third most commonly diagnosed cancers in world. They start as a small proliferated, ulcerated lesions or thickenings from the inner most layers of bowel lining. Left untreated they grow in size, extend through the wall to adjacent organs, involve nearby lymph nodes and at latter stages involve the liver and other distant organs, through blood stream, manifesting as different stages of disease progression.

Colon Cancer Symptoms

Many cases of colon cancer have no symptoms. The following symptoms, however, may indicate colon cancer:

·         Pain and tenderness in lower abdomen

·         Passing of Blood in the stool

·         Constipation, Diarrhea or other changes in bowel habits like narrow stools.

·         Abrupt Weight loss

How is for Colon Cancer diagnosed?

·         Colonoscopy: An endoscope is inserted into the rectum and advanced through the colon, through this the doctor can examine the entire colon.

·         Diagnosis is confirmed with a colon biopsy - Stage of disease is confirmed by pathologists and imaging tests, such as computerized tomography (CT or CAT) scans.

·         Endoscopic ultrasound and magnetic resonance imaging (MRI) may also be used to stage rectal cancer

·         Sigmoidoscopy: In this an endoscope is interested in the rectum and moved through the left side of the colon. It cannot be used to view the middle and right sides of the colon.

·         Fecal occult blood test (FOBT) along with Complete blood count (CBC to check for anemia and CT , MRI or PET scans of the abdomen, pelvic area.

Stages of Colon Cancer

The staging of colon cancer helps doctors determine a course of treatment. Staging is done on a scale from 0 to 4, with the higher stages indicating a cancer than has spread more throughout the body.

·         Stage 0: In this stage, the cancer hasn’t grown beyond the inner layer of the colon or rectum.

·         Stage I: The cancer has spread through the colon’s inner lining, but hasn’t spread beyond the colon wall or rectum.

·         Stage II: The cancer has grown through the colon or rectal wall, but hasn’t spread to nearby lymph nodes.

·         Stage III: The cancer has invaded nearby lymph nodes but isn’t affecting other parts of the body.

·         Stage IV: The cancer has metastasized throughout the body to sites such as the liver, lung, ovaries or the lining of the abdominal cavity.

 

Surgery to treat colon cancer

Surgery is the cornerstone of treatment for colon cancer. You may need to have the entire colon removed or only part of your colon.

·     How much of your colon has to be removed depends on the location and particular characteristics of your tumour. Sometimes only a polyp is cancerous, and removal of the polyp may be all that is necessary.

·      

      Surgery may also be done to relieve symptoms when the cancer has caused a bowel obstruction. The usual procedure is bypass for obstructions that cannot be cured.

Rather than making long incisions common in traditional "open" surgery, laparoscopic surgery requires only small incisions to perform the operation.

What is laparoscopic surgery?

The word "laparoscopy" means to look inside the abdominal cavity with a special camera or scope. To perform laparoscopy, three or four small (five-10mm) incisions are made in the abdomen. The laparoscope and surgical instruments are inserted through these small incisions. The surgeon is then guided by the laparoscope, which transmits a picture of the intestinal organs on a video monitor.

The benefit of using this surgical approach is that you are less likely to experience pain and scarring after surgery, a more rapid recovery and less risk of infection.

Colon surgeons have used laparoscopy to treat the following conditions:

·         Crohn's disease

·         Certain bowel cancers

·         Diverticulitis

·         Familial polyposis

·         Faecal incontinence

·         Rectal prolapse

·        

Factors that may increase your risk of colon cancer - Low cost Colon Cancer Treatment in India

Cancer Treatment  in India

The human colon is a muscular, tube-shaped organ measuring about 4 feet long. It extends from the end of your small bowel to your anus, twisting and turning through your abdomen (belly). The colon has 3 main functions.

• To digest and absorb nutrients from food
• To concentrate fecal material by absorbing fluid (and electrolytes) from it
• To store and control evacuation of fecal material

The right side of your colon plays a major role in absorbing water and electrolytes, while the left side is responsible for storage and evacuation of stool.

Factors that may increase your risk of colon cancer include:

·  Older age. About 90 percent of people diagnosed with colon cancer are older than 50. Colon cancer can occur in younger people, but it occurs much less frequently.

·  African-American race. African-Americans have a greater risk of colon cancer than do people of other races.

·  A personal history of colorectal cancer or polyps. If you've already had colon cancer or adenomatous polyps, you have a greater risk of colon cancer in the future.

·  Inflammatory intestinal conditions. Chronic inflammatory diseases of the colon, such as ulcerative colitis and Crohn's disease, can increase your risk of colon cancer.

·  Family history of colon cancer and colon polyps. You're more likely to develop colon cancer if you have a parent, sibling or child with the disease. If more than one family member has colon cancer or rectal cancer, your risk is even greater.

·  Low-fiber, high-fat diet. Colon cancer and rectal cancer may be associated with a diet low in fiber and high in fat and calories. Research in this area has had mixed results. Some studies have found an increased risk of colon cancer in people who eat diets high in red meat.

·  A sedentary lifestyle. If you're inactive, you're more likely to develop colon cancer. Getting regular physical activity may reduce your risk of colon cancer.

·  Diabetes. People with diabetes and insulin resistance may have an increased risk of colon cancer.

·  Obesity. People who are obese have an increased risk of colon cancer and an increased risk of dying of colon cancer when compared with people considered normal weight.

·  Smoking. People who smoke cigarettes may have an increased risk of colon cancer.

How is for Colon Cancer diagnosed?

·  Colonoscopy: An endoscope is inserted into the rectum and advanced through the colon, through this the doctor can examine the entire colon.

·  Diagnosis is confirmed with a colon biopsy - Stage of disease is confirmed by pathologists and imaging tests, such as computerized tomography (CT or CAT) scans.

·  Endoscopic ultrasound and magnetic resonance imaging (MRI) may also be used to stage rectal cancer

·  Sigmoidoscopy: In this an endoscope is interested in the rectum and moved through the left side of the colon. It cannot be used to view the middle and right sides of the colon.

·  Fecal occult blood test (FOBT) along with Complete blood count (CBC) to check for anemia and CT , MRI or PET scans of the abdomen, pelvic area

Treatment Options available for Colon Cancer at B est Cancer Hospitals in India

Minimal Invasive Laparoscopic Colon Cancer Surgery

The surgeon enters the abdomen by placing a canula (a narrow tube like instrument) into the abdomen (belly) through a small incision (½ -- ¼ inch)

Carbon Dioxide gas is pumped into the abdomen through the port (cannula) to puff-up or inflate the belly, making working room for the surgeon.

 A laparoscope (a tiny telescope connected to a video camera) is placed through the canula, and allows the surgeon to see a magnified lighted view of the internal organs on a TV monitor

 2 to 4 other canulas are inserted to allow use of special instruments to work inside the abdominal cavity (belly).

For more information visit:          http://www.medworldindia.com        
                    https://www.facebook.com/medworld.india

Please scan and email your medical reports  to us at care@medworldindia.com and we shall get you a Free Medical Opinion from India’s Best Doctors.

Call Us : +91-9811058159

Mail Us : care@medworldindia.com