Understanding Coloreactal Cancer And
How To Manage It

Your guide to understanding all aspects of colorectal cancer

“When you come to the end of your rope, tie a knot and hang on.” 

Franklin D. Roosevelt

Early detection and diagnosis always increase your chances of receiving successful treatment and beating all forms of cancer – especially colorectal cancer. Detecting colorectal cancer early will significantly boost your odds of survival.

You can read the section that details the various types of cancer before embarking on the journey to understand colorectal cancer better. Read more

Let’s understand
the anatomy first

The colon is an essential part of the human digestive system. The digestive system removes and processes nutrients from foods and helps pass waste material out of the body. The colon (large bowel) is the first part of the large intestine and is about 5 feet long. Together, the rectum and anal canal make up the last part of the large intestine. The anal canal ends at the anus.

What is colorectal cancer?

Colorectal cancer (also known as bowel cancer) begins when malignant cells start to form in the walls of the lower digestive tract (large intestine and rectum). These cells grow in an abnormal or uncontrolled manner and form a cell clump known as a polyp or adenoma. These are mostly benign, but can sometimes become cancerous. Cancer may sometimes spread or metastasize through the cancerous polyps and tissue to other parts of the body.

Types of Colorectal Cancer

Most colorectal cancers are classified as adenocarcinomas. These cancers start in the cells that make mucus to lubricate the inside of the colon and rectum. Other rarer types of cancers can originate in the colon and rectum as well these include

Carcinoid tumours

Gastrointestinal stromal tumours (GIST)

Lymphomas

Sarcomas

Carcinoid tumours

Gastrointestinal stromal tumours (GIST)

Lymphomas

Sarcomas

What causes colorectal cancer?

Clinical practitioners and researchers do not know the exact causes of colorectal cancer. There are certain risk factors (detailed below) that can increase your chance of developing it; however, having one or more risk factors does not mean that you will definitely get colorectal cancer. On the other hand, having no risk factors also does not mean you will not get the disease. Colorectal cancer is likely to be caused by a combination of these factors, rather than just one.

What are the Risk Factors?

Colorectal cancer often goes undetected as the symptoms are similar to those of indigestion. It is therefore important to remain vigilant of the common signs and symptoms, which include

A family history of colorectal cancer

Excessive smoking or use of chewing tobacco

High alcohol consumption

Obesity

What can be done to lower your risk of getting colorectal cancer?

Evidence suggests that taking appropriate steps to avoid risk factors like smoking and excessive alcohol consumption may reduce the risk of colorectal cancer. Having a lifestyle that includes regular physical activity has also been linked to a decreased risk of colorectal cancer. Being treated for polyps and adenomas in a timely manner may also reduce the probability of getting colorectal cancer.

What are the Symptoms?

Colorectal cancer often goes undetected as the symptoms are similar to those of indigestion. It is therefore important to remain vigilant of the common signs and symptoms, which include

Blood in the stools

Changes in bowel habits (including more frequent bowel movements, constipation or diarrhoea)

Changes in the appearance or consistency of bowel movements

Changes in bowel function (such as feeling the bowel hasn’t emptied completely after a bowel movement)

Feeling of bloating

Unexplained weight loss

Extreme fatigue

Pain in the rectum or anal area

A lump in the abdomen

Pain, cramps or swelling in the abdomen

Iron deficiency anaemia (low red blood cell count)

Screening for colorectal cancer

Colorectal cancer may occur in both men and women. If you experience any of the symptoms listed above or any other inexplicable change, make an appointment with your doctor for prompt evaluation. If you or your loved one have a family history of colorectal cancer, have an open discussion with your doctor about undergoing genetic testing or routine check-ups.

Screening tests for colorectal cancer

Screening tests may be done when you have no cancer symptoms at all. The main objective of screening is to detect precancerous changes at the cellular level, which if left untreated can lead to cancer. The secondary objective is to find the cancer at an early stage, when treatment is usually more successful.

It is important to remember that your physician does not necessarily think you have cancer if he or she suggests a screening test. They could just be following a normal screening protocol for your age group.

Fecal Occult Blood Test

What to expect

The fecal occult blood test is a routine screening test to check for colorectal cancer. It is a laboratory test used to check stool samples for hidden (occult) blood. If hidden blood is found, additional tests may be required to determine the source of the bleeding. 

The fecal occult blood test is generally pain-free, unless you have an underlying condition that makes it painful or uncomfortable to pass bowel movements. It is important that you choose a doctor and clinical team that you are comfortable with to perform your test. 

Prior to undergoing the fecal occult blood test, your doctor may ask you to avoid certain fruits and vegetables, and red meat. If you are taking any vitamins, supplements, ayurvedic medicines or homeopathic medicines, inform your doctor prior to taking the test.

During the test:

  • You will typically be given a test kit, with room for collecting two or three stool samples.
  • You will be asked to collect a stool sample from two or three bowel movements, usually taken on consecutive days.
  • Be sure to collect the samples in a clean container.
  • After the samples are ready, you will be asked to return them to your doctor or a designated lab.

Colonoscopy

What to expect

A colonoscopy is used to examine the lining of the bowel from the inside. During the procedure, your doctor will examine your bowel for any polyps that could be cancerous. You can expect some minor pain or discomfort while undergoing the procedure. It is important that you choose a doctor and clinical team that you are comfortable with to perform your procedure.

Prior to the procedure, you will need to ensure that your colon is empty. Any residue may obscure the view of the colon and rectum during the exam. In order to ensure that the colon is empty, your doctor may ask you to:

  • Refrain from taking solid foods the day before the procedure
  • Have clear liquids (such as plain water, black tea or black coffee or juices)
  • Stop taking food and liquids the night before the procedure
  • Take a laxative
  • Have an enema

It is important that you follow the instructions given by your doctor in order to ensure a successful procedure. Be sure to inform your doctor prior to the procedure if:

  • You are pregnant or breastfeeding
  • You have previously had an allergic reaction to sedatives
  • You are taking any vitamins, supplements, ayurvedic medicines or homeopathic
    medicines

During a colonoscopy:

  • You will be asked remove your clothing (including undergarments) and change into a hospital gown. You may also be asked to empty your bladder.
  • You may be given a mild sedative or pain medication, either in a pill form or through an IV, to minimize discomfort during the procedure.
  • You will be asked to lie on your side on the examination table, usually with your knees drawn towards your chest.
  • Try to relax, as this will make the procedure more comfortable for you.
  • Next, the doctor will insert a colonoscope into your rectum. The colonoscope is a long, flexible tube with a tiny camera attached at the tip.
  • The doctor will then move the colonoscope through your colon. When the scope is moved, you may feel mild abdominal cramping or have the urge to have a bowel movement.
  • If any abnormal areas or polyps are seen, your doctor may recommend that a biopsy be done.
  • The exam will usually take 30 minutes to an hour to complete.
  • After the procedure, you may receive special instructions regarding the sedative. For
    example, your doctor may keep you under observation while you recover, to ensure that you do not have an allergic reaction. You may also be told to temporarily follow a special diet.
  • You may feel a cramping pain and experience light bleeding after the procedure. Ifyou experience excessive bleeding or persistent abdominal pain, inform your doctor immediately.

Diagnostic tests for colorectal cancer

If the screening protocol detects abnormalities, your doctor may recommend further follow-up diagnostic tests to confirm if cancer is present. Refer to this section for more information about diagnostic tests for colorectal cancer. Read more

Staging colorectal Cancer

If your doctor confirms that you have colorectal cancer, further tests may be done to study the cancer cells and determine

If the disease has spread beyond the bowel (i.e. determine the stage of cancer)

How quickly the cancer will grow

How likely it is to spread through the body

What sort of treatments might work

The likelihood of the cancer to recur (come back)

The stage of your cancer is a key aspect in determining your treatment. Refer to this section to understand your cancer diagnosis and for more information about how colorectal cancer is staged. Read more

Treatments for
Coloreactal cancer
The decision about the best course of treatment is based on these test results and the type, stage, grade and size of your tumour. Treatments like surgery, chemotherapy and radiation therapy are some of the options used for colorectal cancer. Refer to this section to understand the types of cancer treatments for colorectal cancer and possible side effects. Read more
Your cancer journey

Everyone deals with a colorectal cancer diagnosis and treatment in a different way. Refer to this section, to understand various aspects of your cancer journey and the road to recovery. Read more

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