What are the symptoms of colorectal cancer?

The symptoms of colorectal cancer (cancer of the colon or rectum) can vary, but some of the most common include:

1. Change in bowel habits:

• Diarrhea or constipation that persists
• Narrowing of stools
• A feeling of incomplete bowel emptying

1. Blood in stool:

• Bright red blood from the rectum
• Dark red/maroon colored stools indicating bleeding from higher up

1. Abdominal discomfort:

• Cramps, gas pains, or bloating
• A persistent feeling of abdominal fullness

1. Fatigue and weakness:

• Due to blood loss from intestinal bleeding

1. Unexplained weight loss
2. Nausea and vomiting

• Caused by intestinal obstruction in some cases

Other possible symptoms:

• Anemia (from chronic blood loss)
• Abdominal mass or lump
• Change in appetite

Many of these symptoms can also indicate other gastrointestinal issues. But persistent or worsening symptoms should prompt a visit to the doctor, especially for those over age 50 or with a family history of colon cancer.

It’s important to note that early stage colorectal cancer may not cause any noticeable symptoms. This underscores the importance of regular screening, even when feeling well. As the cancer advances, signs and symptoms become more likely.

Seeking prompt medical evaluation for any unusual GI symptoms or positive screening tests can allow for early detection when colorectal cancer is most treatable.

What are the causes of colorectal cancer?

Colorectal cancer can develop due to a combination of genetic and environmental factors. Some of the main causes and risk factors include:

1. Age – The risk increases significantly after age 50.
2. Personal history of colorectal polyps or inflammatory bowel disease (ulcerative colitis, Crohn’s disease).
3. Family history – Having a first-degree relative (parent, sibling, child) with colorectal cancer increases your risk.
4. Inherited gene mutations – Conditions like familial adenomatous polyposis (FAP) or hereditary non-polyposis colorectal cancer (HNPCC/Lynch syndrome).
5. Diet – A diet high in red/processed meats and low in fiber may increase risk.
6. Obesity and lack of physical activity.
7. Smoking and heavy alcohol use.
8. Type 2 diabetes.
9. Racial/ethnic background – Higher rates in African American and Ashkenazi Jewish populations.

The exact cause is not fully understood, but it develops from mutations in the DNA of colon/rectal cells leading to uncontrolled cellular growth and tumor formation. Most cases arise from precancerous adenomatous polyps in the colon/rectum.

While some risk factors like age, gender and genetics are unchangeable, modifying lifestyle factors like diet, weight, physical activity and avoiding smoking can help reduce risk.

Screening is very important as it allows for early detection and removal of precancerous polyps before they become cancerous. Regular colonoscopies are recommended from age 45-50 in average risk individuals.

What is the treatment for colorectal cancer?

The treatment for colorectal cancer depends on several factors, including the stage and location of the cancer, as well as the patient’s overall health. Here are some of the common treatment approaches:

Surgery:

• For early-stage cancers confined to the colon/rectum, surgery is the primary treatment. The cancerous section of the colon or rectum is removed, along with nearby lymph nodes.
• Types of surgery include colectomy (colon removal), low anterior resection (rectum removal), and abdominoperineal resection (removal of rectum and anus).

Radiation Therapy:

• Radiation is often used before or after surgery for rectal cancers to shrink tumors and kill any remaining cancer cells.
• It can also be used as primary treatment when surgery is not an option.

Chemotherapy:

• Chemo is commonly used after surgery (adjuvant) to destroy any remaining cancer cells and prevent recurrence.
• It can also be given before surgery (neoadjuvant) along with radiation to shrink tumors.
• For advanced cancers, chemo may be the primary treatment.

Targeted Therapy:

• Newer drugs that target specific gene mutations in colorectal cancer cells may be used, especially for advanced cases.
• Examples include cetuximab, panitumumab, and bevacizumab.

Immunotherapy:

• Medications that leverage the body’s immune system to fight the cancer may be options for some patients.

In many cases, a multimodal approach combining surgery with chemotherapy, radiation, and/or targeted therapies is used based on staging and risk factors.

Palliative treatments to relieve symptoms and side effects are also very important, especially for advanced stage cancers.

The treatment plan is individualized, considering the patient’s age, overall health, cancer characteristics, and goals of therapy (curative vs palliative).