Complete guide to colon cancer and how to combat it

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Complete guide to colon cancer and how to combat it

In this guide, you will find everything you need to know about colon cancer: symptoms, diagnosis, conventional treatments and complementary alternative therapies .

What is colon cancer?

Colon (or colorectal) cancer affects the large intestine (colon) or the rectum (the final part of the colon). Usually, it starts with a group of cells (adenomatous polyp) that can form tumors in the lining of the large intestine.

Depending on the exact place where the cancer originates, it is called either colon or rectal cancer, but these two types of cancer are often grouped together because they share many of the same characteristics. There are some types of cancer (that are less common) that do not reach the rectum, such as lymphoma, carcinoid tumors, melanoma and sarcoma. However, to differentiate between these two types of cancer, from now on we will use the term colon cancer to refer to colorectal cancer.

Symptoms

Many people don’t show symptoms in the first stages of the disease and if they do, they tend to vary according to the size and location of the cancer in the large intestine. Possible symptoms include:

  • Changes to intestinal evacuation habits (diarrhea, constipation or reduced diameter of faeces over several days)
  • Rectal bleeding or bright red blood
  • Blood in faeces that may cause stools to appear dark
  • A constant feeling of needing to use the bathroom
  • Abdominal discomfort (cramps, muscle spasms, gas or pain)
  • Weakness or fatigue
  • Unexplained weight loss

Bear in mind that these symptoms can be caused by reasons other than colorectal cancer (e.g. infections, hemorrhoids, or irritable bowel syndrome). However, if you or a relative show any of these symptoms, it is important to consult a doctor as soon as possible to determine the cause and obtain the necessary treatment.

Talk to a doctor about when you should start to carry out testing for colon cancer. In general, it is recommended to start getting tested at the age of 50. However, the doctor may recommend starting testing at an earlier age or more frequently depending on the patient’s risk factors.

Risk factors

1. Advanced age

Most people who suffer from colon cancer are above the age of 50. It can affect young people, but rarely.

2. Personal history of colorectal cancer or polyps

If you have had colon cancer or adenomatous polyps in the past, the risk of developing colon cancer in the future is higher.

3. Inflammatory intestinal disease

Chronic inflammatory diseases of the colon, such as ulcerative colitis and Crohn’s disease, may increase the risk of colon cancer.

4. Hereditary syndromes that increase the risk of suffering from colon cancer

Syndromes of a genetic nature (passed down through generations of your family), such as familial adenomatous polyposis (FAP) or hereditary nonpolyposis colorectal cancer (Lynch syndrome) may increase the risk of colon cancer.

5. Family history of colon cancer

If a parent, sibling or relative has or has had this disease, the chances of getting colon cancer are higher. If more than one member of your family has had this type of cancer, the risk is even greater.

6. Diet low in fiber and high in fat

Colon cancer and rectal cancer may be associated with a diet that is low in fiber and high in fat and calories. Contradictory results have been obtained in the research surrounding this field, but some studies have found an increased risk of colon cancer in people who consume a lot of red meat and processed meat.

7. Sedentary lifestyle

If you have a very inactive lifestyle, your chances of suffering from colon cancer increases. Doing physical activity on a regular basis can reduce your risk of colon cancer.

8. Diabetes

People with diabetes and insulin resistance have a higher risk of suffering from colon cancer.

9. Obesity

Obese people have a higher risk of colon cancer, compared to people within a normal weight range.

10.  Cigarettes and alcohol

People who drink and smoke regularly run a greater risk of developing colon cancer.

Tests for colon cancer

Often, colorectal cancers in the digestive tract may bleed. Sometimes the blood can be seen in the stool or cause it to look darker, but often the stool looks normal. But with time, blood loss can accumulate and can cause low red blood cell counts (anemia). Occasionally, the first sign of colorectal cancer is a blood test that shows a low red blood cell count.

Testing of fecal matter

Fecal matter is examined to detect signs of colon cancer. These tests are less invasive and are easier to carry out, but should be done regularly.

Fecal immunochemical test (FIT)

The fecal immunochemical test (FIT) is also called the immunochemical test of fecal occult blood (iFOBT). For this test, small amounts of stool are collected on cards (or tubes) and these are examined for occult blood. This test reacts with part of the human hemoglobin protein found in red blood cells.

If the test results are positive (if occult blood is detected), a colonoscopy will be required to conduct a more in-depth study. Although the blood in the stool may be due to cancer or polyps, it may also have other causes, such as ulcers, hemorrhoids or other conditions.

This test must be carried out on a yearly basis.

Guaiac fecal occult blood test (gFOBT)

This test detects occult blood in the stool through a chemical reaction, but it does so in a different way to the FIT test. However, it has the same limitations since it cannot determine whether the blood is coming from the colon or from other parts of the digestive tract (for example, the stomach).

Like FIT, if blood is detected in the stool, other tests such as colonoscopy should be performed to find the cause of the bleeding and it must also carried out yearly.

Some foods or medications can affect the results of this test. Therefore, before the test, you should avoid:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil), naproxen (Aleve) or aspirin for 7 days before the test (if you take these medications daily for heart problems or other conditions do not stop taking them without first consulting your doctor).
  • More than 250 mg. of vitamin C per day from either supplements or citrus fruits and juices for 3 days before the test. (This can affect the chemicals in the test and cause the result to be negative, even when there is blood).
  • Red meat (beef, lamb or liver) for 3 days before the test (the components of the blood in the meat could cause the test result to be positive).

Stool DNA testing

Usually, the cells of colorectal cancers or polyps contain DNA mutations (changes) in certain genes.

This test (also known as a multitarget stool DNA test or MT-sDNA) helps identify these abnormal sections of DNA.

This test must be done every 3 years. If DNA changes are detected, a colonoscopy is required.

Visual (structural) exams

These tests allow for the structure of the colon and rectum to be observed in order to detect abnormal areas that may be cancer or polyps. They are performed using an endoscope (an instrument similar to a tube with a tiny camera and a light source at the end) that is inserted into the rectum or with special imaging studies (X-rays).

They do not need to be carried out as often as stool tests, but they do require more preparation. Additionally, there may be some additional risks that do not come with stool tests.

Colonoscopy

This test takes approximately 30 minutes, during which time the doctor examines the entire colon and rectum with a colonoscope (a flexible tube, about the thickness of a finger, which has a small, lightweight video camera on the end). The colonoscope is inserted through the anus into the rectum and colon, and through this instrument, special instruments can be passed to perform a biopsy (sample) or remove any suspicious area, such as polyps, if necessary.

Before the test, the colon and rectum should be evacuated and cleaned, so the doctor will give specific instructions that should be followed the previous days (including diet, pills, liquids and enemas, or combinations of these). It is a test that can cause discomfort, which is why a sedative is used to help the person being examined feel more comfortable.

Colonography by CT (virtual colonoscopy)

This is an advanced type of computed tomography (CT) scan of the colon and rectum using X-rays. However, instead of taking a photograph, like conventional radiography, many images are taken while a device rotates around the patient while he is lying on a stretcher. Then, a computer combines these photographs to form detailed images to give a three-dimensional view of the interior of the colon and rectum, which allows the doctor to detect if there are any polyps or cancer. The test takes about 10 minutes.

Although it is not an invasive test like a colonoscopy, it requires the same type of bowel preparation.

Flexible sigmoidoscopy [H4]

In this test, the doctor inserts a sigmoidoscope through the anus (a flexible tube about the thickness of a finger that has a light source and a small video camera on the end). This instrument is only about 60 centimeters long, which can reach the length of the rectum, but less than half the colon. When advancing with the small camera, the doctor observes the colon and rectum on a video screen to detect anomalies.

Like previous exams, this requires a previous preparation in which the intestines have to be emptied and cleaned.

Prevention

Testing

With colon cancer screenings you can often find polyps before they become cancerous. Removing such polyps can prevent this type of cancer.

Lifestyle

The change of diet and lifestyle is important. Medical research suggests that low-fat, high-fiber diets can lower the risk of developing this type of cancer. Some studies indicate that the risk of colorectal cancer can also be reduced if physical activity is increased, alcohol consumption is limited and tobacco products are avoided.

Stages of colon cancer

Tumors are usually classified on a scale of 0 to IV, where stage 0 is the initial and most localized phase of cancer, and stage IV is the most advanced stage, in which the cancer has already spread to other organs outside the colon or of the rectum.

Stage 0

The cancer is at a very early stage and only present in the innermost layer of the intestine.

Stage I

The cancer has already passed through the superficial lining (mucosa) of the colon or rectum, but remains in the inner layers of the colon; it has not spread beyond the wall of the colon or rectum.

Stage II

The cancer has reached or passed through the wall of the colon or rectum, but has not spread to nearby lymph nodes.

Stage III

The cancer has invaded the nearby lymph nodes, but still has not affected other parts of the body.

Stage IV

The cancer has spread to other organs outside of the colon, such as the liver, lungs, ovaries or bones.

Treatments

The type of treatments depends on various factors, including the stage of the cancer. The main treatment options can include: surgery, chemotherapy, radiation and targeted therapy.

Surgery

Stage 0 colon cancer can be treated by removing the tumor. This is often done by means of a colonoscopy.

For cancer in stages I, II and III, it is necessary to carry out major surgery to remove the part of the colon where cancer is present. This surgery is called colon resection (colectomy). Generally, in a colectomy, nearby lymph nodes are also removed and tested for cancer.

Chemotherapy

Chemotherapy uses drugs to destroy cancer cells. Almost all people with stage III colon cancer receive chemotherapy after surgery for 6 to 8 months. This is called complementary chemotherapy. In this way, chemotherapy helps treat any remaining cancer cells and can help reduce the risk of cancer recurrence and death.

Occasionally, chemotherapy may also be used prior to surgery to reduce the size of the cancer before the operation. Chemotherapy is more often used before surgery in cases of rectal cancer rather than colon cancer.

Radiotherapy

Radiation therapy uses powerful energy sources, such as x-rays, to destroy cancer cells, shrink large tumors before an operation so they can be removed more easily, or relieve symptoms of colon cancer and rectal cancer.

Radiation therapy, either alone or in combination with chemotherapy, is one of the standard treatment options for the initial control of rectal cancer, followed by surgery.

Targeted therapy

This concentrates on specific targets (molecules) in the cancer cells. These targets influence the way cancer cells grow and survive, so by destroying them, the drug inhibits cancer cells from spreading.

Medication used in targeted therapy can be administered alone or together with chemotherapy. These are usually reserved for people with advanced colon cancer.

Alternative therapies

These are therapies to go alongside conventional treatments.

Ginseng tea

Ginseng is a medicinal plant with various health benefits, because it contains substances called ginsenosides that have stimulating properties and help to revitalize the body.
Its high concentration of antioxidants helps inhibit the spread of cancer cells. In some cases this tea can lead to the automatic death of this type of cells.

Green tea

Green tea is a good source of catechins and epicatechins. These are organic compounds that are responsible for reducing the presence of free radicals, preventing the spread of cancer cells and have an anti-tumor effect.

For this reason, drinking green tea as a substitute for coffee is a good option. Remember that you can drink as much of this tea as you want.

Exercise

Physical activity is recommended for your general wellbeing, but it is even more important when you are suffering from colon cancer. Doing exercise will improve your blood flow and help your metabolism work more efficiently.

Blueberries

These small fruits contain a large amount of antioxidants, including catechin, quercetin, flavonoids, phenolic compounds and many more, which will have positive effects on cancer cells and strengthen the immune system. A handful of blueberries a day is enough to help fight free radicals.

Cannabis*

Cannabinoids ease discomfort, since they help reduce nausea and vomiting, stimulate appetite and relieve pain that may be caused by chemotherapy and radiotherapy treatments.

In conjunction with conventional treatments, cannabinoids can potentiate the death of tumor cells, reducing their potential for spread and metastasis.

*Always check to see if it is legal in your jurisdiction before obtaining any cannabis-based product.

Coping and support strategies

If you have been diagnosed with colon cancer, or know someone who has, we have made a list of some alternatives to help you deal with this news. We know that a cancer diagnosis can pose an emotional challenge and that everyone has a different way of dealing with this situation, but if you are still discovering what works best for you, you may like to try one of these options.

Get to know yourself and your cancer

The more informed you are about cancer, the easier it will be to decide on a treatment. You shouldn´t be scared or embarrassed to ask your doctor or look up information in reliable sources. If you would like to know more about cancer you can visit our full article here [link to IDC 2002]

It is also recommended to take some time for yourself. Focus on yourself, meditate, feel every part of your body, learn to understand yourself; A little self-awareness may help you cope with your cancer.

Surround yourself with family and friends

Having someone close to you, who understands and supports you is very important. If you have a close relationship with someone, you can deal with cancer knowing that you are supported, which makes a big difference. Your wellbeing starts with how you feel.

Find someone to talk to

Find someone who is willing to listen and talk to you about your hopes and fears. If you prefer, you can also speak to a therapist, doctor or someone from a support group. It is important to express your doubts or thoughts, to make yourself heard and not to keep fears to yourself.

Want to know more about cancer and how to combat it? We are here to support you and guide you.