newsprompt.coCOLON CANCER PROGNOSIS
Colorectal carcinoma starts in the colon or the rectum. These carcinomas can also be called colon carcinoma or rectal carcinoma, depending on where they start. Colon carcinoma and rectal carcinoma are often grouped together because they have many features in common. carcinoma starts when cells in the body start to grow out of control. Colon carcinoma and carcinoma of the rectum can begin as a small polyp, detectable through regular carcinoma screening, such as colonoscopy. Colon carcinoma symptoms include a change in bowel habits or bleeding, but often there are no symptoms. With early detection, operation, radiation, and/or chemotherapy can be effective treatment. Colon carcinoma is sometimes called colorectal carcinoma, which is a term that combines colon carcinoma and rectal carcinoma, which begins in the rectum.
The colon and rectum:
To understand colorectal carcinoma, it helps to know about the normal structure and function of the colon and rectum. The colon and rectum make up the large intestine (or large bowel), which is part of the digestive system, also called the gastrointestinal (GI) system (see illustration below). Most of the large intestine is made up of the colon, a muscular tube about 5 feet (1.5 meters) long. The parts of the colon are named by which way the food is traveling through them.
- The first section is called the ascending colon. It starts with a pouch called the cecum, where undigested food is comes in from the small intestine. It continues upward on the right side of the abdomen (belly).
- The second section is called the transverse colon. It goes across the body from the right to the left side.
- The third section is called the descending colon because it descends (travels down) on the left side.
- The fourth section is called the sigmoid colon because of its “S” shape. The sigmoid colon joins the rectum, which then connects to the anus.
The work of the colon and rectum:
The colon absorbs water and salt from the remaining food matter after it goes through the small intestine (small bowel). The waste matter that’s left after going through the colon goes into the rectum, the final 6 inches (15cm) of the digestive system. It’s stored there until it passes through the anus. Ring-shaped muscles (also called a sphincter) around the anus keep stool from coming out until they relax during a bowel movement.
Its inception:
Polyps in the colon or rectum:
Most colorectal carcinomas start as a growth on the inner lining of the colon or rectum. These growths are called polyps.
Some types of polyps can change into carcinoma over time (usually many years), but not all polyps become carcinoma. The chance of a polyp turning into carcinoma depends on the type of polyp it is. There are different types of polyps.
- Adenomatous polyps (adenomas): These polyps sometimes change into carcinoma. Because of this, adenomas are called a pre-carcinomaous condition. The 3 types of adenomas are tubular, villous, and tubulovillous.
- Hyperplastic polyps and inflammatory polyps: These polyps are more common, but in general they are not pre-carcinomaous. Some people with large (more than 1cm) hyperplastic polyps might need colorectal carcinoma screening with colonoscopy more often.
- Sessile serrated polyps (SSP) and traditional serrated adenomas (TSA): These polyps are often treated like adenomas because they have a higher risk of colorectal carcinoma.
Causes:
Health care professionals are certain that colorectal carcinoma is not contagious. Some people are more likely to develop colorectal carcinoma than others. Factors that increase a person’s risk of colorectal carcinoma include increasing age, African-American race, high fat intake, a family history of colorectal carcinoma and polyps, the presence of polyps in the large intestine, and inflammatory bowel diseases, primarily chronic ulcerative colitis.
Age:
Increasing age is the main risk factor for colorectal carcinoma. Around 90% of colorectal tumors are diagnosed after age 50.
Race:
African Americans have a higher incidence of colorectal carcinoma than people of other races.
Diet and colorectal carcinoma:
Diets high in fat have been shown in numerous research studies to predispose people to colorectal carcinoma. In countries with high colorectal carcinoma rates, the fat intake by the population is much higher than in countries with low carcinoma rates.
Stages:
When colorectal carcinoma is diagnosed, additional tests are performed to determine the extent of the disease. This process is called staging. Staging determines how advanced colorectal carcinoma has become. The staging for colorectal carcinoma ranges from stage I, the least advanced carcinoma, to stage IV, the most advanced carcinoma.
- Stage I colorectal carcinomas involve only the innermost layers of the colon or rectum. The likelihood of cure (excellent prognosis) for stage I colorectal carcinoma is over 90%.
- Stage II carcinomas exhibit greater growth and extension of the tumor through the wall of the colon or rectum into adjacent structures.
- Stage III colorectal carcinomas manifest the spread of carcinoma to local lymph nodes.
- Stage IV (metastatic) colorectal carcinomas have spread or metastasized, to distant organs or lymph nodes far from the original tumor.
Treatment
Which treatments are most likely to help you depends on your particular situation, including the location of your carcinoma, its stage and your other health concerns. Treatment for colon carcinoma usually involves an operation to remove the carcinoma. Other treatments, such as radiation therapy and chemotherapy, might also be recommended.
An operation for early-stage colon carcinoma
If your colon carcinoma is very small, your physician may recommend a minimally invasive approach to an operation, such as:
- Removing polyps during a colonoscopy (polypectomy). If your carcinoma is small, localized, completely contained within a polyp and in a very early stage, your physician may be able to remove it completely during a colonoscopy.
- Endoscopic mucosal resection. Larger polyps might be removed during colonoscopy using special tools to remove the polyp and a small amount of the inner lining of the colon in a procedure called an endoscopic mucosal resection.
- Minimally invasive operation (laparoscopic). Polyps that can’t be removed during a colonoscopy may be removed using an laparoscopic process. In this procedure, your surgeon performs the operation through several small incisions in your abdominal wall, inserting instruments with attached cameras that display your colon on a video monitor. The surgeon may also take samples from lymph nodes in the area where the carcinoma is located.
Signs & symptoms:
Signs and symptoms of colon carcinoma include:
- A persistent change in your bowel habits, including diarrhea or constipation or a change in the consistency of your stool
- Rectal bleeding or blood in your stool
- Persistent abdominal discomfort, such as cramps, gas or pain
- A feeling that your bowel doesn’t empty completely
- Weakness or fatigue
- Unexplained weight loss
Many people with colon carcinoma experience no symptoms in the early stages of the disease. When symptoms appear, they’ll likely vary, depending on the tumor’s size and location in your large intestine.
Diagnosing colon carcinoma:
If your signs and symptoms indicate that you could have colon carcinoma, your physician may recommend one or more tests and procedures, including:
- Using a scope to examine the inside of your colon (colonoscopy). Colonoscopy uses a long, flexible and slender tube attached to a video camera and monitor to view your entire colon and rectum. If any suspicious areas are found, your physician can pass surgical tools through the tube to take tissue samples (biopsies) for analysis and remove polyps.
- Blood tests. No blood test can tell you if you have colon carcinoma. But your physician may test your blood for clues about your overall health, such as kidney and liver function tests.
- Your physician may also test your blood for a chemical sometimes produced by colon carcinomas (carcinoembryonic antigen, or CEA). Tracked over time, the level of CEA in your blood may help your physician understand your prognosis and whether your carcinoma is responding to treatment.
Determining the extent of the carcinoma:
Colon carcinoma stages
- If you’ve been diagnosed with colon carcinoma, your physician may recommend tests to determine the extent (stage) of your carcinoma. Staging helps determine what treatments are most appropriate for you.
- Staging tests may include imaging procedures such as abdominal, pelvic and chest CT scans. In many cases, the stage of your carcinoma may not be fully determined until after colon carcinoma operation.
- The stages of colon carcinoma are indicated by Roman numerals that range from 0 to IV, with the lowest stages indicating carcinoma that is limited to the lining of the inside of the colon. By stage IV, the carcinoma is considered advanced and has spread (metastasized) to other areas of the body.
Summary:
If you’ve been diagnosed with colon carcinoma, your physician may recommend tests to determine the extent (stage) of your carcinoma. Staging helps determine what treatments are most appropriate for you.
Staging tests may include imaging procedures such as abdominal, pelvic and chest CT scans. In many cases, the stage of your carcinoma may not be fully determined until after colon carcinoma operation.
