Colon Cancer Awareness

Recently, I visited my friend's home to assess the health of his father, who wasn't feeling well. It was evident that my friend was a dedicated and caring son, deeply involved in his father's well-being. Observing his genuine contentment while taking care of his father was heartwarming. During our conversation about medical history, I learned that my friend had tragically lost his uncle to colon cancer.

Further inquiries revealed that his uncle's diagnosis was swiftly followed by his passing, occurring within a mere two months. What made this situation particularly alarming was the absence of common symptoms, except for sudden and significant weight loss. Reflecting on this, I realised the importance of raising awareness about this disease.

Colon cancer, also known as colorectal cancer, occurs in the colon or rectum and is a type of cancer that develops from the uncontrolled growth of cells in these areas. Symptoms of colon cancer can vary, and some individuals may not experience noticeable symptoms in the early stages. It's essential to be aware of potential signs and seek medical attention if any of the following persist:

Symptoms:

Change in Bowel Habits: Persistent changes in bowel habits, such as diarrhoea or constipation, that last for more than a few days.

Blood in Stool: Rectal bleeding or blood in the stool, which may appear as bright red or darker, tarry stools.

Abdominal Discomfort: Cramps, pain, or discomfort in the abdomen, often associated with bloating or gas.

Unexplained Weight Loss: Significant and unexplained weight loss without changes in diet or physical activity.

Fatigue: Persistent fatigue or weakness that is not attributable to other factors.

Incomplete Bowel Emptying: Feeling the need to have a bowel movement that doesn't relieve the sensation of fullness or discomfort.

Iron Deficiency Anemia: Low levels of red blood cells due to chronic bleeding, leading to symptoms like fatigue and weakness.

Narrow Stools: Thin or pencil-like stools that may indicate a partial blockage.

Abdominal Cramps or Pain: Continuous or intermittent abdominal pain, discomfort, or cramps.

Change in Stool Consistency: Stool consistency may change, becoming more narrow or ribbon-like.

It's important to understand that these symptoms can be caused by various conditions, and having one or more of these symptoms does not necessarily mean one has colon cancer. However, if these symptoms persist or are concerning, it is advisable to consult a healthcare professional for further evaluation and appropriate diagnostic tests, such as a colonoscopy.

Risk Factors:

Age: Risk increases with age, especially after 50.

Family History: Having a family history of colorectal cancer.

Personal History: Previous colorectal cancer or certain types of polyps.

Inherited Conditions: Conditions like Lynch syndrome or familial adenomatous polyposis (FAP).

Inflammatory Bowel Disease (IBD): Chronic conditions like Crohn's disease or ulcerative colitis.

Diet: Diets high in red or processed meats and low in fiber.

Lifestyle Factors: Lack of physical activity, obesity, smoking, and heavy alcohol use.

Prevention:

Screening: Regular screenings, such as colonoscopies, can detect precancerous polyps.

Healthy Lifestyle: Maintain a balanced diet, exercise regularly, and avoid smoking and alcohol.

Know Your Family History: Understand your family's colorectal cancer history.

Diagnosis:

The diagnosis of colon cancer involves a combination of medical history assessment, physical examination, and various diagnostic tests. Here are the key components of the diagnostic process for colon cancer:

Medical History and Physical Examination: Healthcare professionals begin by gathering information about the patient's medical history, including any symptoms, risk factors, and family history of cancer.

A physical examination is conducted to assess overall health and identify any signs that may indicate colorectal issues.

Colonoscopy: A colonoscopy is a primary diagnostic procedure for colon cancer. During this procedure, a flexible tube with a camera at its end (colonoscope) is inserted into the rectum to examine the
entire colon. It allows for the visualisation of the colon lining and the detection of polyps or tumours.

Biopsy: If abnormal tissue is identified during a colonoscopy, a biopsy may be performed. A small sample of tissue is taken for laboratory analysis to determine if it is cancerous and, if so, to identify the cancer type and its characteristics.

Imaging Tests: Various imaging tests may be used to determine the extent of cancer and its spread. These include:

CT Scan: Detailed cross-sectional images of the abdomen and pelvis.

MRI: Detailed images to assess the rectum and nearby structures.

PET Scan: Detects areas of increased metabolic activity.

Blood Tests: Blood tests may be conducted to check for certain markers associated with colorectal cancer, such as carcinoembryonic antigen (CEA).

Staging: If colon cancer is confirmed, the next step is staging to determine the extent of cancer spread. Staging involves additional imaging tests and may include procedures like endorectal ultrasound for rectal cancer.

Genetic Testing: In some cases, genetic testing may be recommended, especially for individuals with a family history of colorectal cancer or specific genetic syndromes.

Other Laboratory Tests: Additional tests may be performed to assess overall health, liver function, and the presence of anaemia.

Treatment:

Surgery: Remove cancerous tissue and affected lymph nodes.

Chemotherapy: Drugs to kill cancer cells or stop their growth.

Radiation Therapy: High-energy rays to target and destroy cancer cells.

Targeted Therapies: Drugs targeting specific aspects of cancer cells.

Immunotherapy: Boosting the body's immune system to fight cancer.

Consultation:

If you suspect or have risk factors for colon cancer, consult your doctor. Early detection through regular screenings is crucial for improving treatment outcomes in colon cancer. Individuals with risk factors, including a family history of colorectal cancer, should discuss screening options with their healthcare providers.

Dr Zubair Saleem is a Senior Geriatric Consultant and a Gerontologist