Colorectal Cancer

Cancer, in its most basic form, is the uncontrolled growth of a cell or a mass of cells somewhere in the body. It could be almost any cell. Different cells cause different types of cancer based on their properties. If cells of the colon or the rectum become cancerous, they grow and spread further into the gut and tissues surrounding the intestines.

This kind of cancer is typically termed colorectal cancer. Sometimes people call it colon cancer to simplify it.

Presentation:
Colorectal cancer starts and spreads in a unique manner. Therefore, it requires a team of doctors including oncologists, surgeons and gastroenterologists to manage its treatment.
It is a disease of the middle aged and the elderly. It is rarer in people below the age of 40. In 50 year olds of both genders, it is the 2nd most common cause of death in patients in the United States.

Testing for colorectal cancer:
Treatments have gotten better over the decades. 90% of people, who catch the disease early, survive for 5 years or more and can lead perfectly normal and quality lives in most cases.
Detecting it early is of key importance. The problem is, by the time symptoms associated with this disease appear, it is already pretty far advanced. Therefore, when you get close to your 50’s, just waiting around is not a good idea.
Screening tests are the best means when it comes to detecting colorectal cancer at an early stage for a cure. The best screening test is a colonoscopy. Though I’m sure most people would agree it’s an incredibly unpleasant experience, it is a lifesaving one. Men and women above the age of 50 should get a screening colonoscopy done once every 5 years at the minimum, to adequately beat the odds.

Symptoms:
As the disease progresses (if missed or not diagnosed) small pre-cancerous lumps, typically called a ‘polyps’, start invading the inner layers of the gut. They spread rapidly and steal blood from the surrounding tissues mostly leading to:

• Weight loss
• Fatigue
• Difficulty in bowel movement
• Blood in stool
• Nausea

Sometimes tumor cells in the primary mass can jump into the blood stream traveling far and wide, entering the prostate or the spine or even the lungs and the liver. These far flung seeds from the primary site are called ‘metastases’.

Treatment:
If the disease is caught early, a simple endoscopic removal of the pre-cancerous lump and further screening is enough.
Each stage and complication of colorectal cancer requires a multi specialty treatment plan involving many different therapies. At first, your surgical team may want to remove the primary tumor in one fell swoop through open or endoscopic surgery. This may not cure the disease but makes treatment a lot simpler in the long run.
Your oncologist may recommend scheduled chemotherapy and possibly even radiation therapy depending on where the tumor is first seen.
Your primary doctor will also be involved in helping you maintain a healthy diet and supporting your immune system as well as overcoming the debilitating side effects that are associated with chemotherapy and metastatic cancers.

The management of cancer is a process with many steps and there are many situations where your team may need to pivot to another treatment regime to keep up with the changing behavior of the cancer. It requires regular treatment and follow-ups. Regular screening for recurrence after treatment is of vital importance and a healthy outlook on life is advised. Remember any type of cancer is a disastrous diagnosis and you may need the help of a psychologist or a psychiatrist to overcome the perfectly natural response of depression.

Treatments have improved over the years and colon cancer is going from being a death sentence in all cases to being a chronic disease that just needs management and screening in most cases.

I can't stress enough on how important screening is here and why the treatment of an advanced cancer is required when you can prevent the condition all together. If you are 45 years old or above, talk to your doctor about whether you need to get a screening colonoscopy done and find out how often it is needed. Your family history plays a role in the decision making as well, so make sure you discuss other cases in the family with your doctor.