Colon Cancer (Colorectal Carcinoma)

What Is Colorectal Cancer?

When a non-professional person speaks of "colon cancer," he usually means cancer of the colon or rectum (also: colorectal cancer, colon cancer), since tumors of the small intestine are comparatively rare — colorectal carcinomas on the rise, especially in the Western Civilization.

Currently, about 20 out of 100,000 people in Europe are newly affected by this tumor disease every year, which makes colon carcinoma the second most common tumor in industrialized countries, with only breast cancer in women and prostate cancer in men being more common. Especially over the age of 40 years, the risk of developing the disease increases significantly.

How Does Colon Cancer Develop?

Carcinomas develop through a multi-stage process that they have to go through when they become tumors. This process is called the "adenoma-carcinoma sequence." Every carcinoma (cancer) in the intestine was previously an adenoma (benign cell proliferation), although not every adenoma has to become a carcinoma. Removal of the benign adenoma (also called polyp in the large intestine) in a colonoscopy, stops the development of a malignant tumor and prevents the patients from developing the disease.

It is therefore immensely important that every person, whether man or woman, from the age of about 50 years (depending on the risk within the family, e.g., close relatives already who have colon cancer) undergo colonoscopy because this can prevent colon cancer for the most part! As part of the early detection of colorectal cancer as of the age of 50, you should also have an annual stool test for blood, and a rectal examination for deep-seated tumors carried out. Please think about your health - go for a colon cancer check-up and colonoscopy!

Apparent risk factors for the development of colon cancer are high fat and meat consumption as well as low fiber diet. 5 - 10% of colorectal carcinomas are hereditary. The most common disease syndrome leading to colorectal cancer is the so-called "Lynch syndrome" (HNPCC, hereditary nonpolyposis colorectal carcinoma). It comes to numerous tumor sufferings due to genetic defects in the predisposition (besides colon cancer, endometrial carcinoma, stomach carcinoma, etc.)

What Are the Symptoms of Colorectal Cancer?

Depending on the location of colorectal cancer, the symptoms can significantly vary. For example, there may be hidden bleeding in the bowel with blood in the stool, which is often not visible to the naked eye, as they are only small traces. A quick laboratory test can detect blood in the stool. Blood deficiency, weight loss, pain in the lower abdomen, or stool irregularities can also be signs of progressive tumor disease. Similarly, flatulence (meteorism), or constipation (constipation) can be quite unspecific cancer symptoms. Complications caused by an intestinal tumor can be a complete intestinal obstruction (ileus), bleeding, abdominal ruptures (perforations), or even invasions of nearby organs such as the vagina.

How Is Colorectal Cancer Diagnosed?

As colorectal cancer does not cause any specific symptoms or early symptoms, it is usually diagnosed quite late. An essential instrumental method for the detection of intestinal tumors is flexible colonoscopy. A primary method to detect the extent of cancer and possible metastases is computed tomography (CT) with contrast agent.

How Can Colorectal Cancer Be Treated?

If colon carcinoma is detected without distant metastases (tumor spread), the necessary procedure is the complete surgical removal of the tumor. This complete resection in healthy tissue with sufficient safety distance is currently the only curative treatment method. In general, these surgeries can also be carried out minimal invasive. However, the technical feasibility always depends on the exact tumor localization and experience of the surgeon.

After the surgery, patients with lymph nodes affection caused by tumor cells should also undergo chemotherapy. Radiation therapy is only used for treating rectal cancer, where it is frequently used in combination with chemotherapy as radiochemotherapy.

If the patient also has operable liver metastases, they could be removed in the intestinal surgery. Still, since this usually means a high physical strain for the patient, the surgeries are generally carried out at intervals of a few weeks. If the patient has non-operable liver metastases, they can be reduced in size and made resectable by various techniques, such as neoadjuvant chemotherapy (see "liver metastases"). If the tumor stage is already advanced with a large number of distant metastases, curative surgery is usually no longer an option. In this case, it may be advantageous to carry out palliative surgery in individual patients, for example, if the tumor growth leads to intestinal obstruction or bleeding.

What Are the Chances of Healing Colorectal Cancer?

The 5-year survival rate after surgery in patients with entirely removed tumors is over 70%; in most cases, there is a real chance of recovery.

Which Doctors And Clinics are Specialists for Colorectal Cancer in Germany, Austria, and Switzerland?

Anyone who has been diagnosed with colon cancer wants the best medical care. Therefore, the patient is wondering where to find the best clinic for colon cancer.

As this question cannot be answered objectively, and a respectable doctor would never claim to be the best one, we can only rely on the doctor’s experience. The more patients with colorectal cancer a doctor treats, the more experienced he becomes in his specialty.

Colorectal cancer specialists are clinics and doctors who specialize in the diagnosis and treatment of cancer in the digestive organs. OnkoZert can certify them as a colorectal cancer center.

Sources:

• www.krebsinformationsdienst.de/tumorarten/darmkrebs/
• www.darmkrebs.de
• Innere Medizin, Gerd Herold und Mitarbeiter, 2014
• Chirurgie, Siewert/Stein, 9. Auflage, Springer Verlag