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What is bowel cancer?

When a layperson speaks of “colon cancer,” they are generally speaking of large intestine, or colorectal cancer (also: ...

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Information about the field of Bowel cancer

What is bowel cancer?

When a layperson speaks of “colon cancer,” they are generally speaking of large intestine, or colorectal cancer (also: bowel cancer), as tumors in the small intestine are comparably rare. Instances of colorectal carcinoma are constantly increasing in the western world.

Currently, circa 20/100,000 people in Europe are diagnosed yearly with this form of cancer. Colon cancer is the second most common type of cancer in industrial nations, and more common is breast cancer among women and prostate cancer in men. Following the 40th year of age, the risk of contracting this form of cancer sharply increases.

How does bowel cancer occur?

The carcinoma develops through a multi-step process. This process is known as the “adenoma-carcinoma sequence.” Although every carcinoma (cancer growth) in the colon was previously an adenoma (benign cell proliferation), not every adenoma will develop into carcinoma. By the complete removal of a benign adenoma (known as a polyp, in the large intestine) during a colonoscopy, the development of a malignant tumor is prevented and the patient is protected from the progression of illness.

It is therefore extremely important that each adult, male or female, who is 50 years of age or older (in relation to their family risk, for example, if they have close relative with colon cancer) undergoes a colonoscopy. A large number of colon cancer illnesses can be prevented! Within the spectrum of colon cancer early recognition, as of the 50th year of age, a yearly stool examination for blood, and a rectal examination for deep tumors should also take place. Please think about your health – arrange a colon cancer screening and a colonoscopy!

Clear risk factors for the occurrence of colon cancer are the high consumption of fat and meat, as well as low amounts of mineral intake in one’s diet. 5-10% of colorectal cancers are inherited. The most common symptom of illness, which leads to colon cancer, is the so-called “Lynch-Syndrome” (HNPCC or hereditary nonpolyposis colorectal cancer). Due to a genetic defect, there is a tendency to develop certain cancers (in addition to colorectal cancer, also endometrial carcinoma, stomach cancer, etc.).

What are the symptoms of colorectal cancer?

Depending on the location of the cancer within the large intestine, the symptoms can vary greatly. This can lead to hidden intestinal bleeding and to the mixture of blood within the stool. It is often not recognizable to the naked eye, since these are small traces. In a quick laboratory test, blood in the stool can be verified. Anemia, weight-loss, lower abdominal pain or stool irregularities can also be signs of an advanced tumor.  Other unspecific cancer symptoms include flatulence (meteorism) or constipation. Complications that can be results of an intestinal tumor include a complete bowel obstruction (ileus), bleeding, intestinal perforation or invasion into other nearby organs, such as the vagina.

How is bowel cancer diagnosed?

Since colon cancer does not have specific symptoms and does not elicit any early symptoms, the diagnosis is often made late. The most important instrumental method to recognize colon tumors is the flexible colonoscopy. In order to determine the extent of the tumor and possible metastasis, computed tomography (CT) scans are used with a contrast medium.

How can colorectal cancer be treated?

When colon cancer is detected without remote metastasis, the fundamental approach is the complete surgical removal of the tumor. This complete resection in healthy tissue with enough safety distance is currently the only healing treatment method. These interventions can generally also be completed minimally-invasive. The technical feasibility depends on the exact tumor location and the experience of the operating doctor.

Following the operation, patients who also have affected lymph nodes, should additionally maintain chemotherapy. Radiation therapy has a permanent place in the treatment of breast cancer throughout therapy. Here, it is frequently in combined with chemotherapy as radio chemotherapy.

If an operable liver metastasis exists, this can be removed simultaneously during bowel surgery. This is, however, highly strenuous for most patients, so the procedures usually take place a few weeks apart. When an inoperable liver metastasis exists, this can be reduced and made resectionable through various techniques, such as neoadjuvant chemotherapy (see “liver metastasis”). If an advanced tumor state with many remote metastases exists, then, surgical intervention is typically no longer possible. In this case, it can be advantageous for certain patients to go through palliative measures, for example if the tumor growth causes intestinal blockage or leads to bleeding.

What are the recovery prospects by colorectal cancer?

 The 5-year survival rate, following the successful surgery of patients whose tumors have been completely removed, can be over 70%, which is in most cases a significant chance of recovery.

 

Sources:

https://www.krebsinformationsdienst.de/tumorarten/darmkrebs/

http://www.darmkrebs.de/

Innere Medizin, Gerd Herold und Mitarbeiter, 2014

Chirurgie, Siewert/Stein, 9. Auflage, Springer Verlag


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