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JOHNY WILBERT, M.Sc[N]
LECTURER,
APOLLO INSTITUTE OF HOSPITAL MANAGEMENT AND ALLIED
SCIENCE
 Colon cancer is cancer of the large intestine (colon), the
lower part of the digestive system. Rectal cancer is
cancer of the last several inches of the colon. Together,
they're often referred to as colorectal cancers.
 The cause is unknown
 Older age.
 African-American race.
 A personal history of colorectal cancer or polyps.
 Inflammatory intestinal conditions.
 Inherited syndromes that increase colon cancer risk.
 Family history of colon cancer and colon polyps.
 Low-fiber, high-fat diet.
 A sedentary lifestyle.
 Diabetes.
 Obesity.
 Smoking.
 Alcohol.
 Stage I. Cancer has grown through the superficial
lining (mucosa) of the colon or rectum but hasn't spread
beyond the colon wall or rectum.
 Stage II. Cancer has grown into or through the wall of
the colon or rectum but hasn't spread to nearby lymph
nodes.
 Stage III. Cancer has invaded nearby lymph nodes but
isn't affecting other parts of the body yet.
 Stage IV. Cancer has spread to distant sites, such as
other organs —liver or lung.
 A change in bowel habits, including diarrhea or
constipation or a change in the consistency of stool
 Rectal bleeding or blood in stool
 Persistent abdominal discomfort, such as cramps, gas
or pain
 A feeling that the bowel doesn't empty completely
 Weakness or fatigue
 Unexplained weight loss
 COLONOSCOPY Using a scope to examine the inside
of the colon.
 Biopsy
 CT images
 Surgery for early-stage colon cancer
 If the cancer is small, localized in a polyp and in a very
early stage, the doctor may be able to remove it
completely during a colonoscopy. Larger polyps may
be removed using endoscopic mucosal resection.
Polyps that can't be removed during colonoscopy may
be removed using laparoscopic surgery.
 Surgery for invasive colon cancer
 If the colon cancer has grown into or through the colon,
the surgeon may recommend a partial colectomy to
remove the part of colon that contains the cancer, along
with a margin of normal tissue on either side of the
cancer. Nearby lymph nodes are usually also removed
and tested for cancer.
 The surgeon is often able to reconnect the healthy
portions of the colon or rectum. But when that's not
possible, for instance if the cancer is at the outlet of the
rectum, a permanent or temporary colostomy is done.
 This involves creating an opening in the wall of the
abdomen from a portion of the remaining bowel for the
elimination of body waste into a special bag.
Sometimes the colostomy is only temporary, allowing
the colon or rectum time to heal after surgery. In some
cases, however, the colostomy may be permanent.
 Chemotherapy
 Chemotherapy uses drugs to destroy cancer cells.
Chemotherapy for colon cancer is usually given after
surgery if the cancer has spread to the lymph nodes.
 Chemotherapy may be used before surgery to shrink
the cancer before an operation. In people with rectal
cancer, chemotherapy is typically used along with
radiation therapy.
 Radiation therapy
 Radiation therapy uses powerful energy sources, such
as X-rays, to kill cancer cells that might remain after
surgery, to shrink large tumors before an operation so
that they can be removed more easily, or to relieve
symptoms of colon cancer and rectal cancer.
 Radiation therapy, usually combined with
chemotherapy, may be used after surgery to reduce the
risk that the cancer may recur in the area of the rectum
where it began.
 Targeted drug therapy
 Drugs that target specific defects that allow cancer cells
to grow are available to people with advanced colon
cancer, including bevacizumab (Avastin), cetuximab
(Erbitux), panitumumab (Vectibix) and regorafenib
(Stivarga). Targeted drugs can be given along with
chemotherapy or alone.
 Get screened for colon cancer
 Eat a variety of fruits, vegetables and whole grains.
 Drink alcohol in moderation, if at all.
 Stop smoking.
 Exercise most days of the week.
 Maintain a healthy weight.

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Colorectal cancer

  • 1. JOHNY WILBERT, M.Sc[N] LECTURER, APOLLO INSTITUTE OF HOSPITAL MANAGEMENT AND ALLIED SCIENCE
  • 2.  Colon cancer is cancer of the large intestine (colon), the lower part of the digestive system. Rectal cancer is cancer of the last several inches of the colon. Together, they're often referred to as colorectal cancers.
  • 3.  The cause is unknown
  • 4.  Older age.  African-American race.  A personal history of colorectal cancer or polyps.  Inflammatory intestinal conditions.  Inherited syndromes that increase colon cancer risk.  Family history of colon cancer and colon polyps.
  • 5.  Low-fiber, high-fat diet.  A sedentary lifestyle.  Diabetes.  Obesity.  Smoking.  Alcohol.
  • 6.  Stage I. Cancer has grown through the superficial lining (mucosa) of the colon or rectum but hasn't spread beyond the colon wall or rectum.  Stage II. Cancer has grown into or through the wall of the colon or rectum but hasn't spread to nearby lymph nodes.  Stage III. Cancer has invaded nearby lymph nodes but isn't affecting other parts of the body yet.  Stage IV. Cancer has spread to distant sites, such as other organs —liver or lung.
  • 7.  A change in bowel habits, including diarrhea or constipation or a change in the consistency of stool  Rectal bleeding or blood in stool  Persistent abdominal discomfort, such as cramps, gas or pain  A feeling that the bowel doesn't empty completely  Weakness or fatigue  Unexplained weight loss
  • 8.  COLONOSCOPY Using a scope to examine the inside of the colon.  Biopsy  CT images
  • 9.  Surgery for early-stage colon cancer  If the cancer is small, localized in a polyp and in a very early stage, the doctor may be able to remove it completely during a colonoscopy. Larger polyps may be removed using endoscopic mucosal resection. Polyps that can't be removed during colonoscopy may be removed using laparoscopic surgery.
  • 10.  Surgery for invasive colon cancer  If the colon cancer has grown into or through the colon, the surgeon may recommend a partial colectomy to remove the part of colon that contains the cancer, along with a margin of normal tissue on either side of the cancer. Nearby lymph nodes are usually also removed and tested for cancer.
  • 11.  The surgeon is often able to reconnect the healthy portions of the colon or rectum. But when that's not possible, for instance if the cancer is at the outlet of the rectum, a permanent or temporary colostomy is done.
  • 12.  This involves creating an opening in the wall of the abdomen from a portion of the remaining bowel for the elimination of body waste into a special bag. Sometimes the colostomy is only temporary, allowing the colon or rectum time to heal after surgery. In some cases, however, the colostomy may be permanent.
  • 13.  Chemotherapy  Chemotherapy uses drugs to destroy cancer cells. Chemotherapy for colon cancer is usually given after surgery if the cancer has spread to the lymph nodes.  Chemotherapy may be used before surgery to shrink the cancer before an operation. In people with rectal cancer, chemotherapy is typically used along with radiation therapy.
  • 14.  Radiation therapy  Radiation therapy uses powerful energy sources, such as X-rays, to kill cancer cells that might remain after surgery, to shrink large tumors before an operation so that they can be removed more easily, or to relieve symptoms of colon cancer and rectal cancer.  Radiation therapy, usually combined with chemotherapy, may be used after surgery to reduce the risk that the cancer may recur in the area of the rectum where it began.
  • 15.  Targeted drug therapy  Drugs that target specific defects that allow cancer cells to grow are available to people with advanced colon cancer, including bevacizumab (Avastin), cetuximab (Erbitux), panitumumab (Vectibix) and regorafenib (Stivarga). Targeted drugs can be given along with chemotherapy or alone.
  • 16.  Get screened for colon cancer  Eat a variety of fruits, vegetables and whole grains.  Drink alcohol in moderation, if at all.  Stop smoking.  Exercise most days of the week.  Maintain a healthy weight.