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Definition
Colorectal cancer refers to a cancer or a malignant tumor that occurs in the colon and rectum. Most colorectal cancers are adenocarcinomas that occur in the mucous membrane of the colon. In addition to adenocarcinoma, squamous cell carcinoma, malignant lymphoma, malignant sarcoma, and malignant carcinoid tumors can be found. Sometimes cancer from surrounding organs can invade the colon, or cancer from other sites can metastasize (spread) to the colon. Most adenocarcinomas are caused by advanced benign tumors (polyps) called adenomas.
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Symptoms
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when new constipation or diarrhea appears and continues for a considerable period of time
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when the stools have become thinner, when you have bleeding during defecation
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when the stool is mixed with blood
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people who over 40 years old
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When a tumor blocks the intestine and an ileus develops, you may experience severe abdominal pain, bloating, and even feel your intestines wriggling and moving.
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If colorectal cancer has metastasized to the liver, there may be a stiff pain in the right upper abdomen, and jaundice may appear.
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When metastasized to the peritoneum, the entire stomach will make you feel stuffy and uncomfortable, and sometimes the stomach is full due to ascites.
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If it spreads to the lungs, it can result in breathing difficulties and coughing, and if it spreads to the pleura, it causes chest pain and difficulty in breathing.
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Risk Factors
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Age
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Consumption of low-fiber and high-fat diet
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Smoking, excessive drinking
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Medical history of inflammatory bowel diseases
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Family history
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Diagnosis
Screening test is a simple and inexpensive method that allows many people to have early diagnosis and can be used to detect many other common diseases. In order to screen for colorectal cancer, it is recommended that even healthy people without risk factors follow one of the following tests starting from age 50.
· Fecal Guaiac Test
Bleeding is a common symptom in colon tumors, so it is necessary to take a test to find out whether even a small amount of blood comes out with the stools. It is recommended to have the test annually, and if possible, it is recommended to test it twice in a row. Even when the result of the test comes out to be positive, the probability of polyps and colorectal cancer is only 30-50% and 3-5% respectively, so the result does not necessarily mean that you have colorectal cancer.
vSigmoidoscopy
This method can be taken to examine the rectum and sigmoid colon, parts of the large intestine, using a short, thin and easily bendable endoscope. Compared to colonoscopy, it involves simpler and easier preparation and examination procedures, but it is more difficult to observe the entire large intestine, so it sometimes fails to detect the presence of diseases. It is recommended to take sigmoidoscopy every 5 years. If a polyp is found, a biopsy is required, and if the result of the biopsy is found to be an adenoma, a colonoscopy is required.
· Combination of fecal guaiac test and sigmoidoscopy
The fecal guaiac test needs to be taken annually and sigmoid colonoscopy needs to be taken every 5 years. However, there is no direct evidence that the effectiveness of the combination is superior to that of each method. Please compare the cost, inconvenience, and risk carefully and make a wise decision.
· Colonography
To prepare for colonography, please restrict eating beforehand, clean the inside of the large intestine with a laxative. Then barium fluid and air will be inserted through the anus into the large intestine and X-rays will be taken. A colonography is recommended to be taken every 5 or 10 years. Although colon angiography can relatively easily and accurately detect colorectal cancer and polyps larger than 1 cm by observing the entire colon, it is difficult to find small polyps with colon angiography. Usually, colonoscopy must be performed again if polyps or colorectal cancer are found.
· Colonoscopy
Through a colonoscopy, the entire large intestine is observed in detail to find polyps and colorectal cancer, and if necessary, tissue for pathological examination can be collected and polyps or part of early colorectal cancer can be removed and treated (endoscopic polypectomy). However, since colonoscopy causes considerable inconvenience to the patient and has a rather high risk, evaluation of its usefulness as a screening test is still arguable. It is recommended to have a colonoscopy every 10 years.
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Treatments
Treatment methods for colon cancer include surgeries, radiation treatment, chemotherapy, immunotherapy, and endoscopic treatment. However, even advanced colon cancers have a higher chance of being cured with surgery, so surgery is considered the best. The appropriate treatment policy should be determined in consideration of the location of colorectal cancer, the degree of its progression (stage), general condition, the patient’s level of engagement in social activities, and the will of the patient or family, and sometimes multiple treatments should be performed in combination.
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Prevention
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Improving your dietary habits (Eat fresh vegetables and fruits, Reduce excessive intake of red meats (beef, pork), Avoid eating meat products and high-fat foods, Increase Calcium intake)
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Maintaining a healthy weight suitable for your body
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Increase physical activities through regular exercise
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Avoid drinking alcohol and quit smoking
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Get regular check-ups
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Frequently Asked Questions
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How do I prepare my stool for the fecal occult blood test (FOBT)?
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The FOBT is a type of test that checks to see if there is blood in the stool. For an accurate examination, a sufficient amount of feces is taken by deeply puncturing three or more points of the collected stool. If the stool is dry or contaminated with urine or water, the test may not be possible. You should submit your stool to the hospital on the same day the stool is collected.
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A stool examination revealed suspicious findings. Is it colon cancer?
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In the case of upper gastrointestinal bleeding, there is often an inflammation of the stomach or duodenum. Confirmation that the bleeding was caused by an anal disease can be made only if the doctor sees blood from the anus. If the anus is not bleeding, the examination site should be extended upwards. The most reliable test is a colonoscopy.
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Polyps were diagnosed on colonoscopy. What should I do?
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Colon polyps are very common. After a polyp is diagnosed, it needs to be removed by polypectomy for the prevention and early treatment of colorectal cancer. If you have adenomatous polyps that can develop into colorectal cancer, you should consult a specialist for regular examination.
