Colorectal cancer

If you have colorectal cancer or are in the process of being diagnosed, it is understandable that you want to know the answers to many important questions. This article is written for the purpose of answering these questions and providing you with a concise and rounded overview of information on colorectal cancer.

What causes colorectal cancer and where does it occur?

Colorectal cancer is a heterogeneous disease and one of the most common malignancies, accounting for almost 10 % of the incidence of all cancers in the world. It is called “colorectal” because it occurs in the large intestine (colon) and at its end (rectum). Depending on the site of origin, the expressions colon cancer or rectal cancer are also used. 

Various studies suggest that the cause of colorectal cancer is a complex combination of multiple external factors and hereditary predispositions.

As a rule, it develops from adenomas, polyps that grow from the mucous membrane of the colon towards the intestinal interior. Adenomas are relatively common and initially benign, with a mushroom-like shape. However, over a period of five years or more, it is possible for them to become malignant. The probability of an adenoma becoming cancerous is less than 10 %.

What are the risks for colorectal cancer?

Hereditary predispositions mean that people with close relatives who have or have had colorectal cancer have a 2-4-times higher risk of developing the same condition. External risk-increasing factors are connected to eating habits that include foods such as processed meat and refined carbohydrates. This also includes specific habits such as smoking, drinking alcohol and a lack of physical activity.

This is why colorectal cancer is sometimes said to be a “lifestyle” disease.

According to the American Cancer Society, the probability of getting colorectal cancer is slightly higher for men (4.4 %) than for women (4.1 %). The risk of colorectal cancer increases significantly with age, so almost 90 % of people with this condition are sixty or more years old.

In addition, the risk is increased by the long-term presence of inflammatory bowel diseases such as ulcerative colitis and Crohn’s disease.

Symptoms and diagnosis of colorectal cancer

Symptoms of colorectal cancer are: frequent occurrence of blood in the stool, changes in bowel movements such as diarrhea and constipation, unexplained weight loss, abdominal pain, long periods of exhaustion and fatigue.

It is important to point out that these symptoms do not necessarily mean that you have colorectal cancer, they can also be caused by other health issues. For example, the cause of blood in the stool may be hemorrhoids.

However, in case you have some or all of these symptoms, it is important that you consult your doctor.

 In the process of diagnosing colorectal cancer, the “golden standard” is colonoscopy.

In addition to being used for diagnostic purposes, colonoscopy can also remove polyps in the intestine for prevention. If colorectal cancer is detected, further tests include a CT scan and magnetic resonance imaging.


Treatment of colorectal cancer

Surgical treatment of colorectal cancer is the main therapy approach, and the concrete procedure mostly depends on the location of cancer and the level to which it has spread. For the zero stage of cancer, for example, polypectomy — a colonoscopic removal of polyps will be sufficient. A more widespread cancer may also require a resection that removes the entire part of the intestine affected by the cancer.

After surgery, a patient may require a temporary or sometimes even a permanent stoma if the major part of the intestine has been removed by resection.

There is a higher number of people who only have a temporary stoma after the procedure, ranging from a few weeks to six months, depending on the duration of the recovery. In case of a permanent or a temporary stoma, you will use an ostomy system with a bag to collect the digested material.

In the treatment of colorectal cancer, a surgical procedure is usually followed by an adjuvant therapy, which may include chemotherapy and radiotherapy. The purpose of the therapy is to destroy possible remaining cancer cells.

Can colorectal cancer return after surgery?

If you have had colorectal cancer or are waiting for surgery, it is understandable if you feel concerned about the possibility of the disease returning after surgery. Although the possibility always exists, it is encouraging that, after the procedure, elaborate monitoring measures are taken, increasing the likelihood of a timely discovery of possible cancer recurrence and further treatment.

You determine the dynamics of monitoring together with your doctor, depending on the specific case and stage of the cancer. It usually includes an annual colonoscopy for the first five years after the procedure. In addition, monitoring includes physical examinations with laboratory tests at intervals determined by the doctor.

Is it possible to reduce the risk of colorectal cancer recurrence?

Research shows that it is possible to reduce the risk of cancer recurrence through an active lifestyle, which is primarily related to regular exercise and maintenance of a healthy body weight.

After a cancer surgery, it is also advisable to avoid the consumption of processed meat, processed grains and refined sugar. On the other hand, a diet rich in vegetables, fruit, fish and whole grains is recommended.

Some studies suggest that vitamin D is associated with a reduced risk of colorectal cancer and that patients with higher levels of vitamin D in the blood have better outcomes than patients with lower levels of the same vitamin.

However, further research is needed to identify and clarify the role of vitamin D in the fight against colorectal cancer. You should certainly consult health professionals about the best approach to nutrition and the use of possible dietary supplements after surgery. 



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