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Bowel Cancer

Bowel cancer, which is also called colon cancer or colorectal cancer, is a cancer of the large bowel or the last part of the intestinal tract�before the stool leaves the body. These are cancers that begin as polyps growing in the lining of the intestinal tract. These polyps eventually develop cancerous cells and begin to have cancer.

The signs or symptoms of cancer of the bowel include:

• Blood in the stool
• Change in bowel habits
• Feeling that the bowel doesn�t quite empty
• Persistent pain or cramps in the abdomen
• Weight loss that is unexplained
• Fatigue or weakness

There are a couple of inherited diseases that can increase the risk of having cancer of the colon. These include:

• Familial polyposis syndrome or familial adenomatous polyposis syndrome (FAP). There are thousands of polyps, each of which has the potential to cause cancer of the colon.
• Lynch syndrome, in which there are not a lot of polyps but there is a familial increased risk of getting colon cancer at a young age.

These and other hereditary patterns can be checked at an early age so that there can be screening tests done early in life.

Lifestyle and other risk factors for colon cancer include:

• African-American race, who have a higher than average risk for getting colon cancer.
• Age greater than 50 years.
• Inflammatory diseases like inflammatory bowel syndrome and Crohn�s disease.
• Having a known history of polyps of the colon.
• Inherited conditions as above that lead to a high risk for colon cancer.
• Family history of colon cancer or polyps.
• High fat with low fiber in the diet
.
• Having a sedentary lifestyle.
• Diabetes and insulin resistance.
• Being obese.
• Smoking history.
• Alcohol use.
• Previous radiation for another cancer.

There are several tests used to detect cancerous changes in the colon, hopefully before they become full blown cancer. They include stool tests for blood, flexible sigmoidoscopy, which assesses the last few inches of the colon up to the right-sided flexure, and the colonoscopy, considered the gold standard for testing for colon cancer. It checks the entire colon for polyps and cancer. A newer test uses the CT scan and contrast dye to look for polyps. It is called a CT Colonography.

When cancer is found, it is staged to see how severe it is. Doctors use surgery, laparoscopy and CT scan to define the severity of the cancer. The different stages of colon cancer are:

1. Stage I. The cancer hasn�t spread beyond the colon or rectal wall and is localized within the colon itself.
2. Stage II. Cancer has spread to areas outside the column but not to the lymph nodes nearby.
3. Stage III. The cancer has invaded nearby lymph nodes but isn�t affecting other body parts.
4. Stage IV. The cancer has spread to distant areas of the body and is metastatic.

Treatment of Colon cancer includes removing the cancer only, doing a partial colectomy or a total colectomy. Some patients will need a colostomy, which is an opening in the abdomen in which the colon is connected in order to let stool pass. It is done when the two ends of the colon can�t be connected.

Many people will need a course of chemotherapy, which is a series of medications that kill cancer cells. It works for localized and metastatic disease. Radiation is used for localized areas that need a blast of x-rays to kill cancer cells. It can be used on singular areas of metastatic disease as well.

Complications of colon cancer include surgery that pokes a hole in the colon and with which it isn�t repaired. Metastatic disease can be a complication of colon cancer. Spontaneous perforation can occur and patients with a colostomy can have problems with the colostomy such as local infection and leakage.