Colon (Large Intestine) Cancer

Colon cancers are among the most common types of cancer in the world. According to the statistics of the Ministry of Health, it is among the top 5 most common cancer types in our country. Although the risk of colon cancer can be seen at any age, it is often observed after the age of 50. When the distribution by gender is examined, among all cancers, colon cancer ranks third in men and second in women.

What is Colon (Large Intestine) Cancer?

Colon cancer is popularly known as the “large intestine” and develops in the last part of the digestive system, affecting 1 out of every 20 people during their lifetime.

The colon and rectum are parts of the digestive system, the large intestine is the next organ after the small intestine, and its average length is 1.5 m. It is in the form of an inverted U letter, starts with the cecum from the lower right side of the abdomen, goes up and turns under the liver, passes the abdomen horizontally, comes under the spleen located in the upper left corner, and again makes a turn and goes down from the left side and merges with the rectum. The rectum is an average of 15 cm long and is the last part of the digestive system formed by the expansion of the large intestine.

Colon cancer starts in the cells in the colon and as the number of cells increases, it spreads around the colon in a circular fashion like a napkin ring. If diagnosed early, cancer cells can only be detected within the colon.

Early diagnosis is the most important criterion that brings success in the treatment of colon cancer. Colon or large intestine cancer, when detected at an early stage, it is possible to completely get rid of the disease.

Colon (Large Intestine) Cancer Risk Factors

In developed countries, the rate of colon and rectal cancer is 4-10 times higher than in developing countries. Causes of colorectal cancer; lifestyle, changes in environmental factors and hereditary genetic factors.

Characteristics of Polyps;

It doesn’t go away on its own.

It has a genetic feature, patients with colon cancer in their first-degree relatives and polyps in their previous examinations constitute a risk group and should be followed closely.

Polyps are usually around 1 cm, larger than 2 cm can be dangerous and must be removed.

Symptoms such as severe pain, intestinal obstruction, and weight loss are usually late symptoms. Problems such as hemorrhoids and fissures in the anus may cause delays in the diagnosis and treatment of rectal cancer in some patients due to similar symptoms. it is possible for these symptoms to mislead both patients and, rarely, physicians. In general, the possibility of rectum and large intestine cancer should be investigated thoroughly in bleedings from the breech region over the age of 40.

It is not yet possible to prevent the formation of polyps. Those who have adopted a sedentary lifestyle, people with extreme stress, those who use cigarettes and alcohol, those who are obese and those who eat mostly red meat are in the risk group. However, eating pulpy foods, not smoking, everything that regulates bowel movements is an important factor in preventing the formation of polyps.

Other Colon (Large Intestine Cancer) Risk Factors

Age: Although it can occur at any age, it is most often seen in people over the age of 50 and the risk of colon cancer increases with age. The rate of developing colon and rectum cancers in patients over 60 years of age is 10 times higher than those under 40 years of age.

Intestinal inflammations: There are essentially two types of intestinal inflammation. The first is ulcerative colitis, that is, ulcerative colitis that occurs locally in the colon mucosa due to infection. The second is Crohn’s disease, which occurs with intermittent inflammation in any part of the digestive system from the mouth to the anus, or in several different parts at the same time. Although it is a long-lasting, chronic disease, it can be treated. Because of the high risk of cancer, colorectal cancer screening tests should be done more frequently.

Nutrition: The incidence of colon and rectum cancers is quite high, especially in the USA and European countries where fast food consumption is common. Consumption of fiber-free food increases constipation, causing stool to remain in the intestine for a long time and cancer of that area. Delicatessen products, pickled meats, smoked meats, barbecue foods and fried foods cause constipation. In addition, it has been determined that consuming foods rich in fruits, vegetables, legumes, chicken and grains reduces the risk rate.

Obesity: Being overweight increases the risk of colon cancer, regardless of male or female.

Smoking: Many studies have shown that there is a relationship between smoking and colon cancer.

What are the Symptoms of Colon (Large Intestine) Cancer?

The most common colon cancer symptoms are:

• Constant diarrhea and constipation
• The thinning of the stool, which always comes in a normal thickness,
• Bleeding from the anus and stool,
• Egg white-looking secretion in stool

When colon (large intestine) cancer progresses and blocks the intestine, swelling and pain occur in the abdomen.

• The feeling of not emptying the intestines enough,
• Defecation difficulty
• Painful defecation
• Unexplained weight loss
• Vomiting

Colon cancer, also known as colon cancer, is one of the most important symptoms of colon cancer, which is on the right side of the intestine, and colon cancer on the left side of the intestine can show different symptoms. Since the left side of the intestine is a narrower region, complaints such as stool thinning, bleeding, and change in stool pattern are more common in cancers of this region, while on the right side, since the intestine is wider, the cancer progresses insidiously here and takes longer to show symptoms.

Symptoms such as weakness, anemia, loss of appetite and abdominal pain are seen in the patient, as well as painful defecation, iron deficiency anemia, and a feeling of mass in the abdomen are among the important symptoms for colon cancer. Colon cancer diagnosis before the disease progresses greatly increases the chances of survival. Therefore, it is very important to follow the symptoms of colon cancer for early diagnosis.

How is Colon Cancer Diagnosed?

Colon cancer is a type of cancer included in screening programs. The most effective way to prevent cancer or to detect the disease at an early stage is regular endoscopic examinations, and colonoscopy is the leading one. Colonoscopy is an application that can both detect an existing tumor at an early stage and prevent the development of cancer by detecting polyps and similar problems that may lead to cancer before they become cancerous. Every person over the age of 50 is advised to undergo a colonoscopic examination at intervals of 2-5 years, depending on their risk status, personal health history, and family history. The preparation and application of colonoscopy is much easier and more comfortable for the patient today, new colonoscopes are extremely easy to apply and desired results are obtained without causing discomfort to the patient.

The diagnosis of colon cancer is made by some tests performed by specialist physicians. Following the patient’s consultation with the doctor and the physical examination, the following tests are applied respectively:

Examination for occult blood in stool: It is an extremely simple test, performed by examining small samples of stool in the laboratory.

Radiological examinations: Double-contrast colon radiography and computed tomography are performed.

Laboratory tests: Complete blood count, biochemical tests are applied. Among these, CEA (Carcinoembryonic antigen) examination is one of the tests that can be elevated in the blood in large intestine cancers and helps diagnosis.

Endoscopic examinations for definitive diagnosis: a piece of the seen lesion is taken and examined by the pathologist.

If there is a case of colon cancer in the person’s family before the age of 50, he should have a colonoscopy from the age of 40 and the colonoscopy should be repeated every 5 years. In addition, checking for occult blood in the stool once a year is also necessary for the detection and early diagnosis of cancer. If there is no colon cancer in the family, it is appropriate to have a colonoscopy every 5 years, starting from the age of 50.

Classical colonoscopy, besides providing the diagnosis of polyp or cancer, also includes the feature of curing if the patient has a polyp and preventing the formation of cancer. It should not be difficult for the patient to have this done once in 5 years. Because colonoscopy is now a technique that is performed by providing relief of the patient with intravenous needles and made more tolerable with sedation and painkillers.

What are Colon (Large Intestine) Cancer Treatment Methods?

In colon cancer, when the cancer is detected at an early stage on the polyps taken in colonoscopy, surgery may not be needed, only close follow-up is required. Colonoscopy is of great importance in the diagnosis of polyps at an early stage, before they turn into cancer. Studies in recent years have shown that colon cancer can be largely prevented by early removal of polyps by performing colonoscopy. That’s why every man after the age of 45 and every woman after the age of 50 should have a stool screening for occult blood and a colonoscopy. Great attention is paid to patient comfort during colonoscopy. For this reason, the patient is made semi-conscious with a mild pain reliever called “conscious sedation”, and the intestine must be completely emptied by various methods beforehand. Then, all polyps should be removed by entering the intestine with a fiberoptic camera. However, the experience of the physician performing the colonoscopy, the disinfection of the device used and the high image quality are of great importance.

Surgery is the standard treatment option for advanced colon cancer; In other words, it is the removal of the tumor area with some healthy tissue and lymph nodes from the environment. Studies show that operations performed by experienced surgeons in accordance with the principles of oncology are the most important for the patient’s future.

For example, in “stage III” cases where the tumor has spread to the lymph nodes adjacent to the intestine, “adjuvant” chemotherapy (preventing the spread of the disease) is now a standardized procedure all over the world.

In colon cancers, in tumors very close to the anus, it may sometimes be unavoidable to cancel the anus and pass from the abdomen to defecation (with colostomy bags). However, in recent years, preoperative chemotherapy with radiotherapy can significantly protect the anus. In patients who have spread to other organs (metastatic), all three treatment methods (surgery, chemotherapy, radiotherapy) are applied depending on the general condition of the patient, age, and extent of the disease. The aim here is to increase the life expectancy and quality of patients. With the new targeted biological drug therapies in the last few years, the success rates in treatment are increasing day by day.

Nutritional styles and screening tests are of great importance in the protection of individuals who have not been diagnosed with colon cancer. It is necessary to consume plenty of fibrous foods such as vegetables, fruits and cereals, and to get enough calcium and vitamin D. In addition to these, early diagnosis with screening tests as a secondary prevention measure is of particular importance. For this, screening tests are recommended for both sexes, starting from the age of 50. People with a family history of colon cancer should start screening tests at an earlier age.

Preventing Colon Cancer

Although it is not yet possible to prevent colon cancer, it is possible to reduce the risk of colon cancer by paying attention to harmful habits such as diet, sedentary life, obesity, smoking and alcohol that are not suitable for daily life, some life changes should be made for this.

Nutrition: Eating foods rich in fruits, vegetables and legumes is beneficial in reducing the risk of colon cancer. Consumption of red meat and alcohol should be moderate as they increase the risk of colon cancer. A healthy diet and consumption of low-fat foods helps to keep the weight at a certain rate.

Exercise: Studies show that regular exercise reduces the risk of colon and rectal cancer, as well as many types of cancer. However, the doctor should be consulted before starting the exercise program, the doctor will help the person with the appropriate exercise program. Exercise for 30 minutes, 5 days a week or more than 5 days a week is recommended. It is possible that exercise done for 45 minutes to 1 hour may provide more benefits. moderate activities; brisk walking, cycling on flat terrain

Non-steroidal Anti-Inflammatory Drugs (such as Aspirin): Studies show that these drugs reduce the risk of colon cancer. There are potential benefits if they are used regularly, but when there is a potential risk of colon cancer, it is for your benefit to be used with doctor control. Otherwise, there is a risk of stomach bleeding.

Calcium: It may be of little benefit for colon cancer, it is known that 1200 mg of calcium consumed daily reduces colorectal adenoma form by 20 percent and advanced adenoma form by 45 percent. In addition, it has been determined that vitamin D and calcium consumed together reduce the form of adenoma.

Vitamin D: It is a fat-soluble vitamin and is found in fortified milk, cereals, dietary products containing certain types of fish, such as mackerel, salmon, tuna, and sunlight. Vitamin D is assumed to play an active role in preventing some types of cancer, including colon cancer.

Precancerous (polyps that can lead to cancer) Polyp Screening and Treatment: Screening tests applied in cancer types, especially in breast cancer, do not prevent the development of cancer, but increase the success rate in treatment by contributing to the diagnosis at an early stage. The development of cancer can be prevented by screening tests applied to identify precancerous polyps, and removing the detected polyps can prevent the cancer that will develop later.

Preventive Surgical Intervention: Preventive surgical intervention may be recommended for people at high risk of colorectal cancer. With this surgery, the colon and sometimes the rectum and other related organs are removed before cancer development occurs, but this type of surgery may only be valid for patients with high risk of colon and rectal cancer. Before deciding on surgery, you should discuss the benefits and consequences with your doctor.