Development of cancer from the parts of the large intestine is referred to as colorectal cancer. It is also called colon cancer, bowel cancer or rectal cancer. Colorectal cancer is the third most leading cause of cancer deaths in both men and women in the United States and the fourth most common cancer in the United States. More than 145,000 new cases of the disease are diagnosed each year.
Colorectal cancer may develop when Polyps, mushroom-like growths inside the colon, grow and become cancerous. Cells along the lining of the colon or rectum could also mutate and grow out of control, forming a tumor. Symptoms may vary depending upon the size and location of the cancer, but some signs to be aware of are included below.
Signs and Symptoms:
- Changes in bowel movements
- Abdominal cramps and bloating
- Abdominal pain
- Shortness of breath
- Diarrhea, constipation, or both
- Rectal bleeding or blood in the stool
- Loose or watery stools
- Unexplained weight loss and/or loss of appetite
If you notice any persistent symptoms, it is advised to contact your doctor for an evaluation.
It is important to note that polyps may produce few, if any, symptoms during the early stages. Therefore, the American Cancer Society recommends men and women of low to average risk have a colonoscopy at the age of 45. This increases the chances of identifying and removing polyps before they become cancerous.
Risk Factors: (A risk factor is anything that increases the chance of developing cancer)
- Age – majority of people with colon cancer are older than 50
- Family history of colorectal cancer
- Inflammatory bowel disease, Adenomatous polyps
- Physical inactivity, diabetes and obesity
- Nutrition – a low-fiber, high-fat diet
- Smoking and alcohol use
If your signs and symptoms indicate that you could have colon cancer, your doctor may recommend one or more tests and procedures to gather more information, including:
- Colonoscopy – Colonoscopy uses a long and flexible tube attached to a video camera and monitor to view your entire colon and rectum from inside. If any suspicious areas are found, your doctor can pass surgical tools through the tube to take tissue samples (biopsies) for analysis and also remove polyps.
- Blood tests – No blood test can definitively indicate if you have colon cancer, but your doctor may test your blood for clues about your overall health, such as kidney and liver function. Your doctor may also test your blood for a chemical sometimes produced by colon cancers (carcinoembryonic antigen, or CEA). Tracked over time, the level of CEA in your blood may help your doctor understand your prognosis and whether your cancer is responding to treatment.
- PET/CT scan, MRI, Ultrasound, Barium enema – Scans and imaging of the chest, abdomen and pelvis are performed to determine whether colorectal cancer has spread to other parts of the body, such as the lungs, liver, or other organs. The scans also may help doctors stage the cancer.
Treatment depends on several factors like the size, location and the stage of the cancer as well as the current overall health condition of the patient.
Surgery for Colorectal Cancer
Surgery is the most common treatment for colorectal cancer and may range from a minimally invasive procedure, such as removing a polyp during a colonoscopy, to, in rare cases, removing the entire colon.
Colorectal surgery is most often the first-line treatment for colorectal cancer. Other treatments, such as radiation therapy and chemotherapy might also be recommended.
Types of Colorectal Surgery:
Colon Resection / Partial Colectomy: During this procedure, the surgeon removes the part of your colon that contains the cancer, along with a margin of normal tissue on either side of the cancer. Your surgeon is often able to reconnect the healthy portions of your colon or rectum. This procedure can commonly be done by a minimally invasive approach (laparoscopy).
With a laparoscopic colectomy, approximately four to five small incisions are made around the abdomen. The surgical oncologist then inserts a laparoscope, a thin tube equipped with a tiny video camera that projects images of the inside of the abdomen on a nearby monitor. The surgical oncologist then inserts instruments through the incisions to perform the surgery.
A Low-Anterior Resection: Involves the surgical removal of cancer located in the upper part of the rectum. Some adjacent healthy rectal tissue may also be removed, along with nearby lymph nodes and fatty tissue. A pathologist may examine the lymph nodes to determine if cancer cells are present. This will help doctors determine the stage of the disease and whether additional colorectal cancer treatment is needed.
Anastomosis and Diverting Stoma / Ileostomy: After the cancerous portion of the rectum is removed, the surgical oncologist connects the sigmoid colon with the remaining healthy tissue located in the lower part of the rectum creating an “Anastomosis”.
Leakage of colon content from the anastomotic site into the abdominal cavity is a dangerous complication which increases hospitalization time, re-operation and even mortality.
To prevent leakage, surgeons often use an external bypass, also called a diverting stoma. This connects a loop of bowel to a pouch on the patient’s abdomen, which collects the patient’s feces. The temporary stoma is sometimes removed in a second surgical procedure, 3-6 months after with completion of anastomotic healing. This is currently considered the standard treatment for almost 70% of rectal and high-risk colon procedures.
New approaches are needed to satisfy the needs for a short-term, temporary bypass.
The CG-100 clinical study is underway at select sites.
If you or your patient who would like to be considered for the study,