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Bowel Cancer


Presentation

  • After the colonoscopy, the specialist may conduct further tests to find out whether cancer is present and, if it is, its stage of development and if it has spread.[cancerpathways.org.au]
  • In general: right sided tumors are larger and present with a mass, distant disease or iron deficiency anemia left sided tumors present earlier with altered bowel habit Colorectal cancers, 98% of which are adenocarcinomas, arise in the vast majority of[radiopaedia.org]
  • The ultimate judgment regarding the propriety of any specific procedure must be made by the physician in light of all the circumstances presented by the individual patient.[fascrs.org]
  • Colorectal cancer may not present any symptoms, especially in the early stages.[healthline.com]
  • (fatigue, weight loss) or none at all More advanced disease: Abdominal tenderness, macroscopic rectal bleeding, palpable abdominal mass, hepatomegaly, ascites See Presentation for more detail.[emedicine.medscape.com]
Fatigue
  • Common side effects include: hair loss nausea fatigue vomiting Combination therapies often mix multiple types of chemotherapy or combine chemotherapy with other treatments.[medicalnewstoday.com]
  • Healthy Lifestyles Physical Activity Nutrition and Weight Management Supplement Use Immunizations and Infections Late Effects/Long-Term Psychosocial and Physical Problems Anthracycline-Induced Cardiac Toxicity Anxiety and Depression Cognitive Function Fatigue[nccn.org]
  • Fatigue and weakness resulting from occult bleeding (bleeding not visible to the naked eye) may be the person’s only symptoms.[msdmanuals.com]
  • In addition to the above symptoms, you might also experience: excessive fatigue unexplained weakness unintentional weight loss changes in your stool that last longer than a month feeling like your bowels don’t completely empty vomiting If colon cancer[healthline.com]
  • […] common clinical presentations include the following: Iron-deficiency anemia Rectal bleeding Abdominal pain Change in bowel habits Intestinal obstruction or perforation Physical findings may include the following: Early disease: Nonspecific findings (fatigue[emedicine.medscape.com]
Fishing
  • 'You could try doing meat-free Mondays, looking for recipes using fresh chicken and fish, or swapping meat for pulses like beans and lentils in your usual meals.'[dailymail.co.uk]
Overeating
  • […] include: Bleeding from the bottom Blood in stools A change in bowel habits lasting at least three weeks Unexplained weight loss Extreme, unexplained tiredness Abdominal pain Most cases have no clear cause, however, people are more at risk if they: Are over[dailymail.co.uk]
  • Initial investigations and referral If you are over 50 years old, you can participate in the National Bowel Cancer Screening Program every two years using a faecal occult blood test (FOBT).[cancerpathways.org.au]
  • Around 91 percent of those who receive a diagnosis are over 50 years old. Colon cancer is more likely in people with sedentary lifestyles, those with obesity, and those who smoke tobacco.[medicalnewstoday.com]
  • Screening tests are important for people over 50. Colonoscopy is often used to make the diagnosis. Cancer that is caught early is most curable. Surgery is usually performed to remove the cancer.[msdmanuals.com]
  • And over a million men and women live with a history of the disease. Then there’s the good news about colon cancer: It can be prevented. Seventy-five percent of all cases could be avoided by things you can do.[siteman.wustl.edu]
Diarrhea
  • Side effects may include: mild skin changes resembling sunburn or suntan nausea vomiting diarrhea fatigue appetite and weight loss Most side effects resolve a few weeks after completing treatment.[medicalnewstoday.com]
  • […] adenomatous polyposis syndrome (FAP) Gardner syndrome variant Turcot syndrome variant Peutz-Jeghers syndrome hereditary non-polyposis colon cancer syndrome (HNPCC) Clinical presentation is typically insidious: altered bowel habit (constipation and/or diarrhea[radiopaedia.org]
  • Colorectal cancer symptoms include: A change in bowel habits (e.g. constipation or diarrhea). Narrow shaped stools. Bright red or very dark blood in the stool. Ongoing pelvic or lower abdominal pain (e.g., gas, bloating or pain).[fascrs.org]
  • If you do experience symptoms during the early stages, they may include: constipation diarrhea changes in stool color changes in stool shape, such as narrowed stool blood in the stool bleeding from the rectum excessive gas abdominal cramps abdominal pain[healthline.com]
  • Diarrhea, constipation, or feeling that the bowel does not empty all the way. Stools that are narrower than usual. Frequent gas pains, bloating, fullness, or cramps. Weight loss for no known reason. Feeling very tired. Vomiting.[cancer.gov]

Workup

  • […] the abdomen and liver Abdominal/pelvic MRI Positron emission tomography, including fusion PET-CT scan Other procedures that may be warranted include the following: Colonoscopy Sigmoidoscopy Biopsy of suspicious lesions Double-contrast barium enema See Workup[emedicine.medscape.com]

Treatment

  • In some cases more than one type of treatment may be used to get the best outcome. Treatment options: Surgery Surgery is the most common treatment for bowel cancer.[cancerpathways.org.au]
  • Radiotherapy can be used as a standalone treatment to shrink a tumor or destroy cancer cells, or alongside other cancer treatments. Radiation treatments are not often used until a later stage.[medicalnewstoday.com]
  • Treatment Options for Colon Cancer For information about the treatments listed below, see the Treatment Option Overview section.[cancer.gov]
  • Follow-up care after treatment for colorectal cancer is important. Even when the cancer appears to have been completely removed or destroyed, the disease may recur. Undetected cancer cells can remain in the body after treatment.[fascrs.org]
  • The NCCN Templates are not exhaustive and do not represent the full spectrum of care or treatment options described in the NCCN Guidelines or the NCCN Compendium or include all appropriate approaches or combinations of drugs or biologics for the treatment[nccn.org]

Prognosis

  • Overall 5 year survival rate is 40-50%, with the stage at operation the single most important factor affecting prognosis.[radiopaedia.org]
  • In the vast majority of cases metastasis are metachronous diagnosed during the study of metrorrhagia (4) and are associated with a poor prognosis. Differential diagnosis includes, among others, the primary neoplasm of vagina (7).[scielo.isciii.es]
  • POST-TREATMENT PROGNOSIS Patient outcome is strongly associated with colorectal cancer stage at the time of diagnosis. Cancer confined to the lining of the colon is associated with the highest likelihood of success.[fascrs.org]
  • Certain factors affect prognosis (chance of recovery) and treatment options.[cancer.gov]
  • A cancer's stage will determine the treatment options and inform the prognosis, or the likely course the cancer will take.[medicalnewstoday.com]

Etiology

  • The registry identifies colorectal cancer susceptibility genes, analyzes gene interactions in colorectal cancer etiology, conducts ongoing molecular characterization of participants, and translates research findings to better colorectal cancer prevention[mayo.edu]
  • It is a multifactorial disease process, with etiology encompassing genetic factors, environmental exposures (including diet), and inflammatory conditions of the digestive tract.[emedicine.medscape.com]

Epidemiology

  • The latest study of meat and bowel cancer, part-funded by Cancer Research UK, was published in the International Journal of Epidemiology.[dailymail.co.uk]
  • For the new study, published in the International Journal of Epidemiology, experts examined data from 475,581 people aged 40 to 69 at the start of the study and followed them for an average of 5.7 years.[scotsman.com]
  • […] colorectal neoplasia and serum triglycerides and/or plasma glucose might involve luminal or circulatory effects: (a) triglycerides and/or glucose may be associated with fecal bile acids, acids which are positively associated with colorectal cancer risk in epidemiological[ncbi.nlm.nih.gov]
  • The Colon Cancer Family Registry at Mayo Clinic is part of an international research consortium for investigators who conduct population-based and clinic-based interdisciplinary studies on the genetic and molecular epidemiology of colorectal cancer and[mayo.edu]
  • However, most of these studies were retrospective epidemiologic studies and have yet to be validated in prospective, placebo-controlled, interventional trials.[emedicine.medscape.com]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology Genetically, colorectal cancer represents a complex disease, and genetic alterations are often associated with progression from premalignant lesion (adenoma) to invasive adenocarcinoma.[emedicine.medscape.com]

Prevention

  • , diagnosis and treatment. • Website: www.bowelcanceraustralia.org/bca Cancer Australia Information on cancer prevention, screening, diagnosis, treatment and supportive care for Australians affected by cancer, and their families and carers • Telephone[cancerpathways.org.au]
  • […] and early detection of cervical cancer: American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer.[nccn.org]
  • The World Cancer Research Fund's 2007 report Food, Nutrition, Physical Activity and the Prevention of Cancer also said the link between red meat and the disease is 'convincing'.[dailymail.co.uk]
  • PREVENTION Colorectal cancer is preventable. Nearly all cases of colorectal cancer develop from polyps. They start in the inner lining of the colon and most often affect the left side of the colon.[fascrs.org]
  • A central goal of the Colon Cancer Family Registry is the translation of colorectal cancer research to the clinical and prevention settings for the benefit of registry participants and the general public.[mayo.edu]

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