Why is Colon Cancer commonly reported in the advanced stage?

A 58-year-old-male (who is a chain smoker) was referred to me recently by a well-known General Physician in Kochi. Panicked by seeing blood in his stools, one morning, this person took the right step by consulting his general physician immediately.

There are many reasons why there may be blood in stool. The most common reasons are hemorrhoids, anal fissures, and colorectal cancer. Other reasons can include ulcerative colitis, Crohn’s disease, and infections of the intestine.

In this case, the General Physician, based on preliminary examination, suspected colon cancer and directed the person to me for further diagnosis. 

Colon cancer is usually suspected if a person has symptoms such as blood in the stool, changes in bowel habits, unexplained weight loss, or a family history of the disease. By definition colorectal cancer is cancer that starts in the colon or the rectum of the large intestine.

Colon cancer is commonly reported in an advanced stage because it is not usually detected until it has grown and spread to other parts of the body. This poses a danger and can lead to a number of problems, including: 

• A decreased life expectancy 
• A higher chance of the cancer spreading to other vital parts of the body.

Preventing colon cancer is entirely not possible but the predisposition to it can be reduced by:

• Eating a healthy diet that includes plenty of fruits, vegetables, and whole grains; 
• Exercising regularly; 
• Avoiding smoking and excessive alcohol consumption; and 
• Getting regular screenings for colon cancer.
• Reducing red meat, smoked meat, and processed food. 

The male patient referred to me was given timely treatment and guidance at Karkinos Healthcare. With proper medical intervention and digital health tools, we could save him from succumbing to colon cancer (proving that early cancer diagnosis results in better treatment outcome). 

What are the causes of colon/colorectal cancer? 

There are many possible causes of colon cancer. 

Some include: 

• Age 
• Gender (men are more likely to get colon cancer than women) 
• Family history 
• Diet (especially consumption of high calorie food and red meat)
• Lifestyle choices 
• Smoking 
• Excessive alcohol consumption

How is Colon/Colorectal Cancer diagnosed?

A physical exam and a series of tests, including a colonoscopy, may be used to diagnose colon or colorectal cancer.

FIT (Fecal Immunochemical Test) is a stool test that is commonly used to look for possible signs of colorectal cancer. This test is able to look for human blood in the stool that helps in screening of colorectal cancers.

FIT is used more commonly these days for colon cancer testing because it is a more sensitive test than a fecal occult blood test (FOBT). FIT can detect smaller amounts of blood in the stool, which may be a sign of cancer. Stool-based tests like FIT are less invasive and easier to perform, but the only drawback is that they need to be done more often.

Unlike FOBT, there are no drug or dietary restrictions before undergoing FIT (because vitamins and foods do not affect the test), and collecting the samples are much easier. This test is also less likely to react to bleeding from the upper parts of the digestive tract, such as the stomach. 

The visual exams look at the structure of the colon and rectum for any abnormal areas. Colonoscopy is done either with a scope (a tube-like instrument with a light and tiny video camera on the end) put into the rectum. Special imaging (x-ray) tests are also done for further diagnosis.

Treatment for Colon/Colorectal Cancer

If cancer is found early, treatments are more effective. The treatment for colorectal cancer depends on the stage of the cancer. Treatment may include surgery, chemotherapy, radiation therapy, or a combination of these. 

There will be a need for a colostomy if the cancer has advanced. Advanced cancer cases patients usually present 

• Bleeding from the rectum; 
• Inability to have a bowel movement; 
• Inability to urinate;
• Narrowing of the colon, which can block the flow of stool;
• Obstruction of the intestine by a tumor.

Colostomy, a surgical procedure that creates an opening, called a stoma, on the abdomen so that stool can be passed from the intestine to an external bag, is performed in advanced cancer conditions.

The earlier the detection of colon cancer the lesser and simpler the treatment modalities.