What are the 3 ways in which colorectal cancer can present to a doctor?

There could be suspicious symptoms or clinical features, asymptomatic individuals discovered by routine screening or emergency admission to a hospital with intestinal obstruction, perforation or bleeding in the colon causing black or red stools.

What are the symptoms of local tumours?

These include black or jelly-like black or red stools, abdominal pain, unexplained anaemia due to iron deficiency and or change in bowel habits. Less common symptoms are abdominal pain, nausea, and vomiting due to intestinal obstruction.

Do the symptoms differ from tumour location?

A change in bowel habits is more common in left-sided cancer. Symptoms of abdominal pain and black, jelly-like stools are more common in left-sided cancers. Iron deficiency from unrecognised blood loss is more common with right-sided. Caecum and ascending colon have a 4-fold rise in blood loss than on the left side. Abdominal pain can occur with tumours arising at all sites. This can be caused by the spread of the tumour to the intestinal covering that is the peritoneum, partial obstruction or intestinal perforation causing dissemination. Rectal cancer can cause pain while passing stools and the individual has a diminished calibre of stools.

What are the unusual features?

Unexplained weight loss, unexplained anaemia, prolonged fever and symptoms of liver disease due to the spread of colon cancer to the liver are some unusual features.

 How is the diagnosis confirmed?

Colonoscopy and biopsy of the lesion is the standard universal procedure. Histopathology of the specimen confirms the diagnosis. Blood tests for anaemia and CEA, CT scan of abdomen and Chest are other screening tests.

What about metastatic disease?

About 50% of cases present with colon cancer that has already spread to other sites. This makes treatment difficult and survival /Soar, Colorectal cancer is a common and lethal disease. More than 1 lac individuals are likely to have colorectal cancer in India on an annual basis. It can be diagnosed after the onset of symptoms or through screening individuals without symptoms. Poor. The most common sites of spread are regional lymph nodes, liver, lungs, and peritoneum. This can lead to ascites. Cancer cells may not be detected in all ascetic fluids, though the fluid collection is due to cancer spread from the colon.

HOW is the staging of colorectal cancer done?

The local or distant spread of the disease is decided to form a decision regarding therapy and prognosis. This is best accomplished by physical examination, CT scan of the abdomen and pelvis and chest imaging. Certain other tests are done to identify patients with rectal cancer to select patients for surgical approach or initial radiotherapy or chemoradiotherapy.

What are the risk factors for colorectal cancers?

Excess smoking, being overweight, not getting enough exercise, a family history of colorectal cancer, inflammatory bowel disorders, adenomatous polyps, and certain rare inherited conditions can predispose to colorectal cancer.

Can certain food items lower the risk of colorectal cancer?

Lentils, whole grains and beans, oats, barley millets and all other high-fibre diets can lower the risk of colorectal cancer. Fruits that contain antioxidants and high fibre like bananas, oranges, apples, pears and raspberries are useful. They prevent constipation and add to the fibre. The incidence of colorectal cancer is on the rise. Early detection can improve survival through appropriate treatment. Do not ignore early signs like changes in bowel habits or black or red stools or unexplained weight loss. Be more vigilant if you have colorectal cancer in your family. Taking Aspirin, managing your body weight, being physically active and diet low in red meat and high in fruits and vegetables and calcium and vitamin D supplements are found to be useful.


Categories : Cancer

Dr Jay Deshmukh is Chief Physician and Director, Sunflower Hospital, Nagpur Honorary Physician to Honorable Governor of Maharashtra and PondicherryCentral. Dr Jay Deshmukh is an M.B.B.S., M.C.P.S., F.C.P.S., M.N.A.M.S., MD From Internal Medicine – Bombay and New Delhi.

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