Colorectal cancer

What is Colorectal Cancer?

Colorectal cancer is a term used to describe cancers (lumps, growths, tumours) of the colon (the large intestine or bowel) and rectum. Together, they are one of the most common cancers in the world. Tumours can be described as benign or malignant. Benign tumours do not spread, but malignant tumours, such as in colorectal cancer, are made up of cells that can spread to and damage other parts of the body.

• The colon and rectum are part of the body's digestive system and are also known as the large bowel.
  
• The colon is responsible for reabsorbing large amounts of water and nutrients from undigested food products passing along it.
  
• The rectum is situated at the end of the colon and stores the waste material before it is passed out of the body.

Symptoms of colorectal cancer can include:

• A change in bowel habits (diarrhoea, constipation or a feeling the bowel does not empty itself properly).
  
• Blood in the stools.
  
• General abdominal discomfort such as pains, bloating or fullness.
  
• Unexplained weight loss, tiredness and vomiting.

However, many of these symptoms may also occur in association with other conditions and therefore it is essential to see a doctor for a correct diagnosis.

How do you get Colorectal Cancer?

As with many other types of cancer, the exact causes of colorectal cancer are unclear, although a number of risk factors have been identified that may increase a person's chance of developing the condition. For example, the risk is increased:

• In more elderly people.
  
• In people who have a diet high in protein, saturated fats and calories, but low in fibre. Also in those with a high intake of alcohol.
  
• In those with a past history of some female cancers, such as those of the breast, ovary or uterus.
  
• In people who have one or more close family members who have had colorectal cancer.
  
• People with the condition ulcerative colitis, where the lining of the colon becomes inflamed also have a higher risk.
• Another common risk factor for colorectal cancer is the presence of polyps. These are benign growths on the inner wall of the colon or rectum. If they are left untreated, they may, over time, become cancerous.

It should be remembered however, that having one or more of these risk factors does not mean that a person will develop the disease. It just increases their chances of getting it.

How serious is Colorectal Cancer?

Colorectal cancer is potentially a very serious condition and can be life-threatening.

How long does Colorectal Cancer last?

Colorectal cancer is the second most common tumour in men and women (lung cancer is most common).

• It is estimated that 1 or 2 people out of every 100, aged 50 years and over, will develop colorectal cancer.
  
• Approximately 4 out of 10 patients are at the advanced stages by the time it is first detected and confirmed (diagnosis).
  
• This means that surgery is the most likely option after the initial diagnosis and consultation.
  
• In a smaller number of cases, it is possible that the patient may only need treatment by a medical or clinical cancer specialist, without surgery.

How is Colorectal Cancer treated?

Unlike many other tumours, the actual size of the tumour is not the most important factor that determines outcome. More important is how much the tumour has spread. Doctors will do tests to 'stage' the cancer to determine how best to treat it. Treatment of colorectal cancer will vary depending on the extent of the disease:

• In the early stages, the main treatment will be surgery to remove the tumour and surrounding tissue. In some cases, no further treatment will be needed, as the cancer will have been removed. Depending on individual circumstances, the surgeon might be able to reconnect the intestines after removing the tumour and thus avoid the need for a colostomy. This is not always possible however, and a temporary or permanent colostomy might be required in some people.
  
• Sometimes, it may be necessary to use other forms of treatment in combination with surgery to reduce the chance of the cancer coming back.
  
• In both cancer of the colon and rectum, chemotherapy may be given in case any cancer cells have spread to other parts of the body. These powerful medicines work by killing cancer cells by stopping them from dividing and growing.
  
• In rectal cancer, radiation therapy, which also stops tumour cells from dividing and growing, may also be used as this has been shown to be beneficial to some patients.

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