What is Colon Cancer?
Colon cancer is a disease in which malignant cells form in one or more layers of tissue of the colon (the longest part of the large intestine). The majority of the time, it begins with the growth of pre-malignant polyps known as adenomas.
Over several years, these polyps can grow larger and become malignant, developing into a tumor. Because this process can take time, early detection and screening are important to identify the colon polyps before they develop into cancer. If it is determined that you have colon cancer, it is extremely important to take the time up front to secure a comprehensive diagnosis because the unique biology of your tumor will drive treatment decisions.
Warning Signs of Colon Cancer Development
Men and women, especially those with a personal or family history of colon cancer, polyps, or inherited colon cancer syndromes, should get screened for colon cancer, generally before the age of 50. Additionally, people with ulcerative colitis or Crohn’s disease are at higher risk and may require screening at an earlier age.
Physical warning signs for colon cancer that should be monitored and may potentially indicate a problem include:
- Blood in or on the stool
- Recurrent shifts in normal bowel habits such as experiencing diarrhea or constipation for no known reason
- Thinning of the stool
- Increases in stomach discomfort (bloating, gas, fullness and/or cramps that last more than a few days)
- A feeling that the bowel does not empty completely
- Weight loss for no known reason
- Constant and unexplained fatigue
If you are experiencing any of these symptoms, consult a physician in order to either rule out colon cancer or diagnose it early for the best chance of recovery.
Visit Fight Colorectal Cancer for more detailed information on warning signs and risk factors.
How to Detect & Diagnose Colon Cancer?
If you are experiencing symptoms of colon cancer or cancer has been found via screening, your doctor may recommend some or all of the following tests to definitively diagnose it:
- Colonoscopy is a procedure which allows a physician to view and assess the large intestine (colon) by inserting a colonscope into the colon. The colonscope is a thin, flexible, hollow, lighted tube that has a tiny video camera. If necessary, your doctor will use the colonscope to snare and remove polyps from the colon (called a polypectomy) during your colonoscopy.
- Physical exam to check for tenderness, swelling, and/or unusual growths.
- Image testing may include:
- Chest X-ray
- PET scan
- Blood tests could include a complete blood count (CBC), liver function test (LFT), and/or CEA (carcinoembryonic antigen) measurement. CBC is used to rule out anemia caused by a potentially bleeding tumor and an LFT tests your overall liver function. CEA a tumor marker, and for some people, a high CEA measurement may indicate they have cancer.
Your treatment depends on a complete and accurate diagnosis, which takes time to determine. Most people with colon cancer will have surgery to remove the tumor and lymph nodes, which will be examined to determine their exact stage and diagnosis.
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Colon Cancer Staging
After cancer has been diagnosed, the stage of the cancer must be established in order to determine the appropriate treatment. The stage is essentially an indicator of how far the tumor has grown into the colon wall, and if it has spread to other parts of the body. Your doctor will require a staging workup, including colonoscopy, CEA blood level, chest X-ray, and CT scan of the abdomen and pelvis, to determine if the cancer has spread.
To establish the cancer stage, a surgeon removes the tumor and nearby lymph nodes. The tumor is examined by a pathologist to determine the pathologic state – whether they appear normal (called cell differentiation). The pathologist will also determine:
- How much of the colon wall is involved
- Whether or not the cancer has grown into the lymph nodes
- The type of cancer cell and tumor grade (how closely the cancer resembles normal colon tissue when viewed under a microscope)
- Whether there has been any vascular invasion and the number of lymph nodes involved
All of this information will be included in your pathology report. It is important to take the time to gather as much information as possible and review with your healthcare team to help guide decisions about your personal treatment path.