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Colorectal cancer

Colorectal cancer, also known as colon cancer or rectal cancer, is a type of cancer that starts in the colon or rectum. The colon and rectum are part of the digestive system and are located in the lower part of the digestive tract. The colon is the large intestine, which absorbs water and nutrients from food. The rectum is the end of the large intestine, which stores waste before it is eliminated from the body. Colorectal cancer can start as a growth, called a polyp, in the lining of the colon or rectum and may develop into cancer over time. Colorectal cancer is the third most common cancer worldwide, accounting for approximately 10% of all cancer cases. According to the American Cancer Society, an estimated 149,500 new cases of colorectal cancer were diagnosed in the United States in 2021. Colorectal cancer can often be cured if detected early through screening tests.

Risk factor

There are several risk factors that may increase an individual's chances of developing colorectal cancer. These include:
  •  Age The risk of colorectal cancer increases with age, with most cases occurring in individuals over the age of 50.
  • Family history Individuals with a family history of colorectal cancer or polyps are at an increased risk of developing the disease themselves.
  • Inflammatory bowel disease (IBD) Individuals with ulcerative colitis or Crohn's disease, which are types of IBD, have an increased risk of developing colorectal cancer.  
  • Personal history of colorectal polyps or cancer Individuals with a family history of colorectal cancer or polyps are at an increased risk of developing the disease themselves.
  • Certain genetic syndromes Inherited genetic syndromes, such as Lynch syndrome or familial adenomatous polyposis (FAP), can increase an individual's risk of developing colorectal cancer.
  • Sedentary lifestyle Lack of physical activity and a sedentary lifestyle may increase the risk of colorectal cancer.
  • Diet A diet high in red and processed meats, and low in fruits, vegetables, and whole grains, may increase the risk of colorectal cancer.
  • Smoking and alcohol consumption Smoking and heavy alcohol consumption may increase the risk of colorectal cancer.
  • Diabetes People with diabetes may have an increased risk of colon cancer.

It's important for individuals with these risk factors to talk with their healthcare provider about their risk for colorectal cancer and to discuss appropriate screening tests and other preventive measures.

Diagnosis

The diagnosis of colorectal cancer typically begins with a physical exam and a review of the individual's medical history. If colorectal cancer is suspected, the healthcare provider may recommend one or more of the following tests
  • Colonoscopy his is a procedure in which a long, flexible tube with a camera on the end is inserted into the rectum and guided through the colon to look for polyps or cancer.
  • Sigmoidoscopy This is a procedure similar to a colonoscopy, but only the lower part of the colon is examined.
  • Biopsy በDRE ወይም PSA ምርመራ ወቅት ያልተለመዱ ነገሮች ከተገኙ ባዮፕሲ ሊመከር ይችላል። በዚህ ሂደት ውስጥ ለምርመራ የሚሆን  ከፕሮስቴት እጢ ውስጥ ትንሽ ቲሹ ይወጣል፡፡
  • Fecal occult blood test (FOBT) This is a test that checks for blood in the stool, which may be a sign of colorectal cancer.
  • Fecal immunochemical test (FIT) This is a newer type of stool test that checks for blood in the stool.
  • Imaging tests such as CT scans, MRI scans, or PET scans, may be used to help diagnose colorectal cancer and determine the stage of the disease.
It's important to note that early-stage colon cancer may not cause any symptoms, which is why screening tests are so important for early detection. Screening tests for colon cancer may include a fecal occult blood test, sigmoidoscopy, colonoscopy, or virtual colonoscopy. These tests can help detect colon cancer in its early stages, when it's most treatable. If colorectal cancer is diagnosed, further tests may be done to determine the stage of the cancer and whether it has spread to other parts of the body. This information is used to guide treatment decisions. The choice of treatment depends on several factors, including the stage of the cancer, the location of the tumor, and the individual's overall health. It's important for individuals with a family history of colorectal cancer or other risk factors to talk with their healthcare provider about appropriate screening tests and to be aware of the signs and symptoms of colorectal cancer, such as changes in bowel habits, blood in the stool, abdominal pain or discomfort, and unexplained weight loss. Early detection and treatment of colorectal cancer can improve the chances of a successful outcome.

Staging for colorectal cancer

  • Stage 0 This is called cancer in situ. The cancer cells are only in the mucosa, or the inner lining, of the colon or rectum.
  • Stage I The cancer has grown through the mucosa and has invaded the muscular layer of the colon or rectum. It has not spread into nearby tissue or lymph nodes
  • Stage II The cancer has grown through the wall of the colon or rectum but has not spread to nearby tissue or to the nearby lymph nodes
  • Stage IIB The cancer has grown through the layers of the muscle to the lining of the abdomen, called the visceral peritoneum. It has not spread to the nearby lymph nodes or elsewhere
  • Stage IIC The tumor has spread through the wall of the colon or rectum and has grown into nearby structures. It has not spread to the nearby lymph nodes or elsewhere
  • Stage III የኮሎን ካንሰር ምንም ያህል ጥልቀት ቢኖረውም ወደ 4 ወይም ከዚያ በላይ ንፍፊቶች ተሰራጭቷል ነገር ግን ወደ ሌሎች ሩቅ የሰውነት ክፍሎች አልተስፋፋም
  • Stage IIIB ካንሰሩ በአንጀት ግድግዳ በኩል ወይም በአካባቢው የአካል ክፍሎች እና ከ1 እስከ 3 ንፍፊቶች ወይም በኮሎን ወይም ፊንጢጣ አካባቢ ወደሚገኝ ንፍፊቶች ወደ የማይመስሉ እጢዎችአድጓል። ወደ ሌሎች የሰውነት ክፍሎች አልተስፋፋም
  • Stage IVA ካንሰሩ ወደ አንድ ሩቅ የሰውነት ክፍል ማለትም እንደ ጉበት ወይም ሳንባዎች ተሰራጭቷል።
  • Stage IVB ካንሰሩ ከ1 በላይ የሰውነት ክፍሎች ተሰራጭቷል።
  • ደረጃ 4C ካንሰሩ ወደ ፔሪቶኒም ተሰራጭቷል። እንዲሁም ወደ ሌሎች አካላት ተሰራጭቷል፡፡

    • Treatment

    The treatment of colorectal cancer depends on several factors, including the stage and location of the cancer, the individual's overall health, and their personal preferences. Treatment options may include

    • Surgery Surgery is the most common treatment for colorectal cancer. The goal of surgery is to remove the cancerous tumor and any surrounding tissue that may contain cancer cells. Depending on the location and size of the tumor, different types of surgery may be performed, such as a colectomy, proctectomy, or APR (abdominoperineal resection). 
    • Radiation therapy Radiation therapy uses high-energy X-rays or other forms of radiation to kill cancer cells. It may be used before or after surgery to shrink the tumor or to destroy any remaining cancer cells.
    •  Chemotherapy Chemotherapy uses drugs to kill cancer cells. It may be given before or after surgery, or in combination with radiation therapy. Chemotherapy can be administered orally or intravenously.
    • Targeted therapy Targeted therapy drugs target specific molecules that are involved in the growth and spread of cancer cells. These drugs can be given orally or intravenously.
    • Immunotherapy Drug help the body's immune system to recognize and attack cancer cells. Immunotherapy can be given orally or intravenously.
    • Clinical trials Clinical trials are research studies that test new treatments or combinations of treatments. Participation in a clinical trial may be an option for some individuals with colorectal cancer.

    It's important to note that not all individuals with colorectal cancer will require all of these treatments. Treatment plans are individualized based on the specific needs of each person. The healthcare team will work with the individual to determine the best treatment plan for them.

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