Colon cancer, also known as colorectal cancer, is the second leading cause of cancer deaths in both men and women. According to the Centers for Disease Control (CDC), 53,196 Americans died from colon cancer in 2006 (the most recent year for available data). The disease affects slightly more men than women, and risk increases with age.
Excluding very rare types, colon cancer develops in the cells lining the inside of the colon and/or rectum. The colon, or large intestine, is a curving structure that continues the digestion of food from the small intestine, carries it down to the rectum for elimination. While there is no specific cause of colon cancer, certain factors can increase risk of developing the disease. These factors include genetics, diet and health. Individuals with a family history of colon cancer, especially if more than one relative has had the disease, are at increased risk. Also, two genetic syndromes, known as familial adenomatous polyposis and Lynch syndrome, have been associated with colon cancer.
A diet rich in fat and red meat may increase disease risk. In addition, heavy alcohol use as well as smoking may contribute to a colon cancer diagnosis. Health factors such as obesity, diabetes and lack of exercise are associated with increased risk. Moreover, inflammatory disease such as other types of cancer or conditions such as ulcerative colitis can increase the likelihood of developing colon cancer.
These risk factors, however, do not guarantee a diagnosis of colon cancer. As with many cancers, colon cancer develops from the complex interplay of many factors, and no two individuals are the same.
Symptoms that may indicate the presence of cancer cells in the colon or rectum include blood in bowel movements, weight loss, stomach pains, and constipation or diarrhea. Often, individuals will not experience any symptoms of colon cancer until it has become advanced. For this reason, the U.S. Preventive Services Task Force recommends that all individuals ages 50 to 75 undergo routine screening.
Colon cancer screening tests may include an at-home stool test, called high-sensitivity fecal occult blood testing (FOBT); flexible sigmoidoscopy (Flex Sig); and colonoscopy. Flex Sig and colonoscopy exams are performed by a physician. They involve the insertion of a thin tube into the rectum and/or colon to check for cancerous tissue.
Screening exams are so effective that undertaking these tests could prevent sixty percent of colon cancer deaths, according to CDC estimates.
If a diagnosis of colon cancer is made, treatment is determined by the stage of the disease. In other words, earlier stages in which the cancer is small and localized may require less intervention. Typically, surgery can effectively remove small tumors and chemotherapy is prescribed to kill any remaining cells. Chemotherapy drugs commonly used for colon cancer include irinotecan, oxaliplatin, capacitabine and 5-fluorouracil.
More advanced cancers in which the disease has metastasized, or spread, throughout larger areas of the colon or to other parts of the body may require removal of whole sections of the large intestine. Often, the remaining colon can be reconnected to the rectum, but if the cancer has also infected the rectum, a colostomy may be needed. In this procedure, a surgeon creates an opening in the abdomen and attaches a colostomy ‘bag’. Waste collects in the bag instead of passing through the rectum. Chemotherapy and radiation are then prescribed to kill remaining cancer cells, and control as much as possible the spread of the disease.
Although there is no scientific evidence to show that alternative treatments can treat or cure colon cancer, certain therapies can improve the quality of life of cancer patients. Activities such as art, dance and music can shift focus away from the disease and the treatment process, and help reduce stress. In addition, exercise and meditation can improve mood and appetite. Support groups are also a helpful resource for coping with colon cancer. Information on local groups can be found through organizations including the Colon Cancer Alliance, Cancer Care and the American Cancer Society.
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