Colon Cancer-The Good, The Bad and The Ugly

"You have colon cancer." Aren't those words that strike utter fear in your heart when you hear them or hear that they have been spoken to a loved one. My life has been personally touched by these words. My Husbands family recieved word that his Grandfather's colon cancer has recurred. It is with this brave soul that I base my research so that I can understand the disease.

Colon Cancer is cancer that infects the large intestine as apposed to Rectal Cancer which only effects the last 6 inches of the colon. The colon serves to absorb water, salt and minerals from food and store waste until it is eliminated from the body. The American Cancer Society sais that every year 112,000 are diagnosed with Colon Cancer and 41,000 are diagnosed with Rectal Cancer.

Most Colon cancers start as benign clumps of cells called "adenomatous polyps" that over time become colon cancer. The signs and symptoms that you may need to seek medical attention for colon cancer are: change in bowel habits, blood in the stool, persistant cramping, gas or abdominal pain. Other symptoms may be a feeling that the bowel doesn't completely empty, weakness and fatigue and unexplained weight loss. The Mayo Clinic tells all people interested that if they see blood in their stool they need to seek help from a medical professional as soon as possible. This is not always a sign of cancer but could be another problem that could be just as dangerous if left untreated.

The reported causes of Colon Cancer are when healthy cells become altered and those cells divide and form new cells that are not really needed. In the colon or rectum precancerous polyps form in the lining of the intestine. In the later stages these polyps may penetrate the colon wall and matastitize in nearby lymph nodes or other organs.

There are 3 types of polyps. Adenomas have a potential for cancer and are usually removed by a Flexible Sigmoidoscopy or a Colonoscopy. Hyperplastic Polyps are rarely if ever cancer forming. Inflamitory Polyps may follow ulcerative colitis. Ulcerative Colitis does raise the risk of cancer in the colon.

There are many factors that play into colon cancer. Age 50 and over are a higher risk. Family history of cancer will raise your risk factor. This is especially important if you are living with the family members that also have had cancer because of the shared environmental carcinogens from lifestyle and diet. Inflamitory Intestinal Conditions such as Chron's. Inheritated disorders such as Familial Adenomatous Polyposis (FAP) accouts for 5% of these cases. This will produce thousands of polyps in the colon and rectum 90% of which causes cancer by age 45. Hereditary Nonpolyposis Colorectal Cancer (HNPCC) also known as Lynch Syndrome is more common than FAP. Diet is another important factor because some studies have shown that diets that are low in fiber and high in fat and calories raise the risk. Diets high in red meats and processed meats are also linked to a higher risk of cancer. If you lead a sedentary lifestyle the waste stays in the colon longer than if you are active. Also people who are diabetic, obese, smokers or those who drink a lot of alchohol have higher risk factors too.

Always seek advise if you see any of the major symptoms. You can form colon cancer reguardless of age but is more common in those age 50 and older. If you know that you are at a higher risk, you need to get regular screenings. However, if there is nothing to make you think that you are at higher risk then you can wait until age 50.

Screening is often the most daunting aspect of finding a diagnosis. Make sure you find a Doctor that you like and trust as this will help you to feel more comfortable as you move through the screening process. Screening can be moderatly uncomfotable. Also, make sure you discuss your options and concerns with your doctor.

The screening process usually starts with a Stool Blood Test in which you give your doctor a sample and they send it to the lab to test for blood. This is not always conclusive so your doctor may then send you for a Flexible Sigmoidoscopy. This is a flexible, slender lighted tube inserted into the last 2 feet of the colon. There is a slight risk of perforating a colon wall. However, polyps or cancer in the rest of the colon can go undetected because it's further up. A barium enema may be preformed where contrast is given in enema form and looked at with X-ray technology. A colonoscopy is much like the sigmaoidoscopy but has a video camera attached to a monitor so that the doctor can see the colon. The doctor may take the polyps or biopsies at this time. Usually a mild sedative will be given for your comfort and you will drink a large amount of fluid that has a laxitive in it to clean out the colon. The rare risks are bleeding or perforation of the colon wall.

There are 5 stages of Colon cancer. 0 stage is the earliest stage and is also called Carcinoma in situ. 1 stage is when the polyps have grown through the mucossa (inner layer) of the colon but has not spread beyond the colon wall or rectum. 2 stage is when the polyp has grown through the colon wall but not reached the lymph nodes. 3 stage is when the cancer is in the lymph nodes but not spread to other organs. 4 stage is when the cancer has spread to organs such as the liver, lungs, abdominal wall, etc. Then there is the recurrent stage which is when the cancer comes back after treatment. It may come to the colon, rectum or other part of the body.

Luckily there are treatment options. The options that your doctor may choose for you are dependant on the stage of the cancer. The primary options are surgery, chemotherapy and radiation therapy. In the early stages it is usually treated with surgery or a colonoscopy. If the polyps are large then laproscopic surgery may be used which has a lower rate of recurrence than open surgery and patients usually go home a full day earlier than those who undergo traditional surgery. In the advanced stages of colon cancer palliative surgery may be performed to relieve signs and symptoms but it is not a cure. However it will not be performed at all if the cancer is very advanced or you are in poor overall health. Chemotherapy is drugs that are used to destroy cancer cells and can be used with radiation therapy. The side effects are nausea and vomiting, fatigue, hair loss and diarrhea. Radiation therapy is powerful X-rays that are used and targeted to destroy cancerous cells or shrink a tumor proir to surgery. It is rarely used in early colon cancer but is routine in early rectal cancer. Radiation is usually combined with Chemotherapy after surgery to reduce the risk of recurrence. The side effects for Radiation are diarrhea, rectal bleeding, fatigue, loss of appetite and nausea. There is also targeted drug therapy. This is 3 drugs to target the defects that allow the proliferation of cells. These are availlable to patients with advanced stages of colon cancer. The 3 drugs are Bevacizumab (Avastin) which prevenst tumors from developing new blood vessels. Cetuximab (Erbitux) and Panitumumab (Vectibix) which targets the chemical signal that tells cells to divide and reproduce. All 3 are usually used along with Chemotherapy but can be used alone.

What can I do for preventative care? Well, if you are 50 and older you should get an anual Fecal Occult Blood Test and a Flexible Sigmoidoscopy every 5 years. As well as a double contrast barium enema every 5 years. You should also have a colonoscopy every 10 years. You can also make many lifestyle changes. Add plenty of fruits, vegetables and whole grains to your diet. Limit your fat intake especailly saturated fats. Make sure to vary your diet to increase vitamin and mineral intake. Limit your alchohol intake and quit smoking!! All this plus stay active and maintain a healthy weight.

What do I do if I or someone I love is given the diagnosis of cancer?! After the diagnosis, coping is the hardest thing to do and will make everything else seem insignificant. Make sure that you talk to your doctor immediately to know what to expect. Be proactive with your health. If you think you need a second opinion, get one and never let others make health decisions for you if you do not need them too. You may want to instate a living will to make sure nobody takes over for you "in your best interest". You have cancer and want to be handled with dignity and respect. Maintain a close support system. This also includes going to a coping group or other program with others that are dealing with the same problems and issues. Surround yourself with people who love you and will support your health decisions. Set reasonable goals for yourself, now is not the time to try to run the 30K marathon. And lastly take time for yourself. Everyone needs alone time and this is very important as you learn more about what you are dealing with. It's a lot of information and sometimes you need time to let it all sink in and begin to cope with.

I am not a doctor therefore I am not giving diagnosis. This is just the information that I have dug up as I personally coped with my Grandfather-in-Law and his colon cancer. I feel that it is my duty as a family member to know what is going on, what to watch for and how to help him and my family cope. I hope that this will reach another person out there who is in desperate need of some information as they deal with the diagnosis of colon cancer. If you are reading this and have that diagnosis or someone you love just got the diagnosis-you are not alone. It's a long and winding road with many stumbling blocks along the way. Just know that you are loved and show love to that person who just got the diagnosis. Good Luck and Gods Bless!!