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Colon
Cancer
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Description
Colon cancer affects the colon which is the
lowest part of the of the digestive system. It usually start out with
polyps (which are benign growths) found on the lining of the colon, When
these growths start growing at a rapid rate they become malignant and
cancerous.
Risk
Factors
· Age — Most
colon and rectal cancers, also called colorectal cancer, develop in people age
40 and older, and risk increases with advancing age
· Family history — Close relatives
of a person who has had colon or rectal cancer have a higher-than-average risk
of developing the disease. In cases where many relatives have had it, known
as familial colorectal cancer, the risk is even greater
· Polyps — Many colorectal
cancers develop from polyps which are multiple, small, tumor-like growths in
the colon A non-cancerous polyp may become cancerous over time, which makes
removal an important step in prevention. Familial Polyposis is an inherited
condition that leads to the development of many polyps in the colon and rectum. Inflammatory Bowel Diseases, such as chronic ulcerative
colitis and Crohn's disease
· Ulcerative Colitis —These
conditions cause inflammation of the lining and wall of the bowel. Scientists
believe that colorectal cancer may result from cell overgrowth when new cells
are generated to replace the diseased tissue
· Diet — A diet high in fat
and low in fruits, vegetables, and high-fiber foods such as whole grain breads
and cereals, has been linked to increased risk of colorectal cancer. In most
studies, the food most strongly linked to increased risk of colon cancer was
red meat.
Symptoms
· Any change in bowel habits
· Diarrhea, constipation, or feeling
that the bowel does not empty completely
· Blood (either bright red or very
dark) in the stool (often seen as coffee ground)
· Stools that are narrower than usual
often stringy
· General abdominal discomfort (frequent
gas pains, bloating, fullness, and/or cramps)
· Weight loss with no known reason
· Constant tiredness
· Vomiting
Incidence and Carriers
A gene linked to colon cancer has been reported in approximately 6% of Ashkenazi
Jews. Approximately 500,000 Ashkenazi Jews may have mutations in this gene.
A majority of these mutations occur at a single location in those Ashkenazi
Jews carrying this gene.
A mutation in the APC gene places one at increased risk of developing colon
cancer, and some have suggested that Ashkenazi Jewish patients with a familial
history of colon cancer be tested for this specific mutation.
Ashkenazi Jews with these cancers and a history of these cancers can be tested
to determine if a gene change is responsible and if that gene change can be
identified. If a family's gene change is identified, other family members can
have the test
to determine whether or not they have inherited the gene change for increased
susceptibility.
The gene test
requires a sample of blood. Results are available within one to two weeks and
the cost of the test
is around $200. When such a test
is positive, regular colonoscopic examination, usually from age 35 onward, is
imperative.
Treatment
Colon Surgery
The main treatment for colon cancer is surgery, in which the cancer and a length
of normal tissue on either side of the cancer are removed, as well as the nearby
lymph nodes.
Radiation Therapy
Radiation therapy is the use of high energy radiation to kill cancer cells either
after surgery, to kill small areas of cancer that may not be seen during surgery,
or instead of surgery. There are two ways to deliver radiation therapy:
· External beam radiation uses radiation
from outside the body, which is focused on the cancer.
· Internal radiation therapy uses
small pellets of radioactive material placed directly into the cancer.
Chemotherapy
Drugs (medications) are given into a vein or by mouth to kill cancer cells throughout
the body. Studies have shown that chemotherapy after surgery can increase the
survival rate for patients with some stages of colon cancer. Chemotherapy can
also help relieve symptoms of advanced cancer.
Tumor vaccines
Tumor vaccines, now in clinical trials for colorectal cancer, are an attempt
to re-educate the body to attack tumor cells. For reasons still unknown, at
some point the body stops attacking cancer cells, even though evidence suggests
that it does mount an immune attack against cancer cells when they are still
small and few in number.
Stem cell support
Use of stem cell support in conjunction with chemotherapy for colorectal cancer
is in clinical trials. Stem cells are very young blood cells that can repopulate
depleted bone marrow. Reintroducing stem cells to the body after high-dose treatment
permits very high doses of chemotherapy or radiotherapy to be used (since doses
high enough to kill all cancer also destroy bone marrow).
Testing
Diagnosis
· Fecal Occult Blood Test
- is a test
used to detect small amount of bleeding in the stool.
· Sigmoidoscopy - is an examination
of the rectum and lower colon (sigmoid colon) using a lighted instrument or
scope.
· Colonoscopy - is an examination
of the rectum and entire colon using a lighted instrument or scope.
· Double Contrast Barium Enema -
patient is given an enema with a solution that contains barium, which outlines
the colon and rectum on the x-rays.
· Digital Rectal Exam - is an exam
in which the doctor inserts a lubricated, gloved finger into the rectum to feel
for abnormal areas
· biopsy
· CEA assay - measures a protein
called carcinoembryonic antigen, which is sometimes higher in patients who have
colorectal cancer.
Screening Recommendations
The AHCPR panel recommended that, beginning at age fifty, persons at average
risk for colorectal cancer undergo one of the following screening regimens:
· Fecal occult blood testing annually
· Flexible sigmoidoscopy every five
years.
· Fecal occult blood testing annually
and flexible sigmoidoscopy every five years.
· Double-contrast barium enema every
five to 10 years
· Colonoscopy every 10 years.
Resources and More
Colon Cancer Alliance, Inc.
175 Ninth Avenue
New York, NY 10011
Office: 212-627-7451
Toll Free Help-line: 1-877-422-2030
Fax: 425-940-6147
Website:
http://www.ccalliance.org/
American Society of Colon & Rectal Surgeons
Telephone: 847-290-9184
Fax: 847-290-9203
85 W. Algonquin Road, Suite 550
Arlington Heights, IL 60005
Website:
Email:
This society offers a variety of brochures including several on colonoscopy
and colorectal cancer. They can also provide listings of colorectal surgeons
in your area.
Colon Cancer Discussion List
Association of Cancer Online Resources
173 Duane Street, 3rd Floor
New York, NY 10013-3334
Website:
The Colon Cancer Discussion List is provided by Association of Cancer Online
Resources, Inc. (ACOR), a non-profit organization that provides information
and support to cancer patients and those who care for them through the creation
and maintenance of cancer related Internet mailing lists and Web-based resources.
On the Colon Cancer Discussion list about 600 people regularly answer questions,
exchange information and provide support to those dealing with colorectal cancer.
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