Colon cancer is second only to lung cancer both in frequency and mortality. Like all other cancers, colon cancer starts as a collection of cells that begin to divide without control, and form a tumor. Many cancers of the colon arise in, or begin as benign polyps that may be asymptomatic. Therefore a proper diagnosis and means of detecting these polyps before they evolve into cancers is the most effective way of avoiding colon cancer.
The incidence of Colon cancer increases with age but can occur at any age. In some cases there may be a history of colon cancer in the family but a direct genetic factor has never been established.
The common symptom for colon cancer is rectal bleeding. Generally the blood is mixed in the stool. Those patients who have routine annual physicals may have blood in the stool detected by special tests done during a routine rectal exam.
The treatment of colon cancer depends largely on adequate diagnosis. Patients complaining of rectal bleeding or found on routine physical to have blood in the stool will be sent for evaluation by colonoscopy. If a diagnosis of colon cancer is made through colonoscopy with biopsy, the patients will generally be referred to a surgeon for treatment.
Before surgery is conducted, the patient is first of all required to undergo a series of standard diagnostic tests. Many of these are routine preoperative tests common to all major surgery, however, a CT scan of the abdomen and pelvis with contrast and a CEA blood determination are specific tests
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Those patients requiring surgery are generally admitted to the hospital a day before surgery for preparation of the bowel for surgery. This is done by a combination of enemas, oral laxatives, oral antibiotics, and intravenous fluids to prevent dehydration. This preparation is extremely important in cleaning out the colon and reducing the risk of infectious complications that may be associated with surgery.
The surgical procedure for removal of the colon will depend on the amount of colon to be removed and generally lasts from two to four hours.
At first an incision is made in the abdomen usually down the middle, the surgeon will isolate the diseased portion of the colon from the surrounding organs and removes it. After removing the infected section, the surgeon will reconnect the colon with sutures or with a stapling device. This procedure is called anastomosis or resection and is one of the most common procedures used to remove colon cancer.
A colostomy may be constructed to help eliminate waste products while the colon is healing. A colostomy is an incision into the colon (large intestine) to create an artificial opening or "stoma" to the exterior of the abdomen. This opening serves as a substitute anus. Bowel movements fall into a collection pouch.
Following surgery, recovery in the hospital takes about a week. The patient is not allowed to eat or drink anything until GI tract function resumes as evidenced by passage of flatus and bowel movement. Generally, it takes 4 to 5 days for GI tract function to resume.
Radiation may be required as an addition to surgery and chemotherapy in the treatment of colon cancer. Chemotherapy for colon cancer is indicated for large tumors that involve the full thickness of the bowel wall or that invades lymph nodes or has metastasis to the liver or other organs.
The chances of survival from colon cancer are by early diagnosis and treatment. A yearly rectal examination with testing of the stool for blood should be part of every physical examination.
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