Rectal and colon cancer symptoms. Colon and rectal cancer. Poorly differentiated tumors are combined

Such a dangerous disease as colon cancer does not have pronounced symptoms, so it is difficult to detect the disease in the early stages. Survival when diagnosed with oncology depends on the stage at which the disease is detected, how quickly the oncology develops, and on a number of other reasons. Does the age of men or women affect the onset of the disease, what causes cancerous lumps in the body, and is the disease treated with folk remedies?

Colon cancer is usually diagnosed at a late stage, which minimizes the chances of recovery.

Definition

Colon cancer is a disease characterized by the appearance of a malignant compaction on the mucous membrane of the organ and its bend. The factors that trigger bowel cancer are unknown, but men suffer from this disease more often than women. Colon cancer is a common disease among older people.

Colon cancer manifests itself and is diagnosed at stages 3–4, in which case the prognosis for survival (how long the patient will live) and recovery declines, the cancerous tumor metastasizes to the lymph nodes and nearby organs: liver, stomach, pancreas, genitourinary system. When the liver is damaged, hepatic hepatitis develops and the patient progresses to liver failure. When the stomach is affected by metastases, the digestion process worsens, the patient develops anemia, food starvation, and against the background of such signs there is rapid weight loss.

Classification and stages

Depending on the rate and how much the compaction grows, it is released:
- exophytic form, when the neoplasm grows in the lumen or flexure of the colon;
- the endophytic form is localized in the thickness of the intestinal tissue;
- with a saucer-shaped shape, both of the above options are combined.
Depending on the factors of origin, there is a classification:
- adenocarcinoma is the most common and complicated variant of a malignant neoplasm, formed from cells of glandular tissues; older people are at risk; the lower the degree of differentiation, the more dangerous the disease and the more difficult it is to treat;
- signet ring cell seal forms on the organ in the form of a ring, this type of neoplasm is difficult to cure, death occurs within 3-4 years;
- squamous cell tumor is common, tends to quickly metastasize, the descending section is affected, and the patient’s death is highly likely;
- melanoma consists of cells that are pigmented by melanocytes, is localized in the anal region and descending part of the intestine, and metastasizes.
Depending on how advanced colon cancer is and whether it has metastases, there is the following classification of stages:
- at stage 1, the tumor reaches a size of 1−1.5 cm, the lymph nodes are not affected, the tumor has not metastasized to tissues and neighboring organs; Surgical removal of the tumor, chemotherapy and radio irradiation are prescribed; if the therapy is adequate, they live a long time;
- at stage 2, the tumor size reaches 2−5 cm, the lymph nodes are not affected or are affected, but only slightly; surgical removal will bring results together with chemotherapy;
- at stage 3, the neoplasm is 5 cm or larger in size, affects the lymphatic system and nearby tissues and organs, and a complication arises; Surgery is rarely prescribed; chemotherapy is performed at the patient’s request;
- at stage 4, the tumor affects the entire organ and metastasizes to neighboring organs: liver, gall bladder, stomach, this stage does not require resection, they do not live long, survival rate is up to 10%.

Causes

Bad habits, poor nutrition, untreated gastrointestinal diseases, poor environment, and age-related changes become the causes of the development of colon cancer.

When studying the etiology of malignant neoplasms, doctors did not come to a unanimous conclusion as to why people get cancer. But studies have shown that those at risk are people whose disease is inherited; the pathology is caused by genetic changes in the body. At risk categories:

age over 55 years;
development of the inflammatory process in the intestines, its complications;
poor nutrition;
insufficient physical mobility of a person, sedentary lifestyle;
alcohol abuse, smoking;
the formation of polyps on the intestinal epithelium; under unfavorable conditions, they develop into cancer.

Signs of Colon Cancer

The first symptoms of colon cancer in the human body are characteristic of stages 3–4, when the patient feels pain and weight loss. When the disease has just begun, there are no signs; if the tumor appears in the ascending area, it will not bother you for a certain time. The diagnosis of the disease occurs during a routine medical examination, when a blood test shows a deviation from the norm and tumor markers are exceeded.

Early on

In the early stages of the growth of a malignant tumor, a person experiences pain in the abdominal area. The pain manifests itself at different times of the day, does not depend on what or how much a person has eaten, and is localized in the place where the tumor is located. The patient loses his appetite and experiences weight loss. After eating, increased gas formation, colic occurs, and intestinal function is disrupted. Digestive problems develop, food is poorly digested, belching occurs, nausea occurs, and the patient feels heaviness.

General symptoms

Symptoms of colon cancer appear at later stages, especially if it is localized in the ascending region, when the tumor is large and has begun to metastasize to neighboring organs and tissues. In a person, the functioning of the entire body is disrupted, this leads to a deterioration in health and disruption of many vital processes of the body. General symptoms:

the development of anemia, appears as a result of internal bleeding, and due to poor absorption of iron and vitamin B12;
the person becomes pale, has dry and brittle hair and nails;
fatigue, against the background of developing painful sensations;
nausea, vomiting, loss of appetite, weight loss.

Diagnostics

The first symptoms of the tumor process appear in the late stages, so diagnosing and identifying the disease is initially problematic. If cancer is suspected, the patient is referred for biochemical blood tests and if pathological processes occur in the body, the tumor marker will exceed the norm. In addition to a biochemical blood test, the patient is indicated for the following diagnosis of colon cancer:

Colonoscopy is a method that is performed using a colonoscope preparation. This is a flexible tube with a video camera at the end. The tube is inserted into the rectum, it is possible to examine the loops of the ascending and lower sections. In addition to diagnosis using colonoscopy, materials are taken for histological examination.
Sigmoidoscopy is a method when a special tube with an optical video camera at the end is used, but histological material is not taken. Using this research method, the doctor examines the mucous epithelium and sees changes, even if they are small in size and located in loops.
Fluoroscopy is performed in patients with suspected cancer when the above methods are contraindicated. X-ray examination includes computed tomography and magnetic resonance imaging, which reveal the extent of organ damage by tumor and metastases, even if it is located in intestinal loops. A chest x-ray is indicated if metastasis to the lungs is suspected.

Colon cancer involves the appearance of a malignant tumor in the area of the colon; its location and shape may vary

Unfortunately, modern medicine has not yet learned to defeat all diseases. This also applies to cancer, which ranks second in mortality on the planet.

Colon cancer is a relatively common type of carcinoma. It involves the appearance of a malignant tumor in the colon area. Its location and shape may differ in each specific case.

Forewarned is forearmed. This article will describe the symptoms of colon carcinoma, its classification, prognosis and treatment methods.

Appearance, development, stages of colon cancer

The number of patients continues to grow. In Russia, every fourth cancer patient is given a disappointing diagnosis of colon cancer. According to scientists, the disappointing increase in cases is directly related to the increased consumption of beef, pork, and a decrease in fiber in the daily diet. Scientists have come to this conclusion - vegetarians suffer from this form of cancer much less often. Elderly people and residents of countries with a good standard of living are at risk.

Photo of colon cancer from the inside

How does cancer appear? In most cases, it results from an adenoma, which is considered a benign tumor. May have large or small sizes. If the tumor is small, it may not appear for several months or even years.

How does the disease develop? Scientists have proven that poor nutrition contributes to this. If you eat only meat and disdain fiber, carcinogens begin to form in the intestines. Frequent constipation also negatively affects the “well-being” of the intestines. As a result, ordinary cells degenerate into malignant ones.

Due to rapid division and subsequent growth, the tumor can occupy the entire lumen of the intestine. Intestinal obstruction is observed, blood vessels are destroyed, and bleeding begins.

Subsequently, the tumor can metastasize to nearby organs, which will ultimately lead to the death of the patient.

Stages of colon tumor development

The appearance and subsequent progression of a malignant tumor occurs gradually. First, the tumor forms on the walls of the intestine, but then it can affect neighboring tissues. It is extremely important to recognize it in the first stages - then the treatment will be successful and the prognosis will be favorable. Modern medicine uses the following classification of cancer stages:

First stage. Detection of a tumor on both the mucous and submucous membranes of the intestine.
Second stage (A). Malignant formation occupies less than 50% of the intestinal lumen. Until it goes beyond the limits and does not penetrate the walls. There are no metastases.
Second stage (B). The formation has dimensions similar to stage 2 (A). It does not protrude beyond the limits, but begins to grow into the walls. There are no metastases.
Third stage (A). The tumor becomes larger, occupying more than 50% of the lumen. It begins to completely grow into the walls of the colon, but does not yet cause metastases in the lymph nodes.
Third stage (B). The malignant neoplasm reaches large sizes. Metastases can be detected in nearby lymph nodes.
Fourth stage. It is characterized by an impressive focus of tumors. Carcinoma has long grown into the intestinal walls, but now it also affects connective tissues and organs. Among the numerous metastases, distant ones begin to occur. In the absence of proper treatment, the fourth stage leads to the death of the patient.

What do the stages of colon cancer look like?

Only a professional oncologist can make an accurate diagnosis and determine the stage of cancer development. To do this, a thorough examination of the patient is carried out, a biopsy of suspicious areas of the intestine is taken, and the lymph nodes are examined.

Classification and types

How to classify this cancer? Medicine of the 21st century has two classifications of cancer. It all depends on the nature of tumor growth and histology. Taking into account the form of tumor growth, cancer can be:

Exophytic. The tumor was detected in the intestinal lumen.
Endophytic. The malignant formation is located directly in the thickness of the walls.
saucer-shaped. A dangerous tumor, more like an ulcer. Combines exophytic and endophytic forms.

There is also so-called intramural growth. If the patient has exactly this type of development of the disease, four types of tumors are distinguished:

Mucosal adenoma. Causes colloid cancer. It is characterized by a fairly decent appearance of mucus and its large accumulation. This type of tumor is diagnosed more often than others.
Signet ring cell carcinoma. It has no clear boundaries and occurs inside the walls. Quite often it affects men and women under the age of 35. It is dangerous due to its metastases, which appear quickly enough and affect surrounding tissues.
Squamous cell carcinoma. It is found in a variety of parts of the intestine, but most often in the distal third.
Glandular squamous tumor. It is found extremely rarely.

Why cancer occurs: reasons

We have already said that excessive consumption of meat can cause tumors. However, this is not the only carcinogenic factor; there are others:

Genetic predisposition. If one of your relatives has had colon cancer, there is a possibility that someone else will develop the tumor.
Incorrect diet. A person consumes a lot of meat and fat, as well as flour dishes. In this case, food of plant origin is almost completely excluded from the diet.
Bad habits.
Sedentary lifestyle. It’s not for nothing that they say that movement is life.
Elderly age. According to statistics, people over 60 years of age suffer from this form of cancer much more often.
Indigestion, various intestinal diseases that occurred previously.

Of course, only one of the factors listed above is unlikely to become a catalyst for the development of cancer. However, a combination of several has every chance of leading to not the best consequences. Nutrition, predisposition, and chronic diseases have a particularly strong influence.

Colon cancer and first symptoms

Like some other forms, a malignant neoplasm in the intestine goes undetected for a long time. Nothing bothers the person; there are no unpleasant sensations as such. Unfortunately, noticeable symptoms begin to appear when the disease progresses. Among the unfavorable signs are:

Discomfort in the intestinal area.
Dull, aching pain that does not stop.
Long-term intestinal obstruction. By the way, this sign may indicate that the patient needs immediate surgical intervention.
Weight loss, appetite is completely or partially absent.
Constant bloating.
A sharp increase in temperature, weakness and malaise. The person becomes pale and feels unwell.
There are bloody clots in the stool, as well as mucus.

The larger the tumor becomes, the larger and brighter it begins to declare itself. Subsequently, loss of consciousness and dizziness are added to the symptoms. The color of the stool may change.

It is worth understanding that the listed symptoms can manifest themselves in completely different ways. You need to look at the stage of the disease, the form of cancer. In the last stages there is severe bleeding, along with feces and pus. In some cases, ascites is recorded.

Bleeding in the intestines is especially dangerous, so at the slightest manifestation you should immediately consult a doctor. The help of a specialist will also be required in case of severe constipation - the problem is solved by surgical intervention.

Primary symptoms may be similar to other diseases

Prognosis and how long patients live (statistics)

It is not for nothing that intestinal carcinoma is considered a life-threatening disease. If treatment was started at stages 3-4, complications are almost inevitable. The disease begins to affect other organs. Among the most common complications are abscess, peritonitis, and phlegmon. The development of fistulas in the vagina or bladder, as well as intestinal perforation with paraproctitis, cannot be excluded.

Whatever the complication, it will require additional examination and effective treatment. The prognosis worsens if the patient is diagnosed with several complications at once. Hence the conclusion - the earlier the disease is diagnosed and the fewer complications it gives, the more favorable the prognosis.

However, let's get back to specific numbers. Due to the fact that in most cases the disease is diagnosed at late stages, every third case ends in death. How effective is surgery? It all depends on the depth of tumor germination and its size, as well as the presence or absence of metastases in organs adjacent to the intestine.

In the first five years after surgery, the likelihood that colon cancer will return is quite high. If no relapse occurs during this time, the risk of tumor development is very low.

As for the stages of the disease, everything is quite simple. If colon cancer is detected at the first stage and treatment is provided promptly, the likelihood of survival and that the disease will not return is 74%. With the fourth stage, everything is much more complicated - here the survival rate is negligible and amounts to 6%.

In case of relapse, metastases most often spread to regional lymph nodes, but can also affect the liver. According to doctors, in 70% of cases of relapse, colon cancer affected the liver.

Treatment

Today, the main and most effective method of treating cancer is surgery. Modern medicine has several types of operations. Their choice depends on many factors: tumor size, stage of the disease, location. The following methods are mainly used:

Intra-abdominal resection.

The section of intestine affected by the malignant tumor is excised. After this, its ends are sewn together with a special machine or manually. Sometimes one end of the intestine is brought out onto the abdominal wall.

Operation using Hartmann's method.

If it is impossible to sew the ends of the intestine, the tumor is first removed, and then the “upper” part of the intestine is brought out onto the abdominal wall. The other end is sutured. Over time, the operation is repeated and the colostomy is sutured.

Abdominal-anal resection.

The affected area of the intestine is excised. After this, both ends are stitched, and the intestine pulled into the anus is excised.

Laparoscopic resection.

Quite a popular method. It is characterized by a lot of advantages, it allows you to stop the progression of the disease, and improves the quality of life.

Of course, treatment is not limited to surgery alone. Other methods are also used that have proven themselves in the treatment of all forms of cancer:

Radiation therapy.

Successfully used in treatment. It cannot replace surgery, but it helps to avoid relapses and consolidate the results. Can be used at any stage. For example, carrying out therapy before excision can reduce the tumor and simplify the operation. Afterwards it is used to reduce the risk of relapse.

Chemotherapy.

Used before and after surgery. Helps remove metastases and prevent re-development. The quality and duration of a person's life are significantly improved. Among the main drugs it is worth noting platinum and 5-fluorouracil, leucovarin, calcium folinate. The use of “chemistry” allows us to achieve a favorable prognosis.

Measures to prevent colon cancer

Of course, it is better to prevent any disease than to try to cure it. Diagnosing cancer is not always possible because it may not manifest itself. On the other hand, the use of preventive measures can reduce the risk of cancer:

If you find yourself in a risk group (you are over 40 years old, one of your relatives has died of cancer), be regularly examined by a doctor and take all the necessary tests. For example, checking stool for blood. Once every three years, a colonoscopy or proctosigmoidoscopy is recommended for all people over 40 years of age.
Always treat polyposis if diagnosed. Do not let the course of the disease take its course if you have been diagnosed with colitis. This and some other diseases can become chronic.
Normalize your diet. First, review your diet. If there are too many meat products, remove them. Include foods in your diet that prevent constipation. Don't forget about complex carbohydrates - they should always be in your diet. The same goes for plant foods.
Give up bad habits.
Move more, play sports. Try to maintain vitamin levels at the proper level. First of all, this concerns beta-carotene, some antioxidants and A, C.

As you can see, following these rules is not difficult. But their implementation will help prevent cancer in any form and avoid expensive and painstaking treatment. At the first suspicious symptoms, contact a specialist.

If treatment is started in a timely manner, carcinoma can be defeated! But for this you need to be attentive to your health, eat right, and regularly undergo examinations by your doctor.

Colon cancer develops from epithelial cells, as does intestinal cancer - all its constituent parts, since the mucous membrane of the gastrointestinal tract is completely covered by epithelial tissue. Colon tumors are more often detected in men, regardless of age.

The large intestine ends the gastrointestinal tract. An anatomical structure such as the ileocecal valve or colonic valve is physiologically assigned to provide isolation of the large intestine and ileum. The ileocecal valve is located in the place where it becomes thick - in the corner to the right and downwards. The anus pumps the gastrointestinal tract.

Spread of tumor in the large intestine

Colon tumors can develop in each of its physiological parts:

the cecum with the presence of a vermiform appendix (appendix);
colon: ascending (directed upward and to the right), transverse (beginning - under the right hypochondrium downwards, directed across the abdomen to its left side), descending (continues the transverse colon, directed downward to the left of the abdomen);
the sigmoid colon, descending into the pelvic cavity;
rectum with anus - the final section where colon cancer can occur.

– it includes cancer of the colon (“colon”) and (“rectum”);

Causes of colon cancer

Risk factors include:

after 50 years of age, oncological tumors occur more often;
genetic predisposition, since some gene mutations in 25% are hereditary;
in ethnic and nutritional factors: in the Jewish population of Eastern Europe, tumors in the colon are more common. A high content of animal fats, foods with refined carbohydrates, and yeast bread in the diet increases the risk of cancer.

Risk factors gradually turn into causes of colon cancer: physical inactivity with bad habits - smoking and alcoholism. With a lack of physical activity, the smooth muscles of the intestines reduce their tone, disrupting peristalsis. Therefore, food does not move towards the anus, but stagnates. Constipation is caused by fermentation under the influence of bacteria. Harmful toxins disrupt the microscopic structure of the mucous membrane and the functional functioning of the intestines.

As a result of tobacco combustion, toxic tars and carcinogens enter the lungs and are absorbed into the blood, which leads to cancer of many organs.

Alcohol irritates the inner wall of the intestines, and toxic metabolic products are formed in the liver. Their impact leads to the degeneration of normal cells into cancer cells.

They move from risk factors to causes of colon cancer, accompanied by inflammatory reactions.

For diseases:

In nonspecific ulcerative colitis, multiple ulcers are inflamed, varying in shape and size. They damage the intestinal mucosa and cause: intestinal bleeding, loose stools, cramps and pain in the abdomen (usually on the left), fever and weight loss;
Crohn's disease can inflame and affect any part of the gastrointestinal tract, but more often the large and small intestines and walls. In the chronic course of inflammation, the wall tissue becomes covered with scars, and they can close the intestinal lumen and cause stenosis or degeneration of normal cells into cancer cells;
polyposis of the colon - a dangerous precancerous condition. The mucous membrane stops renewing itself, as it would normally without polyps. Then they quickly become malignant.

Symptoms and signs of colon cancer

Often patients do not suspect that they are developing colon cancer; symptoms may not appear in the early stages, since there is a wide lumen in the ascending colon and its transverse part. A small tumor goes unnoticed for a long time. Signs indicating the location of the tumor appear later, when the tumor reaches a large size.

Clinical general symptoms of colon cancer may be associated with other organs and systems that are malfunctioning

Local signs and symptoms also indicate colon cancer, the manifestation of which can be noticed during the development and growth of the tumor.

Local symptoms

The first symptoms and local signs can indicate colon cancer when the growing tumor is compressed by the intestinal walls.

They will manifest themselves as a violation of the intestinal microflora:

constant discomfort in the abdomen;
increased gas formation;
unstable stool alternating with constipation.

How to determine?Symptoms of the appearance of erosions and other damage to the wall will indicate to the patient many drops (clots) of blood and clear mucus in the stool. If the tumor is located at the very beginning of the large intestine, the blood will mix with the stool and become dark burgundy in color due to coagulation. At the first drop of blood, you should immediately consult a doctor.

When a tumor is located in the sigmoid colon or rectum, patients complain to the doctor of pain during bowel movements. They arise due to the growth of a node into a plexus of nerves located in the mucous layers, including the submucosal one. Mechanical irritation of the intestinal walls also leads to pain.

When a tumor grows into the intestinal lumen with partial closure of the lumen, feces will partially remain inside the intestine, and the patient will constantly feel this.

Later stages of cancer are characterized by ribbon-like stools with infiltrative growth of cancer in the rectum. In this case, it grows and spreads along the walls, and not into the lumen. Now the lumen will narrow due to loss of elasticity and thickening of the walls over a significant area. The narrow lumen forms ribbon-like feces.

The first symptoms of rectal cancer in women

Symptoms of colon cancer in women are completely similar to the general manifestations of the disease. In order to detect and promptly begin treatment for colorectal cancer, symptoms that appear in the early stages should not be ignored by the patient. Complete diagnostics using high-precision equipment allows you to identify violations at an early stage. The doctor should carefully study all the symptoms that indicate colorectal cancer in women and determine hereditary predisposition.

The first symptoms of colorectal cancer in men

In men, rectal tumors develop in 60% of cases. Quite often, signs of rectal cancer indicate advanced stages of the oncological process, when the likelihood of a favorable prognosis is reduced.

It is worth noting! Symptoms and signs of colon cancer are the same for both women and men.

Symptoms of colorectal cancer in the first stage

A small tumor that develops in the large intestine at the initial stage of its development does not cause pain or discomfort.

But as colon cancer increases in size, it gives symptoms:

abdominal pain;
feeling of heaviness;
increased formation of gases in the abdomen;
irregular bowel movements.

Important! When colon cancer develops, the first symptoms may not cause concern to the patient for a long time and may be mistaken for an upset stomach.

General symptoms

If the oncological tumor is located in the final part of the large intestine - in the sigmoid colon, then the cancer will manifest itself faster with general symptoms due to its small size.

Colon cancer, general symptoms begin with the appearance of:

Anemia

Destructive processes in the colon disrupt the absorption of iron, which is necessary to maintain hemoglobin in the blood. As well as vitamin B12, which promotes the formation of red blood cells. With a decrease in red blood cells and hemoglobin, anemia occurs.

The patient will weaken, reducing performance. He suffers from dizziness and headaches. Anemia is indicated by pale and dry skin, brittle hair and nails.

Food aversions

There is a sharp loss of appetite, as well as weight. Pathology in the body mobilizes all its reserve reserves. And for this you need to eat and allow the body to digest food. Both of these physiological processes are energy dependent. Therefore, when you refuse to eat, especially after chemotherapy, normal tissues are suppressed along with cancer cells.

Unexplained weight loss

According to scientific oncologists, in the later stages of the cancer process, weight loss occurs due to:

disturbances in the digestive processes: disappearance of the mucous membrane and the appearance of a tumor in its place, lack of absorption and assimilation of nutrients, lack of minerals and vitamins - the body’s internal reserves;
tumor disintegration accompanied by significant and constant blood loss - the development of anemia, which contributes to weight loss;
the spread of cancer cells through the bloodstream throughout the body, which disrupts the functional functioning of organs;
release of toxic substances into the blood during tumor disintegration. Intoxication occurs - poisoning of the body and metabolic disorders, and then - weight loss.

With the development of an oncological tumor in the colon, it becomes relatively autonomous, its growth is unregulated, its organo- and histological structure is lost, and tissue differentiation decreases. The tumor grows and spreads more slowly than cancer of the stomach or other intestinal areas.

For a long time, the oncological tumor does not leave the intestine, does not spread deeper into its wall than 2-3 cm. Due to its slow growth, an inflammatory process forms around it. It spreads to nearby organs and tissues.

Along with the inflammatory infiltrate, oncological complexes grow into neighboring organs. Therefore, locally advanced tumors appear that do not give distant metastases. The peculiarity of distant metastasis is that when nearby lymph nodes are damaged, hematogenous damage to the liver, lung or other organs occurs.

Colon cancer is characterized by frequent multicentric growth and the occurrence: synchronous (simultaneous) or metachronous (sequential) of several cancer tumors in the colon and surrounding organs.

Classification of colon cancer

The diverse growth pattern, different histological structure and parameters contributed to the emergence of different classifications of colon cancer tumors:

exophytic – when the tumor grows into the intestinal lumen;
endophytic – when the tumor spreads inside the intestinal wall;
mixed form. Saucer-shaped or tumor-ulcer - with a combination of elements of the first two forms of formation.

To classify cancer by structure, the International Histological Classification is used, in which epithelial tumors are divided into several types:

tubular adenoma of the sigmoid colon;
tubular villous adenoma of the colon;
villous tumor of the rectum or other parts;
adenomatous polyp.

These neoplasms are benign, but colon cancer can develop against their background. Therefore, tubular adenoma of the colon requires regular monitoring.

Classification of colon cancer by histological structure:

adenocarcinoma of the sigmoid colon, rectum;
squamous cell carcinoma of the rectum;
solid cancer;
melanoma;
scirrhous cancer;
signet ring cell carcinoma.

If we adhere to the International Classification, then it includes:

highly differentiated The tumor contains more than 95% glandular structures;
moderately differentiated colon adenocarcinoma. Contains from 50 to 90% glandular structures in cells;
low-grade adenocarcinoma of the colon. Glandular elements make up from 5 to 50% of cells;
undifferentiated contain less than 5%.

The most common epithelial tumor, accounting for 80% of all tumors, is adenocarcinoma of the colon.

To predict the outcome of the disease, you need to know the degree of differentiation, the depth of germination, the clarity of the tumor boundaries, and the frequency of lymphogenous metastasis. For example, well-differentiated colon adenocarcinoma promises a much more favorable prognosis (up to 85%) than poorly differentiated cancer. Moderately differentiated colon adenocarcinoma has a 5-year prognosis of 60-72%.

Poorly differentiated tumors include:

mucous adenocarcinoma (mucosal and colloid cancer, mucinous adenocarcinoma of the colon) - forms a significant secretion of mucus with a mucin component, which accumulates in “lakes” of different diameters;
Mucocellular cancer (or signet ring cell) - grows massively inside the wall, does not have clear boundaries, which makes intestinal resection difficult. It occurs more often in young people, quickly metastasizes and covers the entire intestinal wall and neighboring organs and tissues, although the mucous membrane is little damaged. However, it is difficult to diagnose using X-rays and an endoscope;
squamous cell carcinoma - often located in the rectum and other areas of the colon and can be keratinizing or non-keratinizing;
glandular squamous cell carcinoma – occurs rarely;
undifferentiated cancer with intramural tumor growth requires the choice of surgery taking into account the amount of work and direction of growth;
Basal cell carcinoma (basalioid) is a type of cloacogenic carcinoma.

Cystoadenocarcinoma, mucoepidermoid carcinoma should be differentiated from mucinous adenocarcinoma. Mucinous or dark cell adenocarcinoma of the colon is difficult to treat using x-ray radiology, often recurs and spreads metastases to regional lymph nodes.

Determining the type of colon cancer is necessary to choose treatment tactics.

Classification of colon cancer according to the TNM system

As with other malignant tumors, the TNM classification is used for colon cancer:

T – primary tumor in the intestine:

TX - insufficient data to evaluate the primary tumor;
T0 - the primary tumor cannot be determined;
Tis - tumor within the mucous membrane;
T1 - tumor grows into the submucosa;
T2 - the tumor grows into the muscle layer of the intestinal walls;
T3 - the tumor grows through all layers of the intestinal wall;
T4 - the tumor grows into neighboring organs.

N – presence of metastases in regional lymph nodes:

NX - insufficient data to evaluate regional lymph nodes;
N0 - lymph nodes are not affected;
N1 - metastases were found in 1-3 regional lymph nodes;
N2 - metastases were found in 4 or more regional lymph nodes.

M – presence of distant metastases:

M0 - no distant metastases;
M1 - distant metastases are present.

These indicators indicate the extent of the tumor, the severity of the disease and the prognosis for the patient.

Colon cancer stages

If progressive treatment is used for a diagnosis of colon cancer, the prognosis for 5 years will depend on the depth of germination of the primary tumor, on existing distant and regional metastases, stages and substages.

For convenience, there are 4 stages of colorectal cancer:

Stage 0 - Tis, N0, M0. The tumor grows within the mucous membrane and does not spread to other layers of the intestinal wall. The tumor is called carcinoma in situ or “cancer in situ.”
Stage I - T(1-2), N0, M0. The tumor grows into the intestinal wall, but does not extend beyond it. There are no metastases in regional lymph nodes.
Stage II - T(3-4), N0, M0. The tumor grows through the intestinal wall. There are no metastases in regional lymph nodes.
Stage III - T(any), N(1-2), M0. The tumor grows through the intestinal wall. There are single or multiple metastases in regional lymph nodes.
Stage IV - T(any), N(any), M1. There are metastases in other organs.

Diagnosis of colon and intestinal cancer

Early stages of colon cancer are difficult to detect because there are no characteristic symptoms. Therefore, it is important to identify adenomatous polyps (glandular tissue) and prevent cancer.

Colon cancer - diagnosis:

rectal examination;
endoscopic research methods;
X-ray diagnostic methods;
genetic testing;
laboratory diagnostic methods;
ultrasonography;
colon cancer screening;
additional research methods.

A rectal (digital) examination reveals the presence of large polyps. The little doctor may not feel it. The patient can be in a knee-elbow position, lying on his side with his knees and hips bent, or lying on his back with his legs brought to his stomach and his knees bent.

For endoscopic methods the following is used:

flexible sigmoidoscopy using a sigmoidoscope - an optical tube with a lighting device. Powerful optics greatly enlarge the image, which makes it possible to detect the slightest pathology in the mucosa. The device is inserted into the anus, having previously lubricated it with Vaseline or gel. The method detects early stage cancer and removes polyps;
colonoscopy with a colonoscope - a long flexible tube with a video camera. The image is examined on the monitor, the doctor easily manipulates the sensitive device, which allows you to examine the entire colon and detect, remove them, or take tissue for histological examination.

X-ray methods use:

a barium enema to visualize the desired area of the intestine on pictures;
CT to obtain layer-by-layer images in large quantities, which helps to identify metastases and tumors in distant organs (lungs, liver, etc.);
MRI for layer-by-layer visualization of the intestine. Use safe electromagnetic radiation.
x-ray of the sternum to detect metastases spread through the respiratory and bloodstream;
PET (positron emission tomography) using sugar with radioactive elements. Cancer cells eat sugar, accumulating elements, then they are recorded by a special camera. This helps to find out the number, size and location of tumors.

For genetic testing you need to know about all first-degree relatives suffering from colon cancer. Such a patient is at risk of developing cancer if favorable conditions are created for the activation of genes: consumption of low-quality and fatty foods, abuse of bad habits, lack of active movement, etc.

Laboratory diagnostic methods include:

general clinical blood test;
, if colon cancer is suspected, I use the following tumor markers: , .

Blood serum can indicate the balance of CEA - carcinoembryonic antigen. A blood test for intestinal oncology reveals anemia due to bleeding of intestinal cancer.

The membrane of each cell has antigens (receptors) on its surface. When normal cells transform into cancer cells, the membrane structure is disrupted and the antigenic structure changes. By taking a blood test for intestinal cancer, the level of this antigen can be significantly increased, which confirms the cancer process - the growth of oncological tumors of different sizes and locations.

Laboratory diagnostic methods examine stool for hidden blood, which is not visible to the naked eye. To prevent false positive results, the patient should not consume meat, eggs and fish, and red beets for 3-4 days. These products can stain stool even in the absence of cancer.

This diagnostic method is not suitable for diseases such as hemorrhoids, fissures in the anal area, helminthic infestations that injure the intestinal wall, since blood also gets into the feces.

In the laboratory, it is examined under a microscope, which determines the nature of the tumor (benign or malignant) and predicts the course of the oncological process.

Ultrasonography

During an ultrasound examination, an image of the internal organs is obtained, as well as the tumor: its size, germination, metastasis to neighboring and distant organs and lymph nodes. This method is highly informative, but screening allows you to determine whether colorectal cancer is developing.

Colon Cancer Screening

Screening studies can identify the pathological process at an early stage, in the absence of symptoms. It is carried out using three main tests:

colonoscopy;
examination of feces for occult blood;
visual examination of the mucous membrane using a sigmoidoscope.

Additional research:

introduction of microspecimens containing a contrast agent, the description of which is given in detail in the instructions, and subsequent x-ray examination;
stool analysis;
virtual colonoscopy.

Treatment of colon cancer

Treatment for colon cancer includes:

surgical treatment methods;
chemotherapy;
radiotherapy (radiation therapy).

Operations

Treatment of colorectal cancer with conservative methods is impossible, so surgery is performed to remove the tumor. and are used additionally in the treatment of colorectal cancer.

– the most effective and basic method of treating colon cancer. Radical surgery - partial colectomy or hemicolectomy is performed in 80-90% of patients.

Treatment of colon cancer is carried out through a large incision in the anterior wall of the peritoneum, or they resort to laparoscopic surgery (several small punctures), into which a mini-video camera with manipulators and instruments is inserted.

Colon surgeries for oncology:

laparoscopic resection. The operation is in demand as it helps stop the development of the tumor with minimal surgical intervention;
abdominal-anal resection is characterized by the removal of the affected section of the intestine, after which the surgeon suturing both ends and removing the section of the intestine located in the anus;
intra-abdominal resection - removal of the affected area of the intestine. During surgery, a colostomy can be placed on the anterior wall of the abdomen;
obstructive resection (operation according to the Hartmann method). It is carried out when there is a high probability of long-term healing of the wound surface. The surgeon removes the tumor, then creates a colostomy and sutures the other end of the intestine. Subsequently, surgery to close the colostomy is possible.

In case of metastasis to lymph nodes, treatment is performed with lymphodenectomy (removal of lymph nodes).

Colostomy for rectal cancer

Treatment of rectal cancer in some cases requires the creation of a colostomy. A colostomy is an opening through which gases and stool are removed from the colon.

Indications for colostomy removal:

damage to a large part of the intestine;
an inflammatory process developed after radiation therapy;
suppuration in the large intestine;
it is not possible to remove the tumor surgically;
high probability of complications when removing a fragment of the colon;
germination of formation into organs.

Quite often, a colostomy is necessary to save the patient’s life.

Recovery after surgery

The recovery process after surgery is interconnected with the degree of surgical intervention, the general condition and age of the patient.

Adaptation is divided into 3 periods:

the first two months – intestinal functions are characterized by severe disorders;
the body’s adaptation to living conditions lasts up to 4-6 months: functional and psychological;
The period of stable adaptation lasts up to 4-12 months, which depends on the scope of the surgical operation.

It is important to know! Every patient with colon cancer should be observed by a doctor for the first 1-3 years (2 times a year). In the absence of relapses, observation with all tests by an oncologist remains for life - once a year. If necessary, an irrigoscopy or colonoscopy is performed, and consultations are obtained during examinations from a gynecologist, mammologist, urologist and other specialists.

Chemotherapy

Chemotherapy is carried out before and/or after operations with drugs that reduce the size of tumor formation and the likelihood of the spread of metastases or prevent the rapid growth of the tumor. Chemotherapy can replace primary therapy if surgery is not possible or the tumor is no longer amenable to surgical treatment.

Chemotherapy is carried out by administering the following drugs:

to inhibit intracellular metabolism and suppress the activity of cancer cells;
– a new chemotherapeutic agent, a precursor to 5-fluorouracil. The difference between the drug is that its inactive form, when it reaches cancer cells, becomes active and destructive for them;
Leucovorin - a type of folic acid, to normalize physiological processes in cells, reduce side effects and inhibition of normal cells and tissues by chemicals;
Platinum-based oxaliplatin to inhibit the synthesis of proteins and genes in cancer cells.

Side effects of chemistry include: nausea, vomiting, inflammation of the intestinal mucosa, diarrhea, low white blood cell count (neutropenia), hair loss.

What is palliative chemotherapy and when is it used? Palliative chemotherapy is used when surgery is not possible due to the large size of the tumor and active metastasis. Chemotherapy for stage 3 and 4 colorectal cancer is maintenance therapy to relieve general symptoms and improve patients' quality of life. In this case, there is no talk of complete recovery.

Recovery after chemotherapy

How to recover after chemotherapy? First of all, the doctor needs to correctly select modern drugs, including cytostatic drugs, in order to avoid gastrointestinal disorders and complications. For this purpose, special premedication is also carried out on the eve of chemotherapy in order to reduce irritation of the gastric mucosa, the development of nausea and vomiting.

Many patients are admitted to the hospital with impaired renal function. If they are prescribed heavy chemotherapy without prior preparation, they will be doomed to death. Therefore, they undergo hemosorption and other procedures to restore kidney function: cystostomy and nephrostomy.

Compression of the biliary tract or metastases by a tumor leads to impaired liver function. Then patients undergo percutaneous drainage through the liver to prevent obstructive jaundice or to treat it. After this, chemotherapy is carried out.

Restoring the body after chemotherapy for colon cancer is not necessary for all patients. After preliminary preparation for chemotherapy, the correct dosage of drugs, and undercover therapy, patients are discharged home.

When conducting “chemotherapy of despair”, even with a severe somatic and neuropsychiatric status, the patient must undergo rehabilitation.

Is it necessary? Baldness may not occur, since the hair follicles are strengthened with modern hormonal drugs and hair does not fall out. But this happens in very rare cases.

It is important to know! Chemical drugs accumulate in the hair structure, so the body strives to get rid of them. There is no need to slow down the process of baldness and prevent the body from developing a protective compensatory mechanism. The bulbs do not fall out along with the hairs, so at a rate of 0.5-1 mm per day they will grow back in 2-3 months.

Recovery from chemotherapy is necessary when there are major changes due to the effects of the chemo and decaying tumor tissue.

Namely, if there are changes:

red blood sprout - hypochromic anemia;
white blood sprout - leukocytopenia and agranulocytosis;
coagulograms – development of thrombocytopenia.

It is necessary to restore a patient in a hospital setting in case of toxic hepatitis and damage to the kidneys and myocardium by toxins. And also in cases of depression and acute psychosis, suicidal attempts, conscious refusal to eat.

Nutrition and diet

For many patients, before surgery, after it and during chemotherapy, it remains unchanged. For other patients, a colon cancer diet is developed with 3-5 therapeutic meals a day to reduce the side effects of chemotherapy.

Usually, debilitated patients in the later stages of oncology are hospitalized in clinics, with most body functions impaired, and the presence of cancer cachexia. They need basic replenishment of the balance of vitamins, microelements, carbohydrates, fats and proteins.

For patients who are unable to feed themselves due to stenosis, enteral stents are installed for parenteral nutrition. They are restored to an acceptable level of basal metabolism, then undergo chemotherapy.

Carried out as part of general therapy to cleanse the blood and increase immunity, smoothing out the side effects of chemotherapy. They use tinctures, infusions and decoctions of berries, poisonous and medicinal herbs and mushrooms growing in the country, for example, chaga, as well as Chinese ones - cordyceps, shiitake, meitake, reishi, Brazilian agarica. Folk remedies such as soda or minerals are used, and special nutrition is developed.

Radiation therapy

Colon cancer is destroyed using X-rays after surgery. All tumor cells that remain after removal of the tumor itself and parts of the intestine are destroyed to prevent secondary cancer.

Before surgery, radiotherapy or radiation is used to shrink the tumor and make it easier to remove. Radiation therapy can be combined with chemotherapy. Then the side effects appear: diarrhea, rectal bleeding, increased fatigue, redness and swelling of the skin at the site of exposure to rays, loss of appetite, nausea and vomiting.

Conclusion! To avoid cancer, it is necessary to stimulate the immune system with a healthy lifestyle and nutrition, active movement and rest. The colon cancer vaccine (TroVax) may also be used to stimulate the immune system.

Targeted therapy

Targeted therapy is a method of treatment with directed action. The drugs destroy exclusively cancer cells without causing harm to healthy organs and tissues.

Medicines for targeted therapy are manufactured using genetic engineering technology, each of which has its own effect:

suppresses enzyme function;
stops signals for cell division;
crosses the formation of new vessels, which are necessary for tumor growth.

Metastases

The movement of cancer cells is common in colon cancer. Stage 4 rectal cancer with metastases is difficult to treat. Treatment is aimed at improving the patient’s quality of life and reducing the negative impact of the decomposition of affected tissues.

Rectal cancer with metastases

Metastasis in the large intestine occurs in the following organs:

The liver is an organ that receives blood that nourishes the internal organs. Stage 4 sigmoid colon cancer with liver metastases manifests itself in patients with accumulation of fluid in the abdominal cavity, nausea and vomiting, jaundice and exhaustion of the body;
the peritoneum is a thin film that lines the internal organs; after the tumor grows into the organs, foci of cancer appear in the peritoneum;
When peritoneal cancer metastasizes to the lungs, symptoms are supplemented by chest pain, coughing fits, shortness of breath, and blood in the sputum when coughing.

Timely diagnosis allows you to quickly identify metastases in colon cancer and begin to eliminate them. Stage 4 colon cancer with liver metastases has a poor prognosis.

Rehabilitation

After treatment for colorectal cancer of any stage, the human body becomes greatly weakened. Surgical and postoperative treatment of colon cancer in the form of chemotherapy and radiation therapy has a very negative impact on the general well-being of the patient:

in the first 2 months, intestinal disorders appear;
over the next 6 months the person adapts to new living conditions.

Adaptation after treatment occurs no earlier than a year after surgery. Throughout this time, a person must undergo examinations and examinations by an oncologist, and constantly undergo tests. Even after a long remission, a person who has had colon cancer should visit an oncologist once a year to prevent a relapse.

Prevention of colon cancer

Unfortunately, no one can influence hereditary factors and gene mutations on the development of colon cancer. But you can reduce the risk of developing the disease with simple preventive measures:

regular examinations and medical examinations, especially for those whose family has relatives with colon cancer;
the older age group of the population over the age of 50 should undergo examinations by a gastroenterologist every year;
treatment of intestinal colitis and removal;
proper nutrition in which vegetables and fruits should predominate;
active lifestyle.

Forecast

The survival rate of patients with colon cancer depends on the stage at which the pathological process is diagnosed. The average five-year survival rate is about 45%. The survival prognosis for colon cancer after surgery is significantly improved, but there is a high probability of recurrence.

The prognosis for rectal cancer after surgery at stages 1 and 2 for 5 years is 60%. At stage 3, the prognosis is 40%;
The prognosis for a tumor of the sigmoid colon at an early stage is favorable - up to 90%. The prognosis for sigmoid colon cancer at stage 2 after surgery is about 80%, at stage 3 50%;
The prognosis for cecal cancer in the initial stages of the disease is about 70%; at stages 3 and 4, the survival prognosis is reduced to 40%.
For patients with rectal adenocarcinoma, the prognosis at the initial stage is more favorable, survival rate in the first five years is 90%.
For moderately differentiated adenocarcinoma of the colon, the prognosis for stages 3 and 4 is up to 50%.

Informative video:

Colon cancer refers to cancers that form in the large and small intestine. It occurs in both men and women. Signs of intestinal cancer are quite minor at the initial stage.

A malignant tumor forms on the mucous surfaces of the intestine, and most often the tumor appears in the large intestine; there are cases when it is found in the sigmoid, rectum, colon or cecum. The survival prognosis of patients with any cancer depends on the stage at which it was detected. The sooner a tumor can be detected, the greater the patient’s chances for complete healing.

Why intestinal cancer develops, what are the first signs of the disease and what methods of prevention exist - we will look further in the article.

About bowel cancer

Colon cancer is a malignant transformation of the epithelium that can affect any segment of the intestine.

The most susceptible to this disease are people in the age group after 45 years, men and women to the same extent, every 10 years the incidence rate increases by 10%. Colon cancer varies in its histological structure; in 96% of cases it develops from glandular cells of the mucous membrane (adenocarcinoma).

Depending on the location of the tumor, there are:

Small intestine cancer. It occurs quite rarely, in approximately 1-1.5% of cases of all cancers of the digestive tract. The disease mainly affects elderly and senile people; the disease affects men more often than women. Of all parts of the small intestine, tumors prefer to be localized in the duodenum, less often in the jejunum and ileum.
Colon cancer. The predominant number of tumors in this area are located in the sigmoid and rectum. Among people who prefer meat, pathology is observed more often than among vegetarians.

It takes about 5-10 years for colon cancer to develop from a polyp, such as in the colon. An intestinal tumor grows from a small polyp, the symptoms of which in the first stages are characterized by sluggish symptoms.

It can manifest itself, for example, as a gastrointestinal disorder, which distracts from the primary cancer, since many do not pay attention to the discomfort in the intestines during the disorder, not knowing what kind of pain can arise from intestinal cancer, which is why they treat diarrhea.

Causes

Causes of colon cancer:

Elderly age. Here, how old a person is plays an important role. According to statistics, intestinal diseases affect people aged 50 years and older.
Intestinal diseases. People suffering from inflammatory bowel pathologies are most susceptible to this disease.
Wrong lifestyle. If you visit a medical forum, these factors include poor nutrition, including a large percentage of consumption of fats and animal products, smoking, and drinking strong drinks.
Hereditary factor. A person is at increased risk when his relatives have had various forms of intestinal diseases.

In men, according to statistics, this is the second most common cancer after lung cancer, and in women it is the third. The risk of developing cancer increases with age. In medicine there is such a definition of intestinal cancer - colorectal cancer.

First signs

With this diagnosis, cancer cells form and grow in the body, their presence causes the appearance of a malignant tumor. It is almost impossible to determine their presence at an early stage, since the first symptoms and signs of intestinal cancer in women and men are similar to classic indigestion and digestive problems.

In order not to miss the onset of the disease, you should pay more attention to the following signs:

a feeling of heaviness in the stomach not associated with eating;
poor appetite, sudden weight loss;
aversion to fried fatty foods;
signs of dyspepsia;
diarrhea followed by prolonged constipation;
signs;
blood during bowel movements and in stool.

The main problem with cancer is absence of specific symptoms in the early stages, so patients consult a doctor at stages 3-4, when treatment options for colon cancer are already limited.

Stages of development

There are five distinct stages in the development of colon cancer. The complete absence or weak severity of manifestations is observed up to the second (in rare cases even to the third) stage. In the third and fourth stages, the patient experiences severe pain, forcing him to seek medical help.

Stages of development of bowel cancer:

Stage 0 is characterized by the presence of a small accumulation of atypical cells, characterized by the ability to rapidly divide and capable of degenerating into cancer. The pathological process is limited to the mucous membranes.
Stage 1 – the cancerous tumor begins to grow quite rapidly; it does not extend beyond the intestinal walls until metastases can form. Symptoms may include disorders of the digestive tract, to which the patient does not pay due attention. At this stage, when examining the patient using colonoscopy, the appearance of neoplasia can already be detected.
At stage 2, the tumor grows to 2-5 cm and begins to penetrate the intestinal walls.
Stage 3 is characterized by increased activity of cancer cells. The tumor quickly increases in size and penetrates the intestinal wall. Cancer cells invade the lymph nodes. Neighboring organs and tissues are also affected: regional lesions appear in them.
At stage 4, the tumor reaches its maximum size, gives metastases to distant organs. Toxic damage to the body occurs due to waste products of the malignant neoplasm. As a result, the operation of all systems is disrupted.

Life expectancy is determined by the size of the tumor and its ability to localize. Tumor cells that have spread to the surface layer of the epithelium allow 85% of patients to survive. When the muscle layer is affected, the situation worsens - the survival rate does not exceed 67%.

In accordance with the International Classification, there are:

Adenocarcinoma;
Colloid cancer;
Signet ring cell;
Squamous;
Undifferentiated and unclassifiable forms.

Most often (about 80% of cases) adenocarcinoma is diagnosed - glandular cancer, originating from the epithelium of the intestinal mucosa. Such tumors are highly, moderately and poorly differentiated, which determines the prognosis. Signet ring cell carcinoma often affects young people, while squamous cell carcinoma is more often localized in the rectum.

Symptoms of bowel cancer: manifestation in adults

Signs of bowel cancer appear late in the course of the disease. Symptoms of intestinal cancer in the early stages are sluggish, almost unnoticeable. But you should also pay attention to them in order to eliminate irreversible consequences.

Symptoms of intestinal cancer depending on the type:

With stenotic oncology, constipation and colic appear due to the narrowed lumen. At the same time, in the first stage of cancer, a person suffers from flatulence with relief after defecation.
Signs of enterocolitis type bowel cancer are constantly changing stools from diarrhea to constipation and vice versa.
The dyspeptic form is characterized by constant belching with heartburn and the appearance of bitterness in the mouth.
Pseudo-inflammatory oncology causes nausea with vomiting, chills, fever and unbearable pain.
Symptoms of cystitis type intestinal cancer are the appearance of blood when urinating with pain.

Other symptoms:

Quite often, when a malignant tumor develops in the intestines, patients experience fullness, even after a successful trip to the toilet;
some experience sudden, unexplained weight loss, despite maintaining their usual routine and diet;
the presence of blood impurities in the stool may also indicate the development of an oncological process in the intestines;
the first signs of intestinal oncology are usually mild, so they can be mistaken for general malaise (drowsiness, general weakness, fatigue) or digestive disorders. However, as the process worsens, they become more pronounced and complemented.

Signs of intestinal cancer are determined by the location of the tumor and the stage of its development. If the tumor has affected the right part of the organ, the following symptoms occur:

diarrhea;
the presence of blood in the stool;
pain in the abdominal area;
anemia.

Development of a tumor in the left part of the intestine:

The patient complains of constant constipation, difficulties during excretion of feces, and bloating.
There is a frequent alternation of loose stools with constipation, through narrowing and relaxation of the lumen of the colon, this is often a symptom of cancer.
Excretion of feces occurs with great difficulty, often with blood and mucus, and is accompanied by painful sensations.

Symptoms and manifestation
thick	Signs of colon cancer in men and women: Constipation, diarrhea; Digestive problems - bloating, rumbling; The presence of blood in the stool; Abdominal pain; Loss of body weight; False urges or tenesmus; For complications such as: fistulas, inflammation, abscesses a number of other symptoms are added.
thin	Specific symptoms of small intestine cancer: recurrent abdominal pain accompanied by a “copper taste”; vomiting and nausea; weight loss; anemia; liver dysfunction.
sigmoid colon	Predominant characteristic symptoms may be as follows: the appearance of impurities of blood, pus, mucus in the stool; false urge to defecate; intoxication of the body; flatulence; acute pain during bowel movements.

Symptoms of bowel cancer in women and men

Signs of intestinal cancer in men and women with this course are practically no different. Later, if the tumor progresses and spreads to neighboring organs, the prostate is the first to be affected in men, and the vagina is the first to be affected in women; the rectal space and anal canal are also affected.

At the same time, the patient begins to worry severe pain in the anus, coccyx, sacrum, lumbar region, men feel difficulty during urination.

If it is oncology, the clinical outcome is not always favorable. Malignant neoplasm appears in women after 35 years of age; in the primary form, it does not spread metastases to the uterus. First, the patient experiences general weakness throughout the body and classic signs of dyspepsia, then specific signs of an intestinal tumor appear. This:

recurrent pain during bowel movements;
disruption of the menstrual cycle;
blood in stool;
impaired urination;
sudden weight loss, lack of appetite;
blood impurities in the daily urine sample;
aversion to fried, fatty foods.

Late stages of colon cancer are characterized by the addition of general symptoms to local ones. Signs of intestinal cancer appear:

The skin becomes dry and pale.
Frequent dizziness and headaches.
Weakness and fatigue of the patient.
Unreasonable weight loss and exhaustion.
Damage to other systems and organs of the body.
Low presence of blood in the body, low level of protein in it.

The appearance of metastases

Colon cancer most often metastasizes to the liver; there are frequent cases of damage to the lymph nodes of the retroperitoneal space, the peritoneum itself, abdominal organs, ovaries, lungs, adrenal glands, pancreas, pelvic organs and bladder.

The following circumstances become unfavorable factors for the prognosis:

tumor growing into fatty tissue;
cancer cells with a low degree of differentiation;
large intestine with perforation;
the transition of primary cancer to organs and tissues “in the neighborhood” and to large veins, closing their lumen;
carcinoembryonic antigen of high concentration in plasma before surgery. It is associated with an increased risk of recurrence regardless of cancer stage.

Patients with metastases are divided into two groups:

patients with single metastases;
patients with multiple metastases (more than 3).

Diagnostics

The diagnostic search begins with a detailed clarification of the nature of the complaints and clarification of the presence of patients with colonorectal cancer among close relatives. Particular attention is paid to patients with previous inflammatory bowel processes and polyps.

In the early stages, the presence of intestinal cancer can be indicated by any even mild sensation of discomfort in the abdominal area, which is complemented by changes in the blood test and the patient’s age over 50 years.

Features of the blood test:

decreased hemoglobin levels and red blood cell counts;
level up ;
high ESR;
presence of blood (occult blood) in the stool;
increased blood clotting;
tumor markers.

The diagnosis is made after the following studies:

X-ray diagnostics of the intestines (irrigoscopy). It is an X-ray examination of the intestinal walls after the administration of an X-ray contrast agent through an enema, for which a barium suspension is used.
Retromanoscopy. The examination of a section of the intestine from the anus to a depth of 30 cm is carried out with a special device that allows the doctor to see the intestinal wall.
Colonoscopy. Examination of the intestinal area from the anus to a depth of 100 cm.
Laboratory examination of feces for occult blood.
CT and MRI can determine the location of the tumor, as well as the presence or absence of metastases.

How are people with bowel cancer treated?

To get rid of cancer, different methods are used: surgery, radiotherapy and chemotherapy. Treatment of rectal cancer, like any other malignant tumor, is a very difficult and lengthy process. The best results are obtained by surgery, during which the tumor and surrounding tissue are removed.

If the disease is diagnosed in a timely manner, surgical intervention is performed with a retromanoscope, which is inserted into the rectum through the anus. At the last stage of the disease, extensive surgical entry is used. Sometimes patients with intestinal oncology have this organ partially cut off.

After surgery, the two parts of the intestine are sewn together. If it is impossible to connect them, one of the parts of the intestine is removed to the peritoneum.

Treatment also includes:

Radiation therapy uses x-rays to stop tumor growth and cause cancer cells to die.
Radiotherapy is a preparatory stage for surgical treatment. It is also indicated in the postoperative period.
Chemotherapy involves the administration of cytostatic drugs that have a detrimental effect on tumors. Unfortunately, these drugs also negatively affect healthy cells in the body, so chemotherapy has a lot of unpleasant side effects: hair loss, uncontrollable nausea and vomiting.

Chemotherapy is used systemically, before or after surgery. In some cases, local administration into the blood vessels feeding metastases is indicated. The main drug used for chemotherapy is 5-fluorouracil. In addition to it, other cytostatics are used - capecitabine, oxaliplastin, irinotecan and others. To enhance their action, immunocorrectors (interferogens, stimulators of humoral and cellular immunity) are prescribed.

Forecast

The prognosis for colon cancer depends on the stage at which the disease was detected. Thus, with the initial forms of the tumor, patients live long, and the five-year survival rate reaches 90%, while in the presence of metastases it remains no more than 50%. The most unfavorable prognosis is in advanced cases, as well as with significant damage to the rectum, especially in the distal section.

How long do people live at different stages of bowel cancer?

The initial stage (difficult to diagnose) is a guarantee that a positive result will reach 90-95% survival rate, if, of course, the surgical intervention was successful.
At the second stage progression of the tumor and its spread to neighboring organs leaves a chance of survival for 75% of patients. That is, those patients who have successfully undergone surgery and radiation therapy.
At the third stage, the size of the tumor is critical, and it grows into regional lymph nodes. 50% of patients manage to survive.
The fourth stage practically does not guarantee a successful outcome. Only 5% manage to survive a malignant neoplasm that has grown into individual organs and bone tissues, forming extensive metastases.

Prevention

Oncological diseases are insidious and unpredictable. People who have a hereditary predisposition to cancer or have been diagnosed with diseases that can transform into cancer, as well as all people over the age of 40, should think about prevention.

Increased physical activity;
Enriching the diet with foods containing fiber;
Quitting bad habits (smoking, drinking alcohol).

Colon cancer is a dangerous disease that can be prevented by following preventive measures and conducting a full diagnosis of the body 1-2 times a year. If you or your loved ones have the symptoms described in this article, be sure to make an appointment with a gastroenterologist and get diagnosed.

Colon cancer primarily affects the epithelial lining of its walls.

The anatomical structure of the large intestine, which is the final section of the gastrointestinal tract (starting from the ileocecal valve, separating the large intestine and ending with the anus), is represented by five sections:

The cecum ends in a process called the appendix.
The ascending colon, located on the right side of the abdomen.
Transverse colon, extending transversely to the left side of the abdomen.
The descending colon continues the transverse colon and runs down the left side of the abdomen.
The sigmoid colon, located in the pelvic cavity.
A relatively short rectum ending in the anus.

Definition and Statistics

Colon cancer, called colorectal, is a cancer that develops from epithelial tissues lining the walls of any of its five sections.

Since in the medical literature the large intestine is often called the large intestine, let us immediately say that both of these concepts are synonymous and interchangeable.

Medical statistics indicate the steady progression of this formidable disease: throughout the world, five hundred thousand new patients (usually residents of industrialized countries) become ill with colon cancer every year.

The lowest (five people per 100,000 population) incidence rates are in Africa, average (33 per 100,000 people) in the southern and eastern regions of Europe, high (52 per 100,000 inhabitants) in North America and the western regions of Europe.

In the structure of male oncology, colon cancer occupies the third position (after and ), in the structure of female oncology it occupies the second position (second to ). Men are affected by this disease 1.5 times more often than women.

Colon cancer can affect a person of any age (including children), but most often it affects people in the older age group: in persons over 60 years of age it is observed in 28% of cases, in patients over 70 years of age – in 18%.

Interestingly, in individuals whose age exceeds 80 years, the incidence of colon cancer sharply decreases to the levels characteristic of younger patients.

It is characterized by late detection: in the majority (up to 70%) of patients it is detected already at stage 3-4. To date, it has been established that colon cancer develops from adenomas of a certain type (villous, tubular and tubular-villous structure). The process of development of a malignant tumor of the colon develops from 10 to 15 years.

Classification

Based on the nature of their growth, malignant tumors of the large intestine are divided into:

exophytic forms growing into the lumen of the affected intestine;
endophytic forms developing in the thickness of the intestinal wall;
saucer-shaped forms that combine the characteristics of both forms described above.

Depending on the location of the pathological process and the cellular structure of tumor tissues, cancer is represented by many types.

When localized in the colon, a malignant tumor can be represented by:

(the frequency of its distribution is more than 80%);
mucous adenocarcinoma;
undifferentiated neoplasm;
mucocellular cancer;
unclassified cancer.

When the rectum is affected, it is represented by all of the above types, characteristic of, as well as:

basal cell;
glandular squamous cell carcinoma.

Reasons for the development of pathology

The following risk factors contribute to the development of colon cancer:

Age over fifty years.
The presence of inflammatory diseases of the colon (nonspecific,).
Hereditary predisposition (the presence of a similar pathology in close relatives increases the risk of developing colon cancer several times). About a quarter of all cases are caused by a genetic factor.
Ethnicity. People from the eastern region of Europe and of Jewish origin are most susceptible to colon cancer.
Poor nutrition, which boils down to eating foods low in fiber but containing large amounts of fat and refined carbohydrates, abuse of meat dishes and yeast bread.
Insufficient level of physical activity, which provokes a decrease in intestinal motility and the development of constipation.
Addiction to and.
. A polyp localized on the walls of the colon can eventually develop into a malignant tumor.

Clinical manifestations

Colon cancer at the very beginning of its development is completely asymptomatic and can only be detected by chance, during a clinical examination or during bowel examination procedures performed in connection with another disease (suspected or already identified).

Symptoms of colon cancer in the early stages

As the malignant tumor grows, the following first signs develop:

Pain in the abdominal area (abdominal pain syndrome), differing in nature and degree of intensity depending on the location of the tumor process. They can be cramping, aching, pressing.
Constant discomfort in the abdomen, accompanied by rumbling and increased gas formation.
Irregular bowel movements, characterized by alternating diarrhea and constipation.
Constant belching, frequent attacks of vomiting.
Heaviness and feeling of fullness in the stomach.

General symptoms

General symptoms that develop in the later stages of colon cancer indicate a disruption in the functioning of other internal organs and systems.

It is characterized by:

The presence of anemia caused by bleeding and impaired absorption of iron and vitamin B12, necessary for the formation of hemoglobin and red blood cells.
Pale and dry skin, brittle hair, brittle nails.
Decreased performance, accompanied by severe weakness, dizziness and headaches.
Loss of appetite.
Sharp weight loss.

Signs in women and men

Men more often (in about 60% of cases) develop rectal cancer, and women (57%) develop cancer of various parts of the colon. There are no specific signs in the clinical course of colon cancer in representatives of different sexes.

Stages and their survival prognosis

For colon cancer, the five-year survival rate of patients is directly dependent on the stage of its detection:

At stage 1, characterized by a small tumor that does not leave the mucous and submucosal layer of the intestinal wall and has not yet spread to the lymph nodes, the survival rate is 95%.
At stage 2, when a malignant neoplasm that has begun to grow into the muscle layer affects more than half of the intestine (and a single penetration into the intestine may be observed), the survival rate is 75%.
At stage 3, characterized by tumor growth into the serosa or its metastasis to a number of regional lymph nodes, only half of the patients survive.
At stage 4, when the pathological process has spread to the tissues of nearby organs and the process of distant metastasis has begun, the prognosis for survival does not exceed 10%.

Metastasis

Colon tumors most often metastasize to:

, which receives most (75%) of the blood entering it from the portal vein, fed by internal organs (including the intestines). It is this circumstance that promotes metastasis. Colorectal cancer that has metastasized to the liver manifests itself as exhaustion, vomiting, nausea, jaundice, the development of ascites (accumulation of fluid in the abdominal cavity), pain and itching.
The peritoneum is a thin connective tissue film that lines the inner surface of the abdominal cavity and covers all internal organs. After a malignant tumor grows through the tissue of the intestinal wall, it affects the peritoneum, forming foci that gradually spread to its neighboring areas, simultaneously affecting the neighboring organs covered by it.
. Colon cancer that has metastasized to this organ is manifested by a constant cough, chest pain, shortness of breath, and hemoptysis.

Complications

Along with metastasis, colon cancer produces a number of complications, ending with:

Complete (due to the blocking of its lumen by tumor tissues).
Perforation of the intestinal walls, associated with the formation of holes through which cancer cells and intestinal contents can enter the abdominal cavity.
Formation of pathological communication between intestinal loops and adjacent organs.
Compression of internal organs.
Difficulty urinating.
Recurrence of a malignant tumor.

Diagnostics

Early is complicated by the absence of characteristic symptoms at the very beginning of the development of the tumor process.

Endoscopic methods

Endoscopic methods include the following procedures:

. The object of study using a sigmoidoscope is the rectum and lower parts of the sigmoid colon. A flexible tube lubricated with gel and equipped with powerful optics that can magnify the resulting image many times, inserted through the anus, makes it possible to detect the presence of the most minor pathological changes in the intestinal mucosa.
Colonoscopy. The colonoscopy procedure is performed using a colonoscope, which also has an optical system and a video camera connected to a monitor. The ability to manipulate the device allows the doctor not only to detect the presence of pathology, but also to remove polyps, as well as take material for a biopsy. Colonoscopy helps to look at the condition of the entire large intestine.

X-ray

X-ray methods are represented by the following procedures:

Barium enema. Before the procedure, the patient is given an enema containing a suspension of barium sulfate, after which a series of x-rays are taken. The barium suspension, which evenly covers the intestinal walls, creates a “filling defect” in the image, which makes it possible to detect the presence of polyps or cancerous tumors.
. This method, used when it is necessary to detect metastases, allows you to take multiple layer-by-layer images of the organ under study using X-rays.
. The MRI procedure is also intended for layer-by-layer visualization of the tissues being studied, but only through electromagnetic radiation. The absence of ionizing radiation makes it safer.
Chest X-ray. The procedure is indispensable for identifying metastases in the lungs.
. Given the high need of cancer cells for sugar, the PET procedure uses sugar labeled with radioactive substances. The accumulation of these substances in a certain area of the body indicates the presence of a cancerous tumor. Using a special camera, the doctor can determine its location and size.

Genetic testing

This type of examination, aimed at identifying genes in the patient’s genetic code that are responsible for the transformation of healthy cells into cancer cells, is performed if the patient has close relatives suffering from colorectal cancer.

Laboratory methods

Laboratory tests for a patient's colon cancer include:

Study .
Performance .

Ultrasonography

The procedure, which uses ultrasound waves to obtain a three-dimensional image of internal organs, allows you to detect a tumor, determine its size and determine the presence of distant metastases.

What tumor markers are determined?

With colon cancer, levels may be elevated:

carcinoembryonic antigen;
, produced by cancer cells that have affected the tissue of the pancreas and colon;
, identifying tumors of the gastrointestinal tract and pancreas;
, appearing in the blood during, colon and.

Test and how much does it cost?

A person who has discovered alarming symptoms can test his stool at home for the presence of occult blood.

To do this, just go to the pharmacy, purchase a test for colon cancer and perform a series of simple procedures, following the manufacturer’s recommendations.

The cost of one home test for colon cancer from Russian manufacturers does not exceed 250 rubles. A foreign-made test will cost 2,200 rubles.

Treatment

The leading step is surgical intervention. Most often, patients undergo radical surgery: partial hemicolectomy or colectomy. The operation can be open (performed through an incision in the abdominal wall) or laparoscopic, performed through several small incisions into which manipulators and a miniature video system are inserted. If the lymph nodes are affected, lymphadenectomy is performed.
An equally important method of treatment is the use of drugs that inhibit the division of cancer cells, as a result of which the tumor decreases in size, stops its rapid growth, or reduces the likelihood of its metastasis to other organs. Chemotherapy can be used before surgery, after surgery, and as the primary treatment for inoperable forms of cancer.
Radiotherapy, which uses x-rays to destroy cancer cells, is a third therapeutic option for treating colon cancer.

Used preoperatively, it can lead to a significant reduction in cancer tumor size. When treating a patient who has undergone surgery, radiation therapy destroys abnormal cells remaining after surgery, preventing recurrence of the malignancy.

In what cases is a colostomy performed?

A colostomy is an artificially created opening with a section of the colon inserted into it, intended for the removal of gases and feces.

Indications for colostomy for rectal cancer are:

Removal of most of the tumor-affected colon.
There is a high risk of complications that may arise when the ends of the colon are sutured after surgery to remove a fragment of it.
Impossibility of tumor removal. In this case, it is applied to restore intestinal patency in order to remove gases and feces.
The presence of complications accompanying the tumor process (the occurrence of fistulas, suppuration).
Tumor growth into adjacent organs.
The presence of severe inflammation in the large intestine after radiation therapy.

A colostomy can be temporary or permanent. In the first option, after a certain period of time, another operation is performed, during which the ends of the intestine are sewn together and the hole made in the skin is closed.

Patients who have undergone colostomy are forced to use colostomy bags - special containers for collecting stool.

Diet

Rich in plant fiber, a therapeutic diet for colon cancer should:

help cleanse the body;
prevent constipation;
significantly accelerate the removal of toxic substances from the patient’s body.

In case of colorectal cancer, foods containing large amounts of protein and fat should be completely excluded from the diet, replacing them with dishes high in vitamins A and C, complex carbohydrates and plant fiber.

All these substances are found in vegetables (potatoes, cabbage, tomatoes), grains (brown rice, wheat and corn flakes) and fruits (avocado, citrus fruits, bananas).

Having completely abandoned yeast bread, the patient should prefer whole grain or bran varieties.

Prevention

There is no specific prevention for colon cancer.

You can slightly reduce the risk of its development by doing the following:

Individuals at risk should be screened annually for colon cancer.
People over forty years of age are recommended to undergo a digital rectal examination every year.
Patients over fifty years of age should have a colonoscopy or proctosigmoidoscopy every two years, and an occult blood test once a year.
Regular exercise and constant monitoring of body weight are also beneficial.

Is it possible to get a disability group?

To receive disability for colon cancer, the patient must obtain a medical and social expert opinion.

Before it, the patient must go through:

chest x-ray;
X-ray of the intestine;
biopsy;
medical examination of a number of specialists (including oncologist, therapist, neurologist, etc.

In some cases, the patient is examined in an inpatient setting.

In addition, the patient must submit:

urine and blood samples for general and biochemical analysis;
stool samples to obtain a coprogram and test them for dysbacteriosis.

During the initial examination at the medical and social examination, 95% of patients receive disability group I or II. Group III is for patients with persistent moderate limitations in their ability to live.

Video about the prevention and diagnosis of colon cancer: