Colon (colorectal) cancer starts in your colon (large intestine), the long tube that helps carry digested food to your rectum and out of your body.
Colon cancer develops from certain polyps or growths in the inner lining of your colon. Healthcare providers have screening tests that detect precancerous polyps before they can become cancerous tumors. Colon cancer that’s not detected or treated may spread to other areas of your body. Thanks to screening tests, early treatment and new kinds of treatment, fewer people are dying from colon cancer.
What are colon cancer symptoms?
You can have colon cancer without having symptoms. If you do have symptoms, you may not be sure if changes in your body are signs of colon cancer. That’s because some colon cancer symptoms are similar to symptoms of less serious conditions. Common symptoms of colon cancer include:
Blood on or in your stool (poop): Talk to a healthcare provider if you notice blood in the toilet after you poop or after wiping, or if your poop looks dark or bright red. It’s important to remember blood in poop doesn’t mean you have colon cancer. Other things — from hemorrhoids to anal tears to eating beets — may change your poop’s appearance. But it’s always better to check with a healthcare provider any time you notice blood in or on your stool.
Persistent changes in your bowel habits (how you poop): Talk to a healthcare provider if you have persistent constipation and/or diarrhea, or if you feel as if you still need to poop after going to the bathroom.
Abdominal (belly) pain: Talk to a healthcare provider if you have belly pain with no known cause, that doesn’t go away or hurts a lot. Many things may cause belly pain, but it’s always best to check with a healthcare provider if you have unusual or frequent belly pain.
Bloated stomach: Like belly pain, there are many things that may make you feel bloated. Talk to a healthcare provider if your bloated belly lasts for more than a week, gets worse or you have other symptoms like vomiting or blood in or on your poop.
Unexplained weight loss: This is a noticeable drop in your body weight when you’re not trying to lose weight.
Vomiting: Talk to a healthcare provider if you’ve been vomiting periodically for no known reason or if you vomit a lot in 24 hours.
Fatigue and feeling short of breath: These are symptoms of anemia. Anemia may be a sign of colon cancer.
How do healthcare providers treat colon cancer?
Surgery is the most common colon cancer treatment. There are different colon cancer surgeries and procedures:
Polypectomy: This surgery removes cancerous polyps.
Partial colectomy: This is also called colon resection surgery. Surgeons remove the section of your colon that contains a tumor and some surrounding healthy tissue. They’ll reconnect healthy colon sections in a procedure called anastomosis.
Surgical resection with colostomy: Like a colectomy, surgeons remove the section of your colon that contains a tumor. In this surgery, however, they can’t connect healthy colon sections. Instead, they do a colostomy. In a colostomy, your bowel is moved to an opening in your abdominal wall so your poop is collected in a bag.
Radiofrequency ablation: This procedure uses heat to destroy cancer cells.
Healthcare providers may combine surgery with adjuvant therapy. This is cancer treatment done before or after surgery. They may also use these treatments for colon cancer that has spread or come back. Treatments may include:
Chemotherapy: Healthcare providers may use chemotherapy drugs to shrink tumors and ease colon cancer symptoms.
Targeted therapy: This treatment targets the genes, proteins and tissues that help colon cancer cells grow and multiply. Healthcare providers often use a type of targeted therapy called monoclonal antibody therapy. This therapy uses lab-created antibodies that attach to specific targets on cancer cells or cells that help cancer cells grow. The antibodies kill the cancer cells.
How do healthcare providers diagnose colon cancer?
Healthcare providers use several tests to diagnose colon cancer. Those tests include:
What’s the difference between a screening test and tests that diagnose colon cancer?
A cancer screening test checks for cancer when you don’t have any signs or symptoms of cancer. If your screening test shows abnormalities, a healthcare provider may recommend additional tests.
What are common colon cancer screening tests?
A colonoscopy is the most common screening test for colon cancer. Other tests include:
Fecal immunochemical test (FIT): This test detects hidden blood in your poop. Medical pathologists test samples of your poop for blood that you may not see just by looking.
Guaiac-based fecal occult blood test (gFOBT): Like the FIT, this test looks for blood in poop that may not be visible.
Fecal DNA test: This test looks for signs of genetic mutations and blood products in your poop.
Flexible sigmoidoscopy: Healthcare providers use a flexible scope called a sigmoidoscope to see inside your lower colon and rectum.
Virtual colonoscopy: A virtual colonoscopy is an X-ray that looks for polyps, tumors and ulcers (sores) in your colon and rectum.
How do healthcare providers stage colon cancer?
Healthcare providers use the TNM cancer staging system developed by the American Joint Committee on Cancer to stage colon cancer.
There are five stages of colon cancer. Three of the four stages have three sub-stages. The colon cancer staging system includes the following:
Stage 0: Healthcare providers may refer to this as carcinoma in situ. When they do, they’re talking about abnormal or precancerous cells in your mucosa, the innermost layer of your colon wall.
Stage I: Stage I colorectal cancer has grown into the wall of your intestine but hasn’t spread beyond the muscular coat or into close lymph nodes.
Stage II: The cancer has spread farther into the wall of your intestine but hasn’t spread to nearby lymph nodes. There are three types of Stage II colon cancer:
Stage IIA: Cancer has spread through most of your colon wall but hasn’t grown into the wall’s outer layer.
Stage IIB: Cancer has spread into the outer layer of your colon wall or through the wall.
Stage IIC: Cancer has spread to a nearby organ.
Stage III: In this stage, colon cancer has spread to your lymph nodes. Like Stage II colon cancer, there are three sub-stages of Stage III colon cancer:
Stage IIIA: There’s cancer in the first or second layers of your colon wall and it’s spread to one to four lymph nodes.
Stage IIIB: The cancer affects more layers of your colon wall but only affects one to three lymph nodes. Cancer that affects fewer colon wall layers but has spread to four or more lymph nodes is also a stage IIIB colon cancer.
Stage IIIC: There’s cancer in the outer layer or the next outermost layer of your colon and in four or more lymph nodes. Cancer that’s spread into a nearby organ and one or more lymph nodes is also a stage IIIC colon cancer.
Stage IV: Cancer has spread (metastasized) to other areas of your body, such as your liver, lungs or ovaries:
Stage IVA: In this stage, cancer has spread to one organ or to lymph nodes that are farther or more distant from your colon.
Stage IVB: The cancer has moved to more than one distant organ and more lymph nodes.
Stage IVC: Cancer affects distant organs, lymph nodes and abdominal tissue.
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