Excluding skin cancers, colorectal cancer is the third most common form of cancer diagnosed in both males and females in U.S. Estimates from the American Cancer Society report that 108,000 new cases of colorectal cancer are diagnosed each year. The overall lifetime risk for developing colorectal cancer is approximately 1 in 19, with the risk being slightly higher in men than in women.
Colorectal cancer affects people of all races, genders and is most commonly diagnosed in people over the age of 50 years old. A recent study by the Center for Disease Control demonstrated that approximately 41 million people of average-risk have not received a colorectal cancer screening test, according to national guidelines.
What is Colorectal Cancer?
Colorectal cancer refers to cancer that develops within the colon or rectum, cancers of this nature are at times referred to separately as either colon or rectal cancer, depending on the location of origin. These types of cancers often have the same symptoms and features in common. When detected and treated early, colorectal cancer is considered curable.
Colorectal cancer almost always develops from precancerous polyps (abnormal growths) found in the colon or rectum, though an exact cause is still unknown at the current time.
What Causes Colorectal Cancer?
Although the exact cause for colon and rectal cancers is unknown, there is a great deal of ongoing research being done to find out more information. Scientists are beginning to understand the link between changes in deoxyribonucleic acid (DNA) and how the changes can cause normal cells to turn into cancer.
Some genes contain instructions on how cells grow and divide and go through apoptosis (death). Genes that result in a speeding up of cellular division are called oncogenes, genes that slow cellular division or cause apoptosis are called tumor suppressor genes. Changes within several different genes have been linked to the development of cancers.
A small number of colorectal cancers are caused by inherited gene mutations such as; familial adenomatous polyposis (FAP), hereditary nonpolyposis colon cancer (HNPCC) and Peutz-Jeghers syndrome.
Symptoms of Colorectal Cancer
Many people that have colorectal cancer experience no symptoms in the early stages of the disease. However, when symptoms finally do appear, they will differ vary depending upon the stage of cancer, size of the tumor(s) and location within the intestine. Symptoms can include, but are not limited to the following:
- Change in bowel habits, including diarrhea or constipation, or a noticeable change in consistency of the stool for a period of weeks.
- Bleeding from the rectum or bloody stool.
- Pain in the abdomen when having a bowel movement.
- A feeling that the bowel does not completely empty.
- Fatigue or weakness.
- Unexplainable weight loss.
Bloody stool may be a sign of cancer, however, it may also be an indication of another condition. If bright red blood is noticeable after a bowel movement, it is likely from hemorrhoids or fissures (minor tears) in the anus. Additionally, certain foods such as beets, red licorice or red dye number nine can all turn the stool a noticeable shade of red. Iron supplements and certain anti-diarrhea medications can turn the stool a dark, almost black color. Anytime blood in the stool is present, a person should be checked by a physician to make certain it is not a result of something serious.
Colorectal Cancer Treatment
The type of treatment recommended by a physician will depend upon the stage and location of the cancer. The three most common options for treatment include surgery, radiation and chemotherapy.
Surgery (colectomy) is the preferred method for treating colorectal cancer. How much of the colon is removed and whether other treatments are an option would depend on the location of the cancer, how far the cancer has grown into the wall of the bowel, and whether or not the cancer has spread beyond the lymph nodes to other parts of the body.
Chemotherapy involves the use of anti-cancer medications injected through a vein or given orally. A physician may recommend chemotherapy after surgery to kill off any remaining cancer or if the cancer has spread beyond the colon, chemotherapy is also administered in conjunction with radiation. Side effects of chemotherapy include nausea, vomiting, mouth sores, hair loss, fatigue and weight loss.
Radiation therapy is the use of powerful energy rays used to kill any potential cancer cells that may be left after surgery. Radiation can also be done before surgery to shrink the size of tumors, or to relieve the symptoms of colon cancer or rectal cancer. Radiation therapy is often used in early stage colon cancer treatment and is usually combined with chemotherapy to reduce the chances of the cancer spreading beyond the colon wall. Some side effects of radiation therapy include fatigue, rectal bleeding, diarrhea, nausea and appetite loss.
Another treatment called targeted drug therapy uses three specific medications that target specific defects which allow cancer cells to rapidly reproduce. The drugs are bevacizumab, cetuximab and panitumumab, which can be given with chemotherapy or administered alone. Bevacizumab prevents tumors from developing new blood vessels, which deliver oxygen and allow the tumor to continue growing. Cetuximab and panitumumab target a specific chemical signal which tells a cancer cell to divide and reproduce. The Food and Drug Administration approved cetuximab in 2007, as a single-agent treatment for advanced stages of colon cancer, the drug is used as an alternative when other treatments have failed. The use of panitumumab still remains experimental.
Colorectal Cancer Treatment Alternatives
When faced with a diagnosis of colorectal cancer, a person may have questions and concerns about treatment alternatives. There are many reasons why people consider alternative and complementary treatment methods for colorectal cancer, such as:
- For help coping with the side effects of colorectal cancer treatment such as fatigue, pain and nausea.
- For comfort and to ease the worries associated with the stresses of cancer treatment.
- To allow the cancer sufferer to feel they are doing something proactive to help in the treatment and care of their cancer.
- As a way to treat or cure the cancer.
An alternative for colon cancer treatment is complementary and alternative medicine (CAM). CAM is any medical procedure, practice or product that is not considered part of normal treatment protocols. Complementary cancer treatment is used in conjunction with standard medical care, while alternative medicine is used in place of standard medical treatment.
Integrative medicine is a total mind, body and spirit approach to cancer care. It combines standard medical care with complementary and alternative practices that have shown the most success. There are five alternative treatment types which include:
- Mind-body medicine
- Biological based medicine
- Manipulative and body-based practices
- Energy medicine
- Whole medical practices (systems)
Mind and body medicines are based on the specific belief that a persons mind has the ability to affect the body, some examples of mind-body medicine include:
- Meditation: using focused or repetitive words or phrases to relax the mind.
- Biofeedback: use of simple machines, a person learns how to affect certain body functions of which they are normally unaware, such as heart rate.
- Hypnosis: being in a state of relaxation and using focused attention in which a person concentrates on certain emotions, ideas, or suggestions used to help in the healing process.
- Yoga: a system using stretches and poses, with special attention which focuses on breathing techniques.
- Imagery: using imagination to picture scenes or experience that will assist the body in healing.
- Creative outlets: participating in activities like art, music or dancing.
Biologically based practices use things found in nature, and include dietary supplements and herbal products for the treatment of colorectal cancer. Some examples of biologically based practices include:
- Certain foods
- Special dietary practices
Many people suffering from colorectal cancer ask questions about the different types of foods to eat during treatment. It is important to note that while diet does play an integral role in health and well-being, there is no one food or special diet that has been proven to control the development of cancer.
Manipulative and body based practices ultilize body-based practices which are based upon working with one or more particular areas of the body. Such methods include the following:
- Massage: manipulating a specific area of tissue with the hands or using special tools.
- Chiropractic care: a type of manual manipulation which involves the joints and skeletal system.
- Reflexology: using certain pressure points on the hands or feet to affect other parts of a persons body.
Energy medicine is based upon the beliefs the body has energy fields which can be used for both health and wellness. A therapist will use pressure or move the body by putting the hands in or throughout these fields. Some examples of energy medicine include:
- Tai chi: involves the use of slow, gentle movements with focus fixed on breathing and concentration.
- Reiki: the practice of balance energy from a distance by placing hands on or near a person.
- Therapeutic touch: involves moving the hands over energy fields within the body.
Whole medicine systems is a healing practice and belief which has developed over time within different cultures and locations throughout the world. Some examples of whole medicine include:
Ayruvedic medicine: a system from India which involve focus placed on balance within the body, mind and spirit.
Chinese medicine: based upon the view that health is a balance of the body within two forces, the yin and yang. Common practices in Chinese medicine includes the use of acupuncture which involves body stimulation to promote healing or to less the side effects of colorectal cancer treatment.
Homeopathy: involves the use of small doses of a particular substance to trigger the body into healing itself.
Naturopathic medicine: uses many different methods that allow the body to heal itself naturally.
Anytime a person is interested in the treatment alternatives available for colorectal cancer, it is necessary to consult with a physician and cancer care team prior to any changes being made to treatment protocol.
Colorectal cancer survival rates are based upon the percentage of people who survive for a specific period of time after an initial diagnosis has been made. Because no two patients are exactly the same, and colorectal cancer treatments and responses to treatment vary, the survival rates will depend upon several factors.
Completing treatment for colorectal cancer can be both stressful and exciting. For many years after treatment ends, a person can expect to make regular follow-up visits to a physician, which include several exams such as a colonoscopy, manual rectal examination, blood tests and possibly an x-ray, to check out any symptoms that would suggest the cancer has returned.
With early diagnosis and proper treatment a person with colorectal cancer can expect to make a full recovery and be able to live a normal life.