Colon carcinoma is a malignant growth in the large intestine. The tumor, often referred to as colon cancer, is currently one of the most common cancers worldwide. If detected early, the chances of recovery are generally good.
Here you will find all the information and selected doctors for the detection (screening) and treatment of colon cancer.
As a rule, colon cancer is preceded by harmless intestinal polyps which, however, become malignant over the course of several years. This disease generally develops very slowly and often goes unnoticed due to the lack of symptoms. The first symptoms only appear in the late stages, often causing severe pain or bloody stools.
In Germany, colon cancer is the third most common cancer in men and the second most common in women. Every year, German hospitals register over 60,000 new cases. Around 29,000 of these are women and 34,000 are men.
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The exact reason why an intestinal cell becomes a cancer cell is unclear. Damage occurs in the area of certain genes of a cell. This "gene damage" means that the cell is deprived of natural regulation and multiplies uncontrollably.
Colon carcinoma can develop for no significant reason. Nevertheless, there are risk factors that can increase the likelihood of developing colon cancer. These are
The risk of developing colorectal cancer appears to be reduced in:
In most phases of the disease, patients do not experience any symptoms or restrictions. For this reason, colon cancer is often only discovered in the late stages. The chances of successful treatment are then already decreasing. Many sufferers notice blood in their stools or increasingly darker stools.
In addition, many sufferers complain of repeated bowel cramps and severe pain that persist for longer and longer periods of time. Just like the pain and cramps, phases of diarrhea and constipation alternate. The frequent bowel movements are often accompanied by a strong, foul-smelling odor.
Loud bowel noises and flatulence are also noticeable. These are associated with heavy loss of blood, mucus or stool. In addition to an increasing drop in performance, the disease is usually also characterized by a permanent loss of appetite and fatigue. After a marked pallor becomes noticeable in those affected, there is usually an inexplicable reduction in weight. In addition, the lymph nodes enlarge and clearly noticeable hardening occurs in the abdomen.
However, all the symptoms described are not a definite suspicion of colon carcinoma. In most cases, such symptoms also occur in harmless situations. They can also be a sign of increased stress (irritable bowel syndrome). Nevertheless, a doctor should be consulted as soon as possible.
There are various methods available to the doctor for diagnosis. First of all, the doctor will ask several important questions in an in-depth interview in order to assess the risk of colon cancer. In addition to dietary habits, he will therefore also ask about the medical history of all close family members. A previous case of colon cancer among family members generally justifies increased caution.
This is always followed by a physical examination. During this examination, the doctor thoroughly palpates the patient's entire abdomen. In this way, he checks for any indurations. Finally, a blood sample is taken and analyzed. Dedicated physicians also perform a painless palpation of the rectum, as many colon tumors are located there.
Colon carcinoma can best be diagnosed or ruled out beyond doubt with a colonoscopy. The doctor uses this to examine the entire colon for malignant growths. The colonoscopy can also be used to remove benign polyps that can develop into malignant tumor tissue. For this reason, a screening colonoscopy is recommended from the age of 50 for men and from the age of 55 for women.
During a colonoscopy, the doctor performing the procedure inserts a long, flexible tube into the patient's anus. A special gel is usually used to improve lubrication. At the end of the tube is a small camera that transmits video recordings to a connected monitor.
The tube has a working channel through which small instruments such as forceps or snares can be inserted. The doctor uses these instruments to remove suspicious tissue so that it can be analyzed after the examination. They are also used to remove all small polyps. No hospitalization is necessary for this procedure.
The colonoscopy can be performed with or without sedation (artificial sleep).
In individual cases, an examination can also be carried out using a so-called colon capsule endoscopy. During this examination, the patient swallows a small camera which records the entire colon in a video device. However, it is not possible to take a tissue sample or remove a polyp during this procedure.
Colon polyps can be discovered and easily removed during a colonoscopy | License: CC BY 3.0
A biopsy is the removal of a small piece of tissue from the body. This sample can then be examined under a microscope. The doctor can take a biopsy during a colonoscopy. This is done by inserting a thin grasping instrument into a lateral working channel of the colonoscope.
Once the diagnosis of colon cancer has been confirmed, further examinations must be carried out to determine the spread of the tumor. These include, for example
These examinations are called "staging" (determination of the tumor stage) of the carcinoma. The aim of the staging examinations is to find out
Determining the exact stage of the carcinoma is necessary in order to provide the best possible treatment options. It also provides a reasonable indication of the chances of recovery (prognosis).
The treatment of the disease depends primarily on the aggressiveness of the tumor and its spread to the surrounding tissue. In addition, the patient's general state of health also plays a major role. In particular, if the cancer has already invaded the lymph nodes and formed metastases, a combination of several therapeutic approaches is unavoidable.
In the early stages, the disease can usually be completely cured with surgery. In the later stages, additional chemotherapy is often used. In individual cases, comprehensive radiotherapy is even carried out. There are also numerous other treatment options in which drugs target the cancer cells.
Surgery is particularly important in the treatment of colon carcinoma. The aim is to remove all tumor tissue, including all associated lymph nodes and lymph drains. In addition, the doctor thoroughly examines the abdominal cavity in order to identify any metastatic tissue. Colon carcinoma can affect the liver and lungs. In this case, it makes sense to remove large parts of both organs and the blood vessels supplying them.
In the case of colon cancer, it is often necessary to remove a large part of the colon. In this case, the two separate ends are carefully sutured together. The extent of the operation depends on numerous different factors. These include the location and size of the tumor as well as its blood supply and spread in the body. If other organs such as the spleen or kidneys have been affected, it may be necessary to remove them completely.
If the tumor tissue is completely removed by the operation, the disease is considered cured. In this case, it has no chance of spreading again in the body. It may be necessary to temporarily create an artificial anus. In this way, the operated section of bowel regenerates much faster.
During an operation, an attempt is made to remove all of the tumor tissue.
One or the other of these two options may be necessary during treatment. This depends on the location and stage of the colorectal cancer.
Chemotherapy is a drug treatment that attacks cancer cells.
Radiotherapy is a treatment that focuses high-energy radiation on cancerous tissue. This kills cancer cells or stops the cancer cells from multiplying. This therapy is most commonly used when the tumor is located in the rectum.
If the tumor has reached a certain depth of penetration in the rectum (rectum), so-called neoadjuvant radio and/or chemotherapy is carried out before the operation. This is intended to shrink the tumor before it is surgically removed. This increases the chances of a successful surgical procedure.
If chemotherapy or radiotherapy is used after surgery, this form is called adjuvant chemotherapy or adjuvant radiotherapy. The aim of this treatment is to kill every single cancer cell that has detached itself from the primary tumor and could not be removed by surgery.
Without treatment, a colorectal carcinoma will grow, become larger and spread ("metastasize") to other parts of the body. In many cases, a tumor grows slowly. It may remain inside the bowel for several months before breaking through the wall of the bowel and/or spreading. If treated early, the chances of recovery are very good.
If the colorectal carcinoma has broken through the bowel wall or has metastasized, the chance of a cure is much lower. Nevertheless, treatment can often slow down the progression of the cancer.
Colon cancer can be comprehensively prevented. To this end, all risk factors are specifically minimized and great importance is attached to early detection. Numerous diseases and behaviors can drastically increase the risk of developing colon cancer. Ulcerative colitis and Crohn's disease, for example, are already known to be precursors to colon cancer. In addition to genetic factors, diet also has a major influence on individual risk.
A balanced diet with plenty of fiber and less red meat reduces the risk of developing the disease. Healthy physical activity and reducing fat consumption are also important. Finally, chronic obesity and tobacco consumption also increase the likelihood of developing cancer.
A screening colonoscopy should always be considered if changes in bowel habits become permanently noticeable or blood appears in the stool. A doctor should be consulted at the latest if there is a noticeable drop in performance and paleness in combination with unexplained weight loss. In this way, the dangers of the disease and the serious consequences of late treatment can be effectively avoided.
As the risk of developing bowel cancer increases with age, a colonoscopy should be carried out for men from the age of 50 and for women from the age of 55. This applies regardless of whether bowel complaints occur or not. If there is a family history of bowel cancer, an assessment of the colon is also advisable at an earlier age.
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