Staging Of Colorectal Cancer

What is colorectal cancer?
Colorectal cancer is the third most common non-skin cancer among men and women in the United States, and the second leading cause of cancer death. However, if caught early, colorectal cancer is easily curable. Colorectal cancer is formed by cancer cells in the lining of the colon (large intestine) or rectum.

How colorectal cancer is caused
Colorectal cancer usually begins as a benign growth called a polyp. An adenoma is a type of polyp, a benign tumor of tissue on the inside of the colon or rectum. Most polyps will remain benign, but some adenomas have the potential to become cancerous over time. If they are removed early, they can be prevented from becoming cancerous.

Risk factors beyond your control
Some risk factors for developing colorectal cancer are beyond your control. The following factors can increase your risk of developing colorectal cancer.

Inflammatory bowel disease (IBD)
colonic polyp
Over 50 years of age
Family history of colorectal cancer
History of breast or ovarian cancer

Risk factors you can control
However, there are other risk factors for colorectal cancer that can be controlled. The following risk factors can be modified.

Eating a diet high in red or processed meats or eating meat that has been cooked at high temperatures
Overweight or obesity
Inadequate exercise
smokers
drinking wine

Warning Signs of Colorectal Cancer
Screening is important because colorectal cancer usually does not produce any symptoms in its early stages. Screening can detect the cancer before it produces symptoms, when it is most likely to be cured. When the disease begins to spread, it can produce blood in the stool, changes in bowel movement patterns (such as diarrhea or constipation), abdominal pain, weight loss, or fatigue. Tumors that cause symptoms are usually larger and more difficult to treat.

Colorectal Cancer Screening
It is recommended that most people have a colonoscopy every 10 years starting at age 50. A colonoscopy allows the entire colon and rectum to be examined with a tiny camera. This test can detect cancer at its earliest, most treatable stage and prevent it from developing by removing polyps, as shown here.

What is a virtual colonoscopy?
An alternative to colonoscopy is to use CT scan images to look at the colon. This is called a virtual colonoscopy. As with a traditional colonoscopy, the colon must be emptied as thoroughly as possible before the test. In a virtual colonoscopy, it is not necessary to insert a camera into the intestine to see polyps or tumors. One disadvantage is that virtual colonoscopy can only identify but not remove any polyps that are found. A real colonoscopy is needed to remove any polyps that may be identified.

Colonic X-ray (lower gastrointestinal tract)
X-rays of the colon, known as a lower GI series, can provide another way to image the colon and rectum. A chalky fluid known as barium is used as a contrast agent. This photo shows an example of a shrunken “apple core” tumor of the colon. As with virtual colonoscopy, a real colonoscopy or other surgical procedure is needed to remove any tumors or polyps that may be found.

Colorectal Cancer Diagnosis
If you have an abnormality in your colon or rectum, a biopsy will be performed to determine if cancer is present. This can be done during a colonoscopy. The tissue is examined under a microscope to look for cancer cells. This image shows a high magnification of colon cancer cells.

Colorectal Cancer Staging
Staging is the process of determining the extent of spread of the tumor beyond the primary site. Staging may be independent of the size of the tumor. Treatment decisions also depend on the stage of the tumor. Stages of colorectal cancer are as follows.

Stage 0 The cancer is present only in the innermost layers of the rectum or colon.
Stage I – The cancer has not spread beyond the lining of the rectum or colon.
Stage II – The cancer has spread to the muscular layer of the rectum or colon.
Stage III – the cancer has spread to at least one lymph node in the area.
Stage IV – The cancer has spread to distant parts of the body, such as the bones, liver, or lungs. This stage does not depend on how far the cancer has penetrated or whether the cancer has spread to lymph nodes near the tumor.

Survival rates for colorectal cancer
A higher stage means a more severe cancer and a worse prognosis. The five-year survival rate for patients with stage one colorectal cancer is 74%, while it drops to 6% for patients with stage four cancer.

colorectal cancer surgery
Except in very advanced cases, colorectal cancer is usually treated by surgery to remove the tumor and surrounding tissue. Surgery has a very high cure rate for early-stage tumours. In advanced tumors that have spread outside the colon, surgery usually does not cure the disease, but removal of larger tumors can relieve symptoms.

Treatment of advanced colorectal cancer
Colorectal cancer that has spread to the lymph nodes (stage III) can sometimes still be cured. In these cases, treatment usually consists of surgery and chemotherapy for the colon cancer. In cases of rectal cancer, radiation therapy is added before and after surgery, and in more advanced cases. Cancers that recur or spread to other organs after treatment are more difficult to treat and harder to cure, but treatment can relieve symptoms and prolong life.

Coping with chemotherapy
Modern chemotherapy drugs are less likely to cause nausea and other disturbing side effects than older drugs, and there are drugs available to help manage these side effects. Clinical trials are always underway to develop better, more tolerable chemotherapy drugs.

Radiofrequency ablation
Radiofrequency ablation (RFA) is a cancer treatment that uses heat to destroy tumor tissue. A CT scan is used to guide the insertion of a needle-like device into the tumor, through which the heat is applied.RFA can be an option for destroying tumors that cannot be removed by surgery. In patients with a few metastatic tumors in the liver that cannot be surgically removed, chemotherapy is sometimes combined with RFA to destroy the tumor.

Colorectal Cancer Prevention. Diet
According to researchers, eating a nutritious diet, getting enough exercise, and controlling body fat can prevent 45% of colorectal cancers. This means that adopting a healthy lifestyle can greatly reduce the risk of developing colorectal cancer. The National Cancer Institute recommends adopting a diet that is low in fat, high in fiber, and contains at least five servings of fruits and vegetables per day.

Preventing cancer through exercise
One study showed that people who got the most physical activity were 24 percent less likely to develop colorectal cancer than their least active counterparts. There was no difference if this activity was related to work or recreation. The American Cancer Society recommends exercising at least 30 minutes a day, five or more days a week.