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Daniel I
Pathology Report
12 April 2010
Colon Cancer
Colon cancer is common among men and women. About five percent of people
will develop colon cancer (Calvert, et. al. 2002). “Colon cancer is cancer of the large
intestine (colon), the lower part of your digestive system. Rectal cancer is cancer of the
last several inches of the colon” (Mayo Clinic 2009). Colon cancer and rectal cancer
together are called colorectal cancer.
Colon cancer begins as small clumps of cells called adenomatous polyps.
Eventually the polyps become the colon cancers (Mayo Clinic 2009). It is recommended
to get checked often because the polyps don’t have many symptoms. If doctors can catch
the polyps before they turn into cancer it is better (Mayo Clinic 2009).
Colon cancer is categorized as sporadic, inherited, or familial. Sporadic accounts
for seventy percent of all cases (Calvert, et. al. 2002). Less than ten percent of patients
have inherited colon cancer and up to twenty five percent are considered familial
(Calvert, et. al. 2002).
Cancer is the number two leading cause of death in the United States ( Dunne, et.
al. 2002). Among cancers; colon cancer is the third most common (Dunne, et. al. 2002).
This is true for both men and women. Colon cancer is the number two cause for cancer
mortalities in the United States (Dunne, et. al 2002). People have shown to live for some
time with colon cancer. Overall five year rates are sixty five percent (Ko, et. al. 2004).
Still, more than fifty six thousand people die every year because of colon cancer (Dune,
et. al. 2002).
If the cancer is small and caught early enough, it may be able to be removed
during a colonoscopy. If the polyp isn’t attached to the bowel wall, it is likely that the
cancer has been eliminated for good (Mayo Clinic 2009). Laparoscopic surgery may be
used if the polyps are large. If the cancer is too bad and has grown through the colon, the
patient may have to have a colectomy to remove the part of the colon that has the cancer
(Mayo Clinic 2009). Some patients will have to use a colostomy bag. This is usually
temporary but in some cases may be permanent (Mayo Clinic 2009). If the patient is in
poor health or their cancer is advanced the doctor may perform palliative surgery. This
only relieves symptoms (Mayo Clinic 2009). Chemotherapy and radiation are tools used
to help destroy cancer cells (Mayo Clinic 2009). Chemotherapy can be used if cancer has
spread beyond the colons wall. Radiation is used to shrink tumors before they are
removed by surgery (Mayo Clinic 2009). Radiation isn’t usually used in early colon
cancer stages. The use of chemotherapy and radiation can help prevent the return of
cancer in the parts that it started (Mayo Clinic 2009).
Symptoms of colon cancer are seen more in late stages as apposed to early stages.
The symptoms of a patient will depend on the size, location, and the presence of
matastases (Cappell 2005). Some symptoms of colon cancer are: abdominal pain, rectal
bleeding, altered bowel habits, and involuntary weight loss. Some other symptoms that
are not as common are: nausea and vomiting, malaise, anorexia, and abdominal distention
(Cappell 2005). Depending on where the cancer is located, the patient may also have
symptoms of muscle weakness, fatigue, dyspnea, palpitations, or just feeling of poor
health (Cappell 2005).
If the patient has the correct signs and symptoms than there are a number of ways
to test to see if colon cancer is present. The patient may need a colonoscopy which is a
tube inserted into the colon that has a video camera on it. If the camera shows suspicious
areas then the doctor can insert tools to take a sample of the area to be tested (Mayo
Clinic 2010). A barium enema may also be used too. It is a dye that is inserted into the
bowl through an enema. It creates a silhouette of the patient’s rectum and colon which is
than X-rayed (Mayo Clinic 2009).
There are different stages of colon cancer. They range from stage 0 to stage IV.
Stage 0 is the earliest stage of colon cancer. In this stage the cancer is just in the inner
layer of the colon (Mayo Clinic 2009). In stage I the cancer has gone beyond the inner
layer but hasn’t spread past the colon wall. In stage II the cancer has spread past the colon
wall but not to the lymph nodes that are nearby. In stage III the lymph nodes are affected
but not the rest of the body. In stage IV the cancer has spread to other organs of the body
(Mayo Clinic 2009).
There are ways to help prevent colon cancer. It is recommended to start getting
screened for colon cancer around the age of fifty. African-Americans should be screened
even earlier than that because they are at a higher risk (Mayo Clinic 2009). Ways that a
person can be screened include: Annual fecal occult blood testing, flexible
sigmoidoscopy every five years, double-contrast barium enema every five years,
colonoscopy every ten years, virtual colonoscopy every five years and stool DNA testing
(Mayo Clinic 2009). There are other lifestyle changes a person can make as well. Eating
a variety of fruits and vegetables is recommended. They contain vitamins, minerals, fiber
and antioxidants which can help play a role in cancer prevention (Mayo Clinic 2009).
Choosing to drink alcohol in moderation is a good idea. Stopping smoking can increase a
persons chances of preventing cancer. Having a healthy weight and exercising is helpful
too (Mayo Clinic 2009). Over the counter drugs such as aspirin, Advil, Motrin, and
Aleve, have shown to reduce the risk of polyps and colon cancer (Mayo Clinic 2009).
There needs to be a caution when doing this because these drugs may also cause
gastrointestinal bleeding and ulcers (Mayo Clinic 2009). In rare cases doctors may
suggest the removal of the entire colon and rectum to prevent cancer in the future (Mayo
Clinic 2009).
There are risk factors associated with colon cancer. Older persons are at a higher
risk for colon cancer. Close to ninety percent of persons diagnosed with colon cancer are
over the age of fifty (Mayo Clinic 2009). If a person has a history of colorectal cancer or
of polyps they are at a greater risk of the cancer coming back. If a person has ulcerative
colitis or Crohn’s disease they have an increase of getting colon cancer (Mayo Clinic
2009). A person is more likely to develop colon cancer if they have a family history of
colon cancer and if there are more than one family member (parent, sibling, or child) that
has colon cancer there is even a greater risk (Mayo Clinic 2009). Persons with a diet that
is low in fiber and high in fat may be at a risk for colon cancer. It has been shown that
people who eat large amounts of red meat and processed meat are at a greater risk for
colon cancer (Mayo Clinic 2009). Persons who are not very active and don’t get any
exercise are at a greater risk of getting colon cancer. Diabetes, obesity, smoking, and
alcohol have all been shown to increase a person’s chance of getting colon cancer (Mayo
Clinic 2009). If a person is receiving radiation treatments for other cancers in the
abdomen then they too will have an increased chance for colon cancer (Mayo Clinic
2009).
Scientists are continually looking for ways to prevent colon cancer. They are
trying to learn more about the changes in DNA that cause cells in the colon to become
cancerous (National Cancer Society 2010). Recent discoveries of cancer are be used to
help inform those persons that are at a higher risk. Doctors have also discovered that
certain genes act differently to certain treatments. Advancement in how gene changes
cause cancer can lead to new ways of treating colon cancer (National Cancer Society
2010). Early phases of therapy are already happening. Doctors now believe that if a
person is taking calcium, folic acid, or vitamin D, they can have a decrease in colon
cancer risks (National Cancer Society 2010). There have also been studies on ways to be
able to better identify blood in the stool and detecting changes in the DNA (National
Cancer Society 2010). There have been advancements in surgery as well. Doctors are
starting to remove more lymph nodes during surgery to prevent the cancers from coming
back or spreading (National Cancer Society 2010).
Colon cancer awareness is staring to get more attention. In 2009 Colorado,
Kentucky, North Carolina, and South Carolina came together to do the first multi-state
colon cancer awareness program. They were particularly looking to get awareness to
rural communities (Center for Cancer Research 2010). They sent out tool kits with
posters and fliers. The posters and fliers were designed to let people know of the local
community activities about colon cancer awareness (Center for Cancer Research 2010).
References
Calvert, P. (2002, March). The Genetics of Colon Cancer. Annals of Internal Medicine,
137, 603-612. Retrieved April 12, 2010, from ProQuest Nursing & Allied Health Source.
Cappell, M. (2005) The pathology, clinical presentation, and diagnosis of colon cancer
and adenomatous polyps. The Medical Clinics Of North America, 89, 1-42. Retrieved
April 12, 2010 from
http://www.med.upenn.edu/gastro/documents/MedClinNAcolonicpolyps.pdf
Center for Colon Cancer Research. news & events. University of South Carolina,
Retrieved April 12, 2010 from http://www.cccr.sc.edu/
Dunne, J. et. al. (2002 June). Preoperative Anemia in Colon Cancer: Assessment of Risk
Factors. The American Surgeon, 68, 582-587. Retrieved April 12, 2010, from ProQuest
Nursing & Allied Health Source.
Ko, C. et. al. (2004 October), Colon Cancer Survival Rates With the New American joint
Committee on Cancer Sixth Edition Staging. Journal of the National Cancer Institute, 96,
1420-1425. Retrieved April 12, 2010 from ProQuest Nursing & Allied Health Source.
Mayo Clinic. (2009 August). Colon Cancer. Retreived April 12, 2010 from
http://www.mayoclinic.com/health/colon-cancer/DS00035
National Cancer Society. (2010 February). Detailed Guide: Colon and Rectum Cancer.
Retrieved April 12, 2010 from http://www.cancer.org/docroot/home/index.asp