Colon cancer: symptoms, diagnosis, treatment and prognosis

Bowel cancer (also called colon carcinoma) is a common type of cancer. In most people, it is cancer of the colon or rectum. After prostate cancer and lung cancer, colon cancer is the most common type of cancer in men. Colon cancer is also common in women. After breast cancer, colon cancer is the most common type of cancer in women.


  • Blood in stool
  • Mucus in stool
  • Bowel pattern changes
  • Chronic abdominal pain
  • Blockage
  • Diarrhea
  • Weight loss
  • Anemia
  • Fatigue
  • Empty urge to push


What does colon cancer mean?

Colon cancer mainly occurs in patients older than 50 years. The disease almost never occurs acutely, but develops insidiously. It starts with a polyp that develops malignantly. The symptoms that occur depend on where the tumor is located in the colon or rectum. A tumor at the end of the large intestine is most often discovered because it is narrow. This means that complaints occur sooner, such as constipation, severe abdominal pain and weight loss. Anemia occurs because the tumor bleeds. The blood is in the stool, so the patient often does not notice it. Usually, blood and mucus in the stool are only visible when the tumor is in the rectum. Colon cancer spreads through the lymph nodes throughout the rest of the body. The first metastasis often occurs in the liver.


If colon cancer is suspected, a general practitioner will provide a referral to a specialist, usually an internist, surgeon or gastroenterologist. The specialist can have various tests performed, such as an endoscopy, an X-ray of the colon, an endo-ultrasound and blood tests. For an endoscopy, you can opt for a rectoscopy, a sigmoidoscopy or a colonoscopy. An endoscopy means that a doctor or specialized nurse enters the intestine with a tube. During a rectoscopy, only the rectum is examined. With a sigmoidoscopy the large intestine is entered further and with a colonoscopy the entire intestine and sometimes part of the small intestine is viewed. With endo-ultrasound, the colon is also monitored with a tube with a camera, but an ultrasound machine is also riveted to it, when the rectum is visually displayed from the inside on a monitor. X-ray examination makes the large intestine visible using barium porridge and air. This is introduced into the body by inserting a tube through the anus. The CEA level is monitored in the blood. This is a substance that is sometimes secreted by malignant growths in the intestine. If it turns out that you suffer from colon cancer, more tests will be done to see how far the disease has progressed. This can be done via CT, MRI and ultrasound examination.


When treating colon cancer, the part of the intestine in which the tumor is located is usually removed. About half of the intestine is removed. This happens together with a large number of lymph nodes. This is chosen because colon cancer spreads through the lymph nodes. After removal, the surgeon does not stitch the remaining pieces of intestine together. If it turns out that the colon cancer has already progressed so far that removal has become impossible, the specialist may opt for another operation. The surgeon then reroutes the intestine so that no blockage occurs. If this is not possible, a stoma is made. This means that the intestine exits through the abdomen. The stool no longer comes out through the anus, but into a bag that is attached to the skin. It often happens that colon cancer is already at an advanced stage or has even spread. Then treatment with chemotherapy is usually chosen. Metastases can be combated in this way, prolonging the patient’s life. Radiation is usually only chosen when a patient has a tumor in the rectum. Radiation can be given before the operation to make the tumor smaller and easier to remove. Radiation therapy is generally ineffective in treating colon cancer.


The cause of colon cancer is unknown. It is clear that various elements can contribute to causing the disease. This involves hereditary predisposition and eating a lot of unhealthy food. Patients with intestinal diseases such as ulcerative colitis and Crohn’s disease are at greater risk of developing colon cancer.


The sooner colon cancer is discovered, the greater the chance of survival. Colon cancer is best combated when the disease has not yet spread. About sixty percent of all patients are cured of colon cancer. If the disease is still in the early stages, eighty to ninety percent of patients get better. Many metastases often require palliative treatment. The cancer can be inhibited and we look at how the disease can be made as bearable as possible for the patient. After healing, patients remain under the control of a specialist.

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