Colon cancer is a malignant tumor that grows on the mucous membrane lining the walls of the colon. Most frequently, the cancer develops in the areas of the feces stagnation; therefore, chronic constipation is considered one of the predisposing factors of the disease. Chronic colitis and, most importantly, polyposis of the colon also play an important role in the development of cancer. Colon cancer metastasizes through the lymphatic system, affecting the mesenteric lymph nodes, and then a group of nodes along the abdominal aorta. Most often, hematogenous metastases occur in the liver. In the case of the tumor invasion of the intestine serous cover, the dissemination process of the peritoneum, accompanied by ascites can occur.
The clinical symptoms of colon cancer vary with the location of the tumor. The clinical picture of colon cancer in the early stages has no symptoms; nevertheless, a careful survey of the patient can identify the changes in the overall well-being, including a reduced working ability and decreased appetite. In terms of colon cancer, weight loss is rare; in contrast, the patients may even gain extra kilos. In the later stages, a number of signs of the intestinal disorders can occur including transfusion and rumbling in the bowels, diarrhea, constipation, and periodic or constant dull cramping abdominal pain not associated with the food intake. Cancer on the right side of the colon causes anemia due to a chronic blood loss. There are various methods of the colon cancer treatment; this paper discusses the main ones, as well as the preventative measures.
The cases of cancer of the colon comprise 5-6% of all cases of cancer. According to Siegel, DeSantis, and Jemal (2014) “In 2014, there are projected to be 136,830 individuals newly diagnosed with colon cancer and 50,310 colon cancer deaths in the United States.” Siegel, DeSantis, and Jemal (2014) also state that it occurs more frequently in people of 65 years and older. Adenoma, diffuse polyposis, and ulcerative colitis increase the risk of cancer; therefore, they are treated as a timorous disease. “Among women, almost 30% of cases and more than 40% of deaths will occur in those aged 80 years and older, compared with approximately 20% of cases and 30% of deaths among men” (Siegel, DeSantis, & Jemal, 2014).
The main method of treatment for colon cancer is the surgical removal of the tumor, surrounding tissues, and lymph nodes. Not all patients with colon cancer are treated with all possible methods. There are several points that determine when to prescribe the treatment. For example, some patients undergo chemotherapy after surgery. In this case, surgery is the main treatment while chemotherapy is an additional one. The choice of the treatment method depends on the stage of disease, tumor size, and degree of lesion of the lymph nodes, as well as other organs and tissues with the metastases.
The only possible radical treatment of colon cancer is surgical intervention. The operation options differ depending on the location of the tumor. In the case of the cancer of cecum, hepatic flexure of colon or cancer in the places of stagnation of feces, the entire right half of colon is removed, creating a fistula between the ileum and transverse colon (right hemicolectomy). In the case of the cancer of the transverse colon, its resection with the restoration of patency of fistula between the remaining segments can be carried out. In the case of cancer of splenic angle and cancer located in the places of stagnation of feces, the entire left half of the large intestine with a fistula between the transverse colon and the sigmoid colon is removed (left-sided hemi colectomy).
The radiation therapy is the type of treatment that kills tumor cells with radiation; nevertheless, this method is not commonly used to treat colon cancer.
Colon cancer can spread to other body parts. Doctors use the medical treatment to destroy the cancer cells that have spread round the human body; this method is called systemic treatment. It is important to understand the purpose of the systemic therapy in the terms of a medical plan. After surgery, the systemic therapy is used in addition to the primary treatment in order to prevent the disease progression and destroy the cancer cells that may remain in the body. The systemic therapy may also be the primary treatment for metastases. According to Edwards et al. (2012), “For most patients with metastatic CRC (mCRC), treatment is palliative rather than curative. The goals of systemic treatment in these patients are to prolong survival and to maintain quality of life for as long as possible.”
Chemotherapy, in turn, is a systemic treatment for colon cancer. According to Wolpin et al. (2007), “Advances in chemotherapy surgery, and radiotherapy have improved outcomes for patients with colon cancer” (p. 168). Most of these medications are liquids; they are delivered into the body via infusion into a vein. Others medications include pills that a patient need to swallow. The drugs spread round the human body with the blood and attack the tumor cells. Chemotherapy is administered in cycles, where the days of treatment are alternating with the days of rest. The cycle time depends on the medication used. Usually, the cycle lasts for 14, 21, or 28 days. These cycles provide the body with an opportunity to recover before the next treatment stage. According to Meyerhardt and Mayer (2005), “Prospective studies have demonstrated that the use of chemotherapy in the patients with metastatic disease prolongs survival and enhances quality of life in comparison to palliative care alone.” (p. 476)
Preparing the patient for surgery predisposes a thorough cleansing of the intestine. Three-four days before surgery, the patient is put on a light diet, eliminating the intake of bread and vegetables from the daily ration. Two days before the surgery, the patient takes the castor oil and repeated enemas, including on the night before the surgery. The patient also takes antibiotics and sulphonamides prophylactically for two days.
After the operation, in addition to general measures against the postoperative shock, dehydration, and intoxication, a patient is prescribed a liquid paraffin. This easy laxative remedy prevents the formation of dense feces that can injure the joints anastomosis line. Two days after the operation, drinking is allowed; afterwards, the diet is gradually varied with the light liquid food. After the first normal intake of food, a patient is allowed a common diet.
In terms of inoperable and advanced cancer of the colon, palliative surgery has to be carried out; the imposition bypasses the fecal fistula to prevent the possible development of the acute intestinal obstruction with the bowel blockage of tumor. In addition to the palliative surgery, chemotherapy is performed.
A recurrence of colon cancer is rare. It is possible due to the incomplete operation and presence of the distant metastases. In such case, the reoperation is needed. In terms of colon cancer, the prognosis depends on the stage of the disease progression. However, in the absence of metastases in the lymph nodes, the prognosis is favorable as almost half of the patients receive a steady recovery.
Colonoscopy is a diagnostic medical procedure, during which the endoscopist inspects and assesses the inner surface of the colon using a special probe. That is the most informative and reliable method in diagnosing the benign and malignant tumors of colon, as well as nonspecific inflammatory diseases of the colon. During the colonoscopy, a doctor, as well as a patient, can follow the entire process on the screen. Colonoscopy may be used with a purely diagnostic purpose, as well as be an independent method of the endoscopic treatment.
Patients at-risk are subjected to dispensary observation. The prevention of colon cancer largely depends on the timely radical treatment of the intestine polyposis, as well as the proper treatment of colitis. The important preventive measures include the normalization of nutrition, reduction of meat products in the daily diet, and the fight against constipation. No one wants to experience the cancer of the colon. To avoid it, people need to know what to do, what to eat, and which tests to take in order to prevent this disease. Some pieces of advice for the prevention of colon cancer are described below:
- It is advisable to change the daily diet before the symptoms develop. Rectal bleeding, arrhythmias of bowel movements, and bloating are just a few symptoms to mention. If people are aware of these symptoms, this knowledge will help save their lives. The patient should eat more fiber and less fat red meat (C. Thomson & P. Thomson, p. 22).
- People should be aware of the possible risks. If a person is over 50 years old, had Crohn's disease, or someone from the family had the cancer of colon, he/she is at risk. Therefore, one or all of these symptoms are a sufficient reason to visit the doctor.
- It is necessary to do ones best to eliminate all risk factors. It involves not only the changes in eating habits but also giving up all vicious habits. Smoking increases the chances of developing this disease.
- Healthy nutrition and timely examination will help people avoid the disease.
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After analyzing all the information discussed above, it is clear that colon cancer is a rather common disease; thousands of people suffer from it all over the world. The most common treatment for colon cancer is surgery. The recommendations for surgery are positively perceived by most patients as it proves that it is possible to recover. In addition to the surgery, radiation and chemotherapy can be used. For the successful treatment of colon cancer, the early diagnosis is very important, even before the onset of symptoms. Colon cancer is completely curable at its early stages; that is why, the annual examinations are crucial. In patients with diseases of the colon or with family members who have similar problems, the examination should be done more often (every 6 months). The early diagnosis of colon cancer increases the chances of survival. Therefore, regular checkups are important for the early diagnosis and successful treatment of colon cancer.
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