Management of Colorectal Cancer I: Diagnosis and Treatment

Diagnosis and Treatment of Colorectal Cancer
Medical Tutors Limited
April 30, 2020

11:32 PM

Summary
Getting screened for colorectal cancer as an individual reaches the age of 45 is very important. This would enable one to know their status and thus prompting an early treatment that suits their medical history and status.

Diagnosis of Colorectal Cancer

Colorectal cancer is a cancer that affects the colon and rectum part of the human body and in most cases there is usually no symptoms or little symptoms to show that it exists in an individual. Most medical doctors may recommend certain screening tests for healthy individuals who show no sign or symptom of colorectal cancer in order to detect colorectal cancer or noncancerous colorectal polyps. This test would also help to learn if the cancer might have spread to another part of the part from its origin.

It is generally recommended that people with an average risk of colon cancer begin screening around age 50. But people with an increased risk, such as those with a family history of colorectal cancer, black race, signs and symptoms or suspected case of cancer, should consider screening sooner. And just like every other type of cancer, a biopsy is the best way for medical doctors to determine the area of the body that has cancer.

In addition to a physical examination, the following tests may be used to diagnose colorectal cancer.

  • Colonoscopy: This type of test allows the doctor to look inside the entire rectum and colon using a long, flexible and slender tube attached to a video camera and monitor while a patient is sedated. Once the colorectal cancer is found, a completer diagnosis done and the doctor performs a surgery so as to remove the tumor.
  • Biopsy: This is the removal of a small amount of tissue for examination under a microscope. Other tests can suggest that cancer is present, but only a biopsy can make a definite diagnosis of colorectal cancer.
  • Blood Tests: Due to the fact that colorectal cancer often bleeds into the large intestine or rectum, people with the disease may become anemic. Although no blood test can tell if an individual have colon cancer, but medical doctor may test the blood for clues about the overall health, such as kidney and liver function tests. He/she may also test the blood for a chemical sometimes produced by colon cancers (carcinoembryonic antigen, or CEA).
  • Computed Tomography (CT or CAT) Scan: A CT scan can be used to measure the tumor’s size. In a person with colorectal cancer, a CT scan can check for the spread of cancer to the lungs, liver, and other organs. It is often done before surgery.
  • Proctoscopy: This test may be done if rectal cancer is suspected. Here, the doctor looks inside the rectum with a proctoscope, a thin, rigid, lighted tube with a small video camera on the end inserted through the anus. The tumor can be seen, measured, and its exact location can be determined.
  • Chest X-ray: An x-ray may be done after colorectal cancer has been diagnosed to see if cancer has spread to the lungs.
  • Angiography: Angiography is an x-ray test for looking at blood vessels. If the cancer has spread to the liver, this test can show the arteries that supply blood to those tumors.
  • Ultrasound
  • Magnetic Resonance Imaging (MRI) Scan
  • Positron Emission Tomography (PET) Scan

 

Treatment of Colorectal Cancer

In choosing the best treatment plan for colorectal cancer, a medical doctor considers so many factors that include the location of the cancer, its stages and overall health conditions, family history and allergies. The treatment of colorectal cancer usually involves surgery which is used to remove the cancer; chemotherapy and radiation therapy may also be considered.

  1. Surgery

 Early Stage Colon Cancer: In situation where the tumour is very small, a doctor may recommend a minimal form of surgery, such as:

  • Polypectomy: Here the doctor removes the polyps during the early stage of the colorectal cancer. This is usually done during colonoscopy.
  • Endoscopic Mucosal Resection: This is removing larger polyps during colonoscopy using special tools to remove the polyp and a small amount of the inner lining of the colon.
  • Minimally Invasive Surgery (Laparoscopic Surgery). Polyps that can't be removed during a colonoscopy may be removed using laparoscopic surgery. In this procedure, the surgeon performs the operation through several small incisions in the abdominal wall, inserting instruments with attached cameras that display the colon on a video monitor. The surgeon may also take samples from lymph nodes in the area where the cancer is located.

But in certain situation when the cancer has grown into or through the colon, a doctor may recommend:

  • Partial Colectomy: During this procedure, the doctor (surgeon) advises the removal of some part of the colon that contains the cancer, along with a margin of normal tissue on either side of the cancer. The surgeon is often able to reconnect the healthy portions of the colon or rectum. This procedure can commonly be done by a minimally invasive approach (laparoscopy).
  • Lymph Node Removal: Nearby lymph nodes are usually also removed during colon cancer surgery and tested for cancer.
  • Ostomy: In certain situations when it's not possible to reconnect the healthy portions of the colon or rectum, Ostomy is recommended. This involves creating an opening in the wall of the abdomen from a portion of the remaining bowel for the elimination of stool into a bag that fits securely over the opening. Sometimes the ostomy is only temporary, allowing the colon or rectum time to heal after surgery. In some cases, however, the colostomy may be permanent.

Surgery for Advanced Cancer

When an individual overall health is very poor, a doctor may recommend an operation to relieve the blockage of the colon. This surgery isn’t used to cure cancer but to relieve signs and symptoms, bleeding or pain. In specific cases where the cancer has spread only to the liver or lung but the overall health is otherwise good, doctor may recommend surgery or other localized treatments to remove the cancer. Chemotherapy may be used before or after this type of procedure. This approach provides a chance to be free of cancer over the long term.

2.   Chemotherapy: Chemotherapy uses drugs to destroy cancer cells. Chemotherapy for colon cancer is usually given after surgery if the cancer is larger or has spread to the lymph nodes. In this way, chemotherapy may kill any cancer cells that remain in the body and help reduce the risk of cancer recurrence. It might also be used before an operation to shrink a large cancer so that it's easier to remove with surgery.

Chemotherapy can also be used to relieve symptoms of colon cancer that can't be removed with surgery or that has spread to other areas of the body. Sometimes it's combined with radiation therapy.

 3.   Radiation Therapy: Radiation therapy uses powerful energy sources, such as X-rays and protons, to kill cancer cells. It might be used to shrink a large cancer before an operation so that it can be removed more easily. But when surgery isn't an option, radiation therapy might be used to relieve symptoms, such as pain. Sometimes radiation is combined with chemotherapy.

4.   Targeted Drug Therapy: Targeted drug treatments focus on specific abnormalities present within cancer cells. By blocking these abnormalities, targeted drug treatments can cause cancer cells to die. Targeted drugs are usually combined with chemotherapy. Targeted drugs are typically reserved for people with advanced colon cancer.

5.    Immunotherapy: Immunotherapy is a drug treatment that uses the immune system to fight cancer. The body's disease-fighting immune system may not attack the cancer because the cancer cells produce proteins that blind the immune system cells from recognizing the cancer cells. Immunotherapy works by interfering with that process. It is usually reserved for advanced colon cancer.

 

 

 

 

[Next Article on Colorectal Cancer: Causes, Risk Factors and Prevention of Colorectal Cancer]

 

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