Overview

In order to understand colon and rectal cancer, collectively known as colorectal cancer, it might first help to understand what parts of the body are affected and how they work. Cancer which starts in the colon is colon cancer while that begins in the rectum is called rectal cancer. The cancers that is present in either of these organs or present collectively is called colorectal cancer.
Colorectal cancer starts when certain cells lining the colon or the rectum become malformed and start growing abnormally. The abnormal cells grow to form a tumor and this tumor is cancer.

Symptoms of Colorectal Cancer

In starting stages, the colorectal cancer generally exhibits no symptoms. As cancer advances, the symptoms are:

• Changes in bowel movements
• Continual constipation or diarrhea and inability to empty the bowel
• Rectal bleeding
• Dark areas of blood in stool; or lean pencil stools
• Abdominal uneasiness or distended feeling in abdomen
• Fatigue
• Loss of appetite or unexplained weight loss
• Anemia

Diagnosis

After the age of 50, screening for colorectal cancer is recommended. Conventionally, the doctor performs a digital rectal examination in which stool samples were checked for blood. Another test used for screening is sigmoidoscopy to check the lower part of the bowel. In case of any abnormality, you would be advised to go for a colonoscopy.

The doctor can also advise biopsies of any doubtful regions during a colonoscopy. Now a noninvasive screening method known as virtual colonoscopy is used. It makes use of a spiral computed tomography that creates a 3D image of the colon once it is clear and moderately inflated with air.
If biopsy shows cancer X-ray, ultrasound, or CT scans are used to find if it has spread to other organs.

Blood tests are done for checking the liver functioning and measure the level of carcinoembryonic antigen (CEA) which is high in case of colorectal cancer.

Treatments for Colorectal Cancer

Colorectal cancer treatment uses particular therapies for the treatment and control of the disease and ways to cope with emotional and physical needs of the patient. Reinstating and upholding the worth of life is a main goal for doctors.

Certain alternative treatments and complementary cancer therapies must be followed along with standard medical treatment to cope with stresses of cancer and make the treatment more bearable. The major treatments for colorectal cancer are radiation therapy, chemotherapy and surgery. These treatments are used individually or combined depending upon the stage.

Surgery is a fairly valuable treatment for local colorectal tumors. Colonoscope is used to remove    very small tumors. The health care physicians advise to remove a major part of the colon and the lymph nodes as the best way to prevent any kind of spread. The surgeon can connect the fit parts of the colon and rectum. If it is not possible, the surgeon develops an opening called stoma in the abdomen and changes the path of detached colon to it. The litter is gathered in a bag worn on the stoma. This process is temporary and is known as colostomy. After this, the second surgery connects the colon and rectum. The colostomy is permanent in case of rectal cancer. Then, the patient is given painkillers and medication to relieve post-operative diarrhea or constipation.

Radiation therapy is a therapy in which high energy rays are used to kill the cancer cells. Radiation is given after surgery for rectal cancer so as to kill any left over cells. It is also used prior to surgery to diminish the size of a large tumor in order to make the surgery simpler. Radiation therapy is used when the tumor of colon cancer is connected to an organ in the abdomen. The radiation therapy has side effects of bowel hindrance, blood loss and pain.

Chemotherapy drugs help in treating different stages of colorectal cancer. The drugs commonly used are -flurouracil, Xeloda, Camptosar, and Eloxatin.

Different Stages: Treatment and survival rates

Stage 0 - The cancer is formed in the innermost lining of the colon. The treatment involves:
Polypectomy or local excision:  The tumor and the neighboring tissue are removed.
A procedure called an anastomosis is done to remove the affected part of the colon and attach the normal tissue for normal bowel function
At this stage, the cancer can be cured with surgery. The five year survival rate for this stage is 99%.

Stage I - At this stage, the tumors have spread further than the inner lining of the colon to the next two layers. It engages the inner side of the colon. The cancer is limited to the outer side the colon.

The treatment at this stage is surgery to eliminate the cancer and some part of tissue in the region around the tumor. Hard line surgery to eliminate complete cancer is very successful.

 The five year survival rate for this stage is 95%.

Stage II - The Stage II colon cancers are big in size and they stretch via the colon wall. The cancer has not spread in the lymph nodes. The treatment is a surgery to remove cancer and the surrounding area. Depending on the spread, radiation or chemotherapy is advised.
The 5-year survival rate for Stage II cancer is 75%.

Stage III - The cancer has spread outside the colon wall to the lymph nodes which produce cells to fight infection. The treatment involves:

• A surgery to take out the tumor and affected lymph nodes.
• After surgery, the patient is advised chemotherapy and the drugs used are 5-FU and leucovorin.
• Radiation is required if the tumor is big in size and attacks the tissue around the colon.

This cancer might not be curable even if metastasis is absent. At this stage, there are chances that the cancer might have spread to pancreas, small intestine or other pelvic organs.

The 5 year survival rate for stage III cancer is about 68%. If the cancer has spread to more than 5 lymph nodes, the survival rate is quite low.

Stage IV - In stage IV cancer, the cancer has spread to other parts of the body like liver or lungs. The tumor might be of any size. It may or may not have spread to lymph nodes.
The treatment includes:

Surgical removal of cancer.

A surgical procedure to avoid the colon cancer and attach the healthy colon, a process called anastomosis.

• Surgery to get rid of components of other organs like the liver, ovaries and lungs where the cancer might have spread.
• Chemotherapy to reduce symptoms
• Radiation therapy to do away with some symptoms.

The 5-year survival rate for Stage IV cancer is 5%.

Coping With Cancer

Once cancer is diagnosed, feelings of stress and anxiety are normal. Uncertainty and financial concern might lead to fear and depression. At this time, you’ll need guidance and support to cope with the complications of your cancer.

Some tips to decrease the stress are:

• Have a positive attitude.
• Accept the problem as nothing is under your control
• Don’t be panicky. Rather, you need to be self-confident about your feelings
• Practice Yoga or relaxation techniques to relax.
• Take a regular exercise. It will boost the immune system of your body.
• Eat nutritious and balanced meals.
• Take adequate rest and a proper sleep.
• Don't go for alcohol or drug abuse