Colorectal Cancer: Causes, Symptoms and Treatments – What You Need To Know
Colorectal cancer is one of the commonest malignancies in the world. It is the third most common type of cancer for both men and women in the United States, and is the second most deadly.
In West Malaysia, it is among the most frequently reported cancer in males and females respectively and appears to be more prevalent among the Chinese community.
Risk Factors, Causes, Symptoms
At present, the cause of colorectal cancer is not completely understood, it is thought to involve many factors developing over a long period of time. Lifestyle-related risk factors for colorectal cancer include physical inactivity, obesity, high intake of processed or red meat, long-term smoking, alcohol consumption, and a diet lacking in vegetables and fruits.
Personal or family history of colorectal cancer (or polyps), and a personal history of type 2 diabetes, chronic inflammatory bowel disease, or genetic disease such as Lynch syndrome or familial adenomatous polyposis have also been associated with increased risk.
People with colorectal cancer may develop a number of non-specific symptoms. These include a change in bowel habits; diarrhoea; constipation or a feeling that the bowel does not empty completely, and stools with bright red or very dark blood. They may also experience abdominal pain, including frequent bloating, fullness and cramps. They may also be constantly tired and anaemic, or experience an unexplained loss of weight and appetite. However, these symptoms often develop later on in the disease stage.
Treatment, Clinical Trials and Research For Colorectal Cancer
Like most cancers, the treatment of colorectal depends on the specific location and extent of the disease.
Scientists are looking for causes and ways to prevent colorectal cancer, better ways to find it early, and ways to improve treatments. Many studies are looking to identify the causes of colorectal cancer, in the hopes of using this knowledge to help prevent it. Other studies are looking to see if certain types of diets, dietary supplements, or medicines can lower a person’s risk of colorectal cancer. For example, many studies have shown that aspirin and similar pain relievers might help lower the risk of colorectal cancer, but these drugs can sometimes have serious side effects. Researchers are now trying to determine if there are some groups of people for whom the benefits would outweigh the risks.
Meanwhile, medical doctors are looking for better ways to find colorectal cancer early by studying new types of screening tests and improving the ones already being used. The current screening tests available for colorectal cancer include stool occult blood, colonoscopy and M2PK tests. Lab tests have also been developed to help predict patients who have a higher risk of their colorectal cancer recurring after treatment. The tests do look at the activity of the many different genes inside the colorectal cancer cells. So far, though, none of these tests have been shown to help predict which people could benefit from chemo or other treatments.
Researchers have also developed a test that can find areas of colon cancer spread in nearby lymph nodes that wouldn’t have been found with the tests normally used. This test detects a kind of RNA that is in some colon cancer cells but not in normal lymph node cells. This may help identify patients who have a higher stage of colon cancer than originally suspected, and who might benefit from chemotherapy after surgery.
In their constant quest for better ways to treat colorectal cancer, surgeons, for instance, are continuing to improve their techniques for operating on colorectal cancers. They now have a better understanding of what makes colorectal surgery more likely to be successful, such as making sure enough lymph nodes are removed during the operation.
Laparoscopic and Robotic Surgery
Laparoscopic surgery is done through several small incisions in the abdomen instead of one large one, and it’s becoming more widely used for some colon and rectal cancers. This approach usually allows quicker recovery, with less pain after the operation, and it seems to be about as effective as a standard surgery would be. With robotic surgery, a surgeon sits at a control panel and operates very precise robotic arms to perform the surgery. This type of surgery is also being studied to see if it as effective as standard surgery.
Chemotherapy continues to be an important part of treatment for many people with colorectal cancer, and doctors are constantly trying to make it more effective and safe. Different approaches are being tested in clinical trials, including testing new chemo drugs or drugs that are already used against other cancers. Researchers are also studying the best ways to combine chemotherapy with radiation therapy, targeted therapies, and/or immunotherapy.
Targeted Drug Therapy
Targeted therapy drugs work differently from standard chemotherapy drugs. They affect specific parts of cancer cells that make them different from normal cells. Several targeted therapy drugs are already used to treat colorectal cancer. Doctors continue to study the best way to give these drugs to make them more effective, as well as looking at new targeted therapy drugs. Targeted therapies are currently used to treat advanced colorectal cancers, but newer studies are trying to determine if using them with chemotherapy in earlier-stage cancers as part of adjuvant therapy may further reduce the risk of recurrence.
An exciting area of research is the field of immunotherapy, in which the treatment uses the body’s own immune system to fight the cancer. An important part of the immune system is its ability to keep itself from attacking normal cells in the body. To do this, it uses “checkpoints” – molecules on immune cells that need to be turned on (or off) to start an immune response. Cancer cells sometimes use these checkpoints to avoid being attacked by the immune system.
Newer drugs that target checkpoint molecules hold a lot of promise as cancer treatments. Unfortunately, early studies of some of these drugs against colorectal cancer were not encouraging. Researchers are also studying several vaccines to try to treat colorectal cancer or prevent it from recurring after treatment. Unlike vaccines that prevent infectious diseases, these vaccines are meant to boost the person’s immune reaction to fight colorectal cancer more effectively. Many types of vaccines are being studied. For example, some vaccines are created by removing some of the person’s own immune system cells from their blood, exposing them in the lab to a substance that will make them attack cancer cells, and then putting them back into the person’s body. At this time, these types of vaccines are only available in clinical trials.
Reduce Your Risk and Prevent Colorectal Cancer
As with any disease, prevention is always better than cure. While researchers are making several advances in the effort to diagnose and treat colorectal cancer, individuals can reduce their risk of developing this disease with a diet rich in fibre, exercise and with maintaining a healthy weight. Early detection followed by prompt appropriate treatment greatly increases the chances of successful treatment and cure.
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