Colon or colorectal cancer is the fourth common type of cancer that kills both men and women in United States. It is curable if diagnosed early but failure to do so can damage the colon or larger intestine which is the digestive tract that stores our stool. Every 50 year old must have their colons checked because colons tend to be overused. Blood in stools, narrow stools, stomach disorders, change in bowel habits and death are some of the possible serious and painful complications and consequences a colon patient can have (National Cancer Institute).
Colon cancer can be induced by high fat and cholesterol diet. Colon absorbs water and salt that the small intestines didn’t break down completely and it serves as the storage for the whole digestive system’s wastes. High dietary fat causes increase in secondary bile acids and some compounds like steroids. Increased bacterial breakdown of these may result in production of carcinogens which are cancer causing chemicals (MedicineWorld).
Colon polyps are extra tissues that grow in the large intestines. Although most polyps are not dangerous or benign, some types can be developed into cancer cells. Large polyps are most likely to be developed into cancer (NDDIC).
People with previous diagnosed types of cancer such as breast, ovarian and endometrial cancer have increased risk in developing colon cancer. Furthermore, people with family members have a slight risk to have this cancer. Approximately, 5 percent of colon cancer cases are in hereditary form and this typically occur at an earlier age. For both male and female, the risk of inheriting the mutated genes of the affected parent is 50 percent (NHGRI).
The American Joint Committee on Cancer (AJCC) has developed a staging system for determining the level of infection of colorectal cancer which is the TNM system. ‘T’ describes the extent of the spread of primary tumor into the wall of the large intestine. This wall is has layers in which the earliest stage develops in the inner lining which is the mucosa. Then the cancer will grow to the inner muscle layer and extends to the fibrous tissue submucosa. Finally, the cancer will affect the thickest outer muscle layer or the muscularis propria and then to the outermost layers of connective tissues, the serosa but not up to any neighboring tissues and organs. The ‘N’ category shows if the cancer has spread up to the lymph nodes and if so, how many of them are infected. N0 means no nodes has been affected, N1 with 1 to 3 nearby and N2 with 4 or more nearby lymph nodes affected by cancer cells. Lastly, the ‘M’ category indicates if a distant lymph node or organ has been affected. The cancer may crawl and affect the lungs, liver, stomach or ovary (ACS).
The common treatments for colorectum cancer are through surgery, radiation therapy and chemotherapy. Colon surgery is the usual treatment for early stage cancer. Colectomy is the process of removing some part of the colon and some affected lymph nodes. If the colon already has a hole, colostomy can temporarily help the waste removal of the patient. Colostomy is when the end of the colon is attached to an opening made in the abdomen. Laparoscopic-assisted colectomy is designed also to remove some colon and nodes but it does not require large incisions in the abdomen. Instead, several small incisions serve as openings for special long instruments with camera at the end for the surgeon to see the abdomen. And when spotted, one of the small incisions will be made larger to allow the affected parts’ removal. This procedure leaves less pain and wounds heal faster (ACS).
When the colon and rectum were removed, ileostomy is performed to attach the bottom of the small intestine to the stoma. Ileoanal reservoir surgery is the alternative to the permanent ileostomy which requires many critical surgeries. First, the colon and rectum is removed and then a pouch is constructed from the last 18 inches of the small intestine and then attached to the anus. And then the ileostomy will be closed. Continent ileostomy creates an internal reservoir pouch from part of small intestines by constructing a valve and placing a stoma through the abdominal wall. When the pouch is full, a tube is inserted to drain the wastes (NDDIC).
High-energy rays are used in radiation therapy to destroy cancer cells and the therapy is used when the cancer reaches an internal organ or some thin walls of abdomen. The therapy does not guarantee complete elimination of cancer cells. External beam radiation therapy is one type of radiation therapy with which the patient is carefully positioned at a given angle to target the cancer cells. It is like taking X-ray but the radiation is more intense. Endocavitary radiation therapy uses a radiation-emitting hand-held device that is inserted into the anus. The radiation reaches the rectum as well as the colon without passing through the skin and other tissues of the abdomen which brings less likely side-effects. Brachytherapy or internal radiation therapy uses small pellets of radioactive material placed directly onto the top of the cancer. The radiation is short and does not affect the surrounding healthy tissues (ACS).
There are several situations wherein chemotherapy is applied. Adjuvant chemotherapy is conducted to a patient who has undergone surgery to increase survival. It is given if no evidence of cancer cells remained and has the tendency to regenerate. Neoadjuvant chemotherapy, along with radiation therapy, is a pre-operation procedure that shrinks the cancer cells to make the surgery easier. Lastly, the chemotherapy for advanced cancers is used for patients with slim chance of survival. Through shrinking the cancer cells and relieving symptoms, it may extend the survival time of patients (ACS).
A study in University of Utah has discovered a possible colon cancer treatment with a molecule which effects to 85 percent of colon cancer. The team successfully saved a zebrafish’s life by preventing and eliminating the molecule called C-Terminal Binding Protein (CTBP) because CTBP induces adenomatous polyposis coli (APC) gene mutation. Mutations in APC initiate formation of polyps and play an 85 percent role in colon cancers. APC gene controls the amount of CTBP by destroying it. If the APC is mutated, CTBP continues to infest and accumulates in the cell which results into a tumor. The research team is currently developing a medicine made of potential chemical agents that will block CTBP actions (Huntsman Cancer Institute).
Colon cancer is a sum of human’s inattentiveness to the digestive system health. Oftentimes, people just eat and then move the bowel out without paying much attention to what problems may arise. It is interesting that some certain procedures are finished with open wound (ileostomy, colostomy) because usually surgeries end up in sutures and stitches. It is not far in the future that human’s digestive system may be dependent on improvised organs such as pouches. As many and many have colon cancer, technology moves fast as well until medical technology meets the need of human health. And yes, as the University of Utah researchers estimate, maybe three or more years from now oral medicines for cancer will be developed and will be available over-the-counter in the market.
“A New Way To Treat Colon Cancer?.” 9 October 2006. Huntsman Cancer Institute (HCI). 7 May 2008. < http://unews.utah.edu/p/?r=100906-4>.
“Colorectal Cancer.” 6 May 2008. National Cancer Institute (NCI). 6 May 2008. <http://www.nlm.nih.gov/medlineplus/colorectalcancer.html>.
“The Cancer Experience: Colon and Rectum Cancer. After Diagnosis: Staging Colon and Rectum Cancer.” 3 May 2008. American Cancer Society (ACS). 7 May 2008. <http://www.cancer.org/docroot/CRI/content/CRI_2_8_After_Diagnosis_Staging_Colon_and_Rectum_Cancer.asp>.
“What causes colon cancer?.” MedicineWorld.org. 6 May 2008. <http://medicineworld.org/cancer/colon/what-causes-colon-cancer.html>.
“What I need to know about Colon Polyps.” April 2003. National Digestive Diseases Information Clearinghouse (NDDIC). 6 May 2008. <http://digestive.niddk.nih.gov/ddiseases/pubs/colonpolyps_ez/#1>.
“What do we know about heredity and colon cancer?.” 22 October 2007. National Human Genome Research Institute (NHGRI). 6 May 2008. <http://www.genome.gov/page.cfm?pageID=10000466#whatweknow>.