CANCER OR CARCINOMA OF COLON / LARGE BOWEL / LARGE GUT

 

CANCER OF COLON

          CARCINOMA OF COLON




PREMALIGNANT CONDITIONS leading to COLON CANCER:


Precancerous situations which lead to development of colon cancer are:

  • ·      Polyps
  • ·      Ulcerative Colitis
  • ·      Increasing Age >50 years
  • ·      Previous Colon Cancer Surgery
  • ·      Family history of Colon Cancer or Polyposis







    Polyps are usually adenomatous  of 3 types: 
    1. tubular adenoma, 
    2. villous adenoma and 
    3. tubulovillous adenomas.


    Uncommon inherited conditions causing large number of polyps with multiple cancers are Polyposis Syndromes namely :

    • Familial Adenomatous Polyposis (FAP) and 
    • Hereditary Non Polyposis Colon Cancer (HNPCC)



    Video of surgey  by auhor for total colonic polyposis with more than 13 localized cancers in a 12 year old is seen at:


    https://www.youtube.com/watch?v=Wq4FFIbNiPg



    SIGNS AND SYMPTOMS OF COLON CANCER:


    Bleeding in stools , from rectum
    Intestinal blockage
    Abdominal pain
    Irregular bowel movements – constipation or diarrhea or both.



    STAGING AND PROGNOSIS OF COLON CANCER: (See Fig 1)

    1. ·      Stage I    Tumor confined to inner most lining of the colon wall only
    2. ·      Stage II  Tumor confined to the wall of the colon, but not outside
    3. ·      Stage III Tumor extending to outer wall, to the lymph nodes
    4. ·      Stage IV Tumor extension to far away from colon like liver, umbilicus, neck mass,etc           





    Fig 1:







    Prognosis depends on the staging of colon cancer and is given in the above table (Fig1).


    TREATMENT OF COLON CANCER:

    • Stage I    Surgery to remove the tumor and small amount of tissue around the tumor
    • Stage II   Standard surgery to remove the cancer with lymph nodes and an area surrounding the tumor. Chemotherapy may be required
    • Stage III  Surgery to remove cance with all involved lymph nodes + Chemotherapy + may need radiotherapy.
    • Stage IV  Surgery usually ineffective. Exception in the case of liver secondaries ( see table on prognosis).


    PREVENTION OF COLON CANCER:(See Fig 2)


    • ·      High risk groups for colon cancer should be screenedperiodically.
    • ·      Familial groups, ulcerative colitis groups, earlier operated groups of patients should be under supervision.
    • ·      Regular intake of Aspirin in case of polyps, high fibre diet and exercise help.  



    Fig 2.



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