Colon cancer is one of the most common types of cancer worldwide. With an increasing incidence, especially among people under the age of 50, it is essential to be informed about its symptoms, risk factors, prevention methods and treatment options.
What is colon cancer?
Colon cancer is a proliferation of cells that begins in the large intestine, also called the colon. It usually develops from adenomatous polyps that can become cancerous over time if left undetected. At this stage they can be removed by colonoscopy.
Symptoms of colon cancer
The symptoms of colon cancer depend largely on the location in the large intestine. Colon cancer that first develops in the early part of the colon, where the appendix and what is known as the right colon are located, is usually more indolent and is therefore diagnosed at more advanced stages.
In contrast, cancer located in the final part of the intestine, at the level of the sigmoid colon or rectum, usually gives symptoms earlier, such as bleeding or intestinal obstruction. Occasionally, there are also alterations in intestinal transit, such as the appearance of episodes of diarrhea or constipation. Most common symptoms:
Persistent change in bowel habits
Diarrhea, constipation or decreased stool diameter for several days.
Blood
Rectal bleeding, dark stools, or blood in the stool.
Persistent abdominal discomfort
Sensation of need to have a bowel movement that does not go away after a bowel movement, abdominal pain or cramping, or continued discomfort in the abdominal area, such as cramping, gas, or pain.
Weakness or fatigue
Feeling tired, weak, or exhausted.
Unexplained weight loss
Unexplained weight loss is another common symptom of colorectal cancer.
Causes and Risk Factors for Colon Cancer
Colon cancer is one of the most common tumors worldwide, accounting for 10% of all cancer cases. Although historically it has been diagnosed from the age of 50 years onwards, by 2024 a significant increase in the number of cases in people under 50 years of age is expected for the first time in history.
This significant increase in incidence among the very young has meant that the warning signs, previously relevant mainly for those over 50, must now also be monitored in very young patients.
Genetic and hereditary factors
Colon cancer can have a strong genetic component, with some hereditary syndromes significantly increasing the risk. One of the best known is Lynch syndrome, also called hereditary non-polyposis colorectal cancer (HNPCC). People with this syndrome are at high risk of developing colon cancer, often at a younger age than the general population.
Another important syndrome is familial adenomatous polyposis (FAP), an inherited condition in which numerous polyps develop in the colon and rectum during adolescence, leading to an almost inevitable risk of colon cancer if not properly treated.
Lifestyle factors
Lifestyle plays a crucial role in the risk of developing colon cancer. A diet rich in red and processed meats, as well as nitrites, is associated with an increased risk. Alcohol consumption and smoking are also important risk factors. In addition, lack of physical activity and sedentary lifestyle contribute to the development of any type of disease.
Maintaining a balanced diet, avoiding excessive alcohol and tobacco consumption, and regular physical activity are measures that can reduce the risk of colon cancer.
Age and medical history
Advanced age is one of the most important risk factors for colon cancer, as most cases are diagnosed in people over the age of 50. However, with the increased incidence in people younger than 50 years, surveillance should begin earlier if risk factors are present.
Medical history is also crucial; having had adenomatous polyps or a personal or family history of colon cancer greatly increases the risk. It is essential that people with this history undergo regular screening to detect and treat any changes early.
Treatments for colon cancer
Surgery
- Endoscopic resection: a technique used to remove adenomatous polyps or malignant tumors at an early stage.
- Laparoscopic or robotic surgery: this minimally invasive technique allows tumors to be removed through small incisions, offering benefits such as faster recovery and less postoperative pain. Laparoscopic resections of the right and left colon, complete removal of the colon, rectal resections and even the entire colon and rectum can be performed.
Chemotherapy
Administered after surgery to eliminate any residual cancer cells, reducing the risk of recurrence.
Radiation therapy
Uses high-energy rays to destroy remaining cancer cells and may be used before or after surgery to shrink the tumor and reduce the risk of recurrence.
Targeted therapies
These treatments specifically target cancer cells. Examples include the use of monoclonal antibodies or cell signaling inhibitors.
Immunotherapy
Some patients may benefit from immunotherapy treatments if the tumor has certain mutations.
Prevention of colon cancer
Due to the increasing incidence in those under 50 years of age, some countries have already lowered the starting age for the first screening colonoscopy to 45 years. Also, whenever there is a case in the first-degree family or risk factors, the first colonoscopy should be started at the age of 40.
Colon cancer is the only type of cancer that can be prevented by colonoscopy. If polyps are removed before they turn into cancer, the patient will never develop colon cancer. In other organs, such as the lung or breast, cancer appears without a similar window of opportunity. If a patient continues to have screening colonoscopies, it significantly reduces the chances of developing colon cancer.
Colon Cancer Mortality and Prognosis
The prognosis and survival of colon cancer can vary depending on several factors, such as the stage of the disease. 5-year survival rates for colon cancer, according to the American Cancer Society:
Localized: if diagnosed at an early stage, the survival rate is 91%.
Regional: when the cancer has spread externally from the colon or rectum to nearby structures or lymph nodes, the survival rate is 72%.
Metastatic: if the cancer has spread to distant parts of the body, such as the liver, lungs or distant lymph nodes, the survival rate is 13%, a rate that can increase considerably if the patient is a candidate for some surgical or systemic treatments or a combination of both.
Colon cancer is a preventable and treatable disease, especially when detected early. It is essential for people to be informed about risk factors, symptoms, and prevention and treatment options. Getting regular check-ups and adopting a healthy lifestyle are essential steps to reduce risk and improve prognosis if diagnosed.
IVOQA has become a referral center for colon and rectal cancer surgery and treatment. You can request a consultation with leading specialists in the approach to this pathology.
