In Europe, colorectal cancer is the second most common malignant tumor and is curable if diagnosed as early as possible.
WHO IS AT RISK?
Colorectal cancer can occur at any age, but in 90% of cases, it affects individuals over 40 years of age, with the risk doubling in each successive decade. Risk factors include a family history of colorectal cancer (other cases of colorectal cancer in the same family), a history of polyps, ulcerative colitis, and the presence of polyps or cancers in other organs, particularly the breast and uterus.
HOW DOES IT BEGIN?
It is now well known that many types of colon and rectal cancer originate from benign polyps. Therefore, their early removal represents an effective prevention tool.
WHAT ARE THE SYMPTOMS?
The most common symptoms are rectal bleeding and changes in normal bowel habits, such as alternating constipation and diarrhea. These symptoms are also common in benign conditions. Abdominal pain and weight loss are late symptoms and indicate a possible progression of the disease. Unfortunately, many benign polyps or early-stage cancers do not cause any symptoms. Therefore, as a preventive measure, a colonoscopy is recommended once an individual reaches 50 years of age.
WHAT DIAGNOSTIC INVESTIGATIONS ARE USED TO MAKE THE DIAGNOSIS?
Through digital rectal examination, a colon-proctology specialist can already detect neoplasms in the anorectal tract. However, the primary examination is colonoscopy, which can be traditional or virtual. Traditional colonoscopy allows for the removal of small polyps and the performance of biopsies for histological diagnosis. Colon CT scan is also a valuable diagnostic method widely used today.
HOW IS COLORECTAL CANCER TREATED?
Surgery is always necessary. Radiation therapy and chemotherapy are often performed before rectal cancer surgery to reduce its size and limit its spread. Chemotherapy is often performed after surgery to eliminate any remaining cancer cells in the body. If colorectal cancer is diagnosed early, the survival rate after surgery is between 80% and 90%, while if the diagnosis is late, the survival rate drops below 50%. Thanks to new surgical techniques, only 5% of colorectal cancer patients require a colostomy.
CAN COLORECTAL CANCER BE PREVENTED?
Yes, it can be prevented. The most immediate preventive measure is a test for occult blood in the stool. Any patient with a positive test will undergo a colonoscopy. Many doctors recommend directly performing colonoscopy (traditional or virtual), a conduct that is widely accepted. Through colonoscopy, biopsies can be performed, and polyps can be removed directly if their size allows it. Although not completely proven, diet plays an important role in colorectal cancer prevention. A substantial intake of fiber and a reduction in the consumption of fats and smoked foods are important dietary measures for prevention. Furthermore, whenever there are sudden changes in bowel habits with periods of severe constipation alternating with periods of diarrhea (associated with or without blood or mucus in the stool), it is imperative to consult a doctor for further diagnostic tests.
CAN HEMORRHOIDS TURN INTO CANCER?
No, but hemorrhoids can produce symptoms similar to polyps or cancer. In any case, whenever there is anal bleeding, it is necessary to consult a doctor, preferably a colon-proctology specialist.
DO GENETICS PLAY AN IMPORTANT ROLE IN THE DEVELOPMENT OF COLORECTAL CANCER?
Genes are biochemical information contained in DNA that each of us inherits from our parents. Genes determine our physical characteristics but also predispose us to certain diseases. Probably all cancers, especially colorectal cancer (CRC), have hereditary genetic factors that potentially increase an individual's risk of developing them. In other words, genetic alterations are considered the reasons why cancer occurs more frequently and intensely in some families. For these reasons, it is important to provide a detailed family history to the specialist. Personally, I consider the genetic factor very important, but I also consider common environmental factors and dietary habits to be equally important within the same family.
ARE THERE DIFFERENT TYPES OF COLORECTAL CANCER?
From a genetic perspective, there are three classifications of CRC: sporadic, familial, and hereditary. Sporadic cancer (50-60% frequency) generally affects patients over 60 years of age without a positive family history of colorectal cancer. Familial cancer occurs when at least one family member has been or is affected by CRC, especially if they are under 50 years of age. If cancer occurs in a first-degree relative, the risk for other family members doubles.
Hereditary cancer is associated with specific genetic alterations and includes true syndromes, including Hereditary Non-Polyposis Colon Cancer or Lynch Syndrome (HNPCC), Familial Adenomatous Polyposis (FAP), Attenuated Familial Adenomatous Polyposis (AFAP), APCI 1307K, Familial Polyposis or Peutz-Jeghers Syndrome, MYH Associated Polyposis (MAP), Juvenile Polyposis, and Hereditary Polyposis.
WHO IS AT RISK?
Colorectal cancer can occur at any age, but in 90% of cases, it affects individuals over 40 years of age, with the risk doubling in each successive decade. Risk factors include a family history of colorectal cancer (other cases of colorectal cancer in the same family), a history of polyps, ulcerative colitis, and the presence of polyps or cancers in other organs, particularly the breast and uterus.
HOW DOES IT BEGIN?
It is now well known that many types of colon and rectal cancer originate from benign polyps. Therefore, their early removal represents an effective prevention tool.
WHAT ARE THE SYMPTOMS?
The most common symptoms are rectal bleeding and changes in normal bowel habits, such as alternating constipation and diarrhea. These symptoms are also common in benign conditions. Abdominal pain and weight loss are late symptoms and indicate a possible progression of the disease. Unfortunately, many benign polyps or early-stage cancers do not cause any symptoms. Therefore, as a preventive measure, a colonoscopy is recommended once an individual reaches 50 years of age.
WHAT DIAGNOSTIC INVESTIGATIONS ARE USED TO MAKE THE DIAGNOSIS?
Through digital rectal examination, a colon-proctology specialist can already detect neoplasms in the anorectal tract. However, the primary examination is colonoscopy, which can be traditional or virtual. Traditional colonoscopy allows for the removal of small polyps and the performance of biopsies for histological diagnosis. Colon CT scan is also a valuable diagnostic method widely used today.
HOW IS COLORECTAL CANCER TREATED?
Surgery is always necessary. Radiation therapy and chemotherapy are often performed before rectal cancer surgery to reduce its size and limit its spread. Chemotherapy is often performed after surgery to eliminate any remaining cancer cells in the body. If colorectal cancer is diagnosed early, the survival rate after surgery is between 80% and 90%, while if the diagnosis is late, the survival rate drops below 50%. Thanks to new surgical techniques, only 5% of colorectal cancer patients require a colostomy.
CAN COLORECTAL CANCER BE PREVENTED?
Yes, it can be prevented. The most immediate preventive measure is a test for occult blood in the stool. Any patient with a positive test will undergo a colonoscopy. Many doctors recommend directly performing colonoscopy (traditional or virtual), a conduct that is widely accepted. Through colonoscopy, biopsies can be performed, and polyps can be removed directly if their size allows it. Although not completely proven, diet plays an important role in colorectal cancer prevention. A substantial intake of fiber and a reduction in the consumption of fats and smoked foods are important dietary measures for prevention. Furthermore, whenever there are sudden changes in bowel habits with periods of severe constipation alternating with periods of diarrhea (associated with or without blood or mucus in the stool), it is imperative to consult a doctor for further diagnostic tests.
CAN HEMORRHOIDS TURN INTO CANCER?
No, but hemorrhoids can produce symptoms similar to polyps or cancer. In any case, whenever there is anal bleeding, it is necessary to consult a doctor, preferably a colon-proctology specialist.
DO GENETICS PLAY AN IMPORTANT ROLE IN THE DEVELOPMENT OF COLORECTAL CANCER?
Genes are biochemical information contained in DNA that each of us inherits from our parents. Genes determine our physical characteristics but also predispose us to certain diseases. Probably all cancers, especially colorectal cancer (CRC), have hereditary genetic factors that potentially increase an individual's risk of developing them. In other words, genetic alterations are considered the reasons why cancer occurs more frequently and intensely in some families. For these reasons, it is important to provide a detailed family history to the specialist. Personally, I consider the genetic factor very important, but I also consider common environmental factors and dietary habits to be equally important within the same family.
ARE THERE DIFFERENT TYPES OF COLORECTAL CANCER?
From a genetic perspective, there are three classifications of CRC: sporadic, familial, and hereditary. Sporadic cancer (50-60% frequency) generally affects patients over 60 years of age without a positive family history of colorectal cancer. Familial cancer occurs when at least one family member has been or is affected by CRC, especially if they are under 50 years of age. If cancer occurs in a first-degree relative, the risk for other family members doubles.
Hereditary cancer is associated with specific genetic alterations and includes true syndromes, including Hereditary Non-Polyposis Colon Cancer or Lynch Syndrome (HNPCC), Familial Adenomatous Polyposis (FAP), Attenuated Familial Adenomatous Polyposis (AFAP), APCI 1307K, Familial Polyposis or Peutz-Jeghers Syndrome, MYH Associated Polyposis (MAP), Juvenile Polyposis, and Hereditary Polyposis.