Overview

Colon cancer is a type of cancer that begins in the large intestine, which is part of the digestive system. It often develops from abnormal growths called polyps that form on the inner lining of the colon. Some polyps can gradually become cancerous over several years, which is why timely screening and removal of suspicious polyps can help prevent colorectal cancer.

Colon cancer may not cause noticeable symptoms in its early stages. When symptoms occur, they can include changes in bowel habits, blood in the stool, abdominal discomfort, unexplained weight loss, and persistent fatigue. Early diagnosis can provide more treatment options and may improve outcomes.

At Sarvodaya Hospital, our multidisciplinary cancer team provides comprehensive colon cancer treatment based on the cancer's stage, location, molecular characteristics, and overall health of the patient. Treatment may include surgery, laparoscopic procedures, chemotherapy, targeted therapy, immunotherapy, and radiation therapy in selected cases.

Symptoms of Colon Cancer

• Blood in the stool
• Rectal bleeding
• Persistent change in bowel habits
• Diarrhoea or constipation
• Narrower stools than usual
• Feeling that the bowel has not completely emptied
• Persistent abdominal cramps or discomfort
• Bloating
• Unexplained weight loss
• Persistent fatigue or weakness
• Iron-deficiency anaemia
• Reduced appetite
• Nausea or vomiting in advanced cases

Causes of Colon Cancer

• Genetic mutations
• Precancerous colon polyps
• Family history of colorectal cancer
• Inherited conditions such as Lynch syndrome and familial adenomatous polyposis
• Inflammatory bowel diseases
• Increasing age
• Obesity
• Physical inactivity
• Smoking
• Heavy alcohol consumption
• Diets high in processed or red meat

Risk Factors for Colon Cancer

Certain factors can increase the likelihood of developing colon cancer.

• Increasing Age : The risk of colorectal cancer generally increases with age, although it can also occur in younger adults.
• Family History : Having a close relative with colorectal cancer or certain types of polyps can increase risk.
• Inherited Genetic Conditions : Conditions such as Lynch syndrome and familial adenomatous polyposis can significantly increase colorectal cancer risk.
• Inflammatory Bowel Disease : Long-standing ulcerative colitis or Crohn's disease involving the colon may increase the risk of colorectal cancer.
• Previous Polyps : Certain types of colon polyps can become cancerous over time.
• Obesity and Physical Inactivity : Excess body weight and a sedentary lifestyle are associated with an increased risk of colorectal cancer.

Diagnosis of Colon Cancer

Accurate diagnosis helps confirm the presence of cancer, determine its location and stage, and guide treatment planning.

• Medical and Physical Examination : Your doctor reviews symptoms, family history, medical conditions, medication use, and other risk factors before performing an appropriate examination.
• Colonoscopy : Colonoscopy for colon cancer is an important diagnostic and screening procedure. A flexible camera is used to examine the lining of the entire colon and rectum. Suspicious polyps or abnormal tissue can be removed or biopsied during the procedure.
• Biopsy : During colonoscopy, a tissue sample may be collected from a suspicious area. The sample is examined by a pathologist to confirm whether cancer cells are present.
• Blood Tests : Blood tests may assess blood counts, liver function, and other health parameters. A tumour marker called carcinoembryonic antigen (CEA) may also be used in selected patients to help monitor treatment response or recurrence.

Treatment Options for Colon Cancer

The most appropriate colon cancer treatment depends on the cancer stage, tumour location, molecular characteristics, overall health, and individual treatment goals. A multidisciplinary cancer team may combine surgery and systemic treatments for the best possible outcome.

• Colon Cancer Surgery : Surgery is a major treatment option for colon cancer that has not spread extensively. The surgeon removes the cancer along with a margin of healthy tissue and nearby lymph nodes when appropriate.
• Colectomy for Colon Cancer : Involves removing the part of the colon containing the tumour. The remaining sections of the bowel may then be joined together when medically appropriate. In selected cases, a temporary or permanent stoma may be required.
• Laparoscopic Surgery for Colon Cancer : A minimally invasive approach performed through small incisions using specialised instruments and a camera. For appropriately selected patients, it can reduce incision size and may support less post-operative discomfort and faster recovery compared with open surgery.
• Chemotherapy : Chemotherapy for colon cancer uses anti-cancer medicines to destroy or control cancer cells. It may be recommended before or after surgery in selected patients, or as the main treatment when the disease is advanced.

Benefits of Early Colon Cancer Treatment

Early diagnosis and appropriate treatment can significantly influence treatment options and long-term outcomes.

• Enables Timely Treatment : Detecting cancer before it spreads allows treatment to begin promptly and may provide more treatment options.
• May Allow Curative Surgery : When colon cancer is localised, surgery may remove the tumour completely with the aim of achieving long-term disease control.
• Reduces Risk of Complications : Timely treatment can help prevent complications such as bowel obstruction, bleeding, perforation, and severe anaemia.
• Supports Better Recovery : Patients receiving treatment before significant disease progression may have a better opportunity for recovery and rehabilitation.
• Allows Personalised Treatment : Modern pathology and molecular testing help doctors select treatments based on the individual characteristics of the cancer.

Complications if Left Untreated

• Persistent gastrointestinal bleeding
• Iron-deficiency anaemia
• Bowel obstruction
• Bowel perforation
• Abdominal pain
• Weight loss and nutritional problems
• Spread to nearby lymph nodes
• Liver metastasis
• Lung metastasis
• Other distant metastases
• Reduced overall health

When Should You See a Doctor?

• Blood in the stool
• Rectal bleeding
• Persistent changes in bowel habits
• Unexplained weight loss
• Persistent abdominal pain or cramps
• Ongoing constipation or diarrhoea
• Unexplained iron-deficiency anaemia
• Persistent fatigue or weakness
• A family history of colorectal cancer
• Previously diagnosed colon polyps
• Symptoms that continue despite routine treatment

Prevention & Lifestyle Modifications

Certain lifestyle measures can help reduce colorectal cancer risk and support overall health.

• Maintain a Healthy Weight : Maintaining a healthy body weight can reduce the risk associated with obesity.
• Stay Physically Active : Regular physical activity supports healthy bowel function and overall metabolic health.
• Eat a Fibre-Rich Diet : Include vegetables, fruits, whole grains, pulses, and other fibre-rich foods as part of a balanced diet.
• Limit Processed and Red Meat : Reducing processed meat and moderating red meat intake may help lower colorectal cancer risk.
• Avoid Tobacco : Smoking is associated with several cancers, including colorectal cancer. Avoiding tobacco supports overall health.
• Limit Alcohol : Limiting alcohol consumption can reduce cancer risk and support better general health.
• Follow Recommended Screening : Age- and risk-appropriate colorectal cancer screening can help identify precancerous polyps or cancer at an earlier stage.
• Follow Post-Treatment Advice : After colon cancer treatment, attend scheduled follow-ups and recommended colonoscopy or imaging examinations to monitor for recurrence.

Pre- and Post-Treatment Care

Post-Treatment

• Surgical oncology consultation
• Medical oncology consultation
• Colonoscopy and biopsy
• Blood investigations
• CT, MRI, or PET-CT when indicated
• Tumour marker assessment where appropriate
• Molecular and biomarker testing
• Nutritional assessment
• Anaesthesia evaluation before surgery
• Multidisciplinary treatment planning

Post-Treatment

• Taking prescribed medications
• Gradual return to normal activities
• Dietary and nutritional guidance
• Wound and incision care after surgery
• Stoma care when applicable
• Regular oncology follow-up
• Recommended colonoscopy and imaging
• Monitoring for recurrence
• Physical activity as advised
• Psychological and emotional support
• Prompt reporting of new symptoms