Such a dangerous disease as colon cancer does not have pronounced symptoms, so it is difficult to identify the disease in the early stages. Survival in the setting of oncology depends on the stage of detection of the disease, how rapidly oncology develops, and on a number of other reasons. Does the age of men or women affect the appearance of the disease, what causes oncological seals in the body, and is the disease treated with folk remedies?
Colon cancer is usually diagnosed at a late stage, minimizing the chances of recovery.
Definition
Colon cancer is a disease characterized by the appearance of a malignant seal on the mucosa of the organ and its bend. The factors that trigger bowel cancer are unknown, but men suffer from this disease more often than women. Colon cancer is a common disease among older people.
Colon cancer manifests itself and is diagnosed at stages 3-4, in which case the prognosis for survival (how long the patient lives) and recovery falls, the cancerous tumor metastasizes to the lymph nodes and nearby organs: liver, stomach, pancreas, genitourinary system. With liver damage, the development of hepatic hepatitis is observed, the patient progresses to liver failure. When the stomach is affected by metastases, the digestion process worsens, the patient develops anemia, food starvation, against the background of such signs, there is a rapid weight loss.
Classification and stages
- Depending on how fast and how much the seal grows, it stands out:
- exophytic form, when the neoplasm grows in the lumen or bend of the colon;
- the endophytic form is localized in the thickness of the intestinal tissues;
- with a saucer-shaped form, both of the above options are combined.
- Depending on the factors of origin, there is a classification:
- adenocarcinoma - the most common and complicated variant of a malignant neoplasm, formed from cells of glandular tissues, older people are at risk, the lower the degree of differentiation, the more dangerous the disease and the harder it is to treat;
- a ring-shaped seal is formed on the organ in the form of a ring, this type of neoplasm is difficult to treat, death occurs within 3-4 years;
- a squamous cell tumor is common, tends to quickly metastasize, the descending section is affected, the patient is likely to die;
- melanoma consists of cells that are pigmented with melanocytes, is localized in the region of the anal region and the descending part of the intestine, metastasizes.
- Depending on how advanced colon cancer is and whether it has metastases, there is such a classification of stages:
- at stage 1, the neoplasm reaches a size of 1-1.5 cm, the lymph nodes are not affected, the tumor has not metastasized to the tissues and neighboring organs; surgical removal of the tumor, chemotherapy and radiation exposure are supposed, if the therapy is adequate, then they live a long time;
- at stage 2, the size of the tumor reaches 2-5 cm, the lymph nodes are not affected or affected, but only slightly; surgical removal will bring results in conjunction with chemotherapy;
- at stage 3, a neoplasm measuring 5 cm or more affects the lymphatic system and nearby tissues and organs, a complication occurs; surgery is rarely prescribed; at the request of the patient, chemotherapy is performed;
- at stage 4, the tumor affects the entire organ and metastasizes to neighboring organs: the liver, gallbladder, stomach, this stage does not provide for resection, they do not live long, the survival rate is up to 10%.
Causes
Bad habits, poor nutrition, untreated diseases of the gastrointestinal tract, poor environment, age-related changes become the causes of the development of colon oncology. When studying the etiology of the occurrence of a malignant neoplasm, physicians did not come to a unanimous conclusion, why people get cancer. But studies have shown that at risk are people in whom the disease is inherited, the pathology is caused by genetic changes in the body. At risk category:
- age over 55;
- the development of the inflammatory process in the intestine, its complications;
- malnutrition;
- insufficient physical mobility of a person, a sedentary lifestyle;
- alcohol abuse, smoking;
- the formation of polyps on the intestinal epithelium, under adverse conditions, they develop into cancer.
Signs of colon cancer
The first symptoms of colon cancer in the human body are inherent in stages 3-4, when the patient feels pain, weight loss. When the disease has just begun, there are no signs; if the tumor appears in the ascending area, it will not bother you for a certain time. The definition of the disease occurs during a routine medical examination, when a blood test shows a deviation from the norm and tumor markers are exceeded.
At an early stage
In the early stages of the growth of a malignant tumor, a person develops pain in the abdomen. The pain manifests itself at different times of the day, does not depend on what and how much a person has eaten, and is localized in the place where the tumor is located. The patient loses his appetite, there is a loss in weight. After eating, there is increased gas formation, colic, and intestinal function is disturbed. Digestive problems develop, food is poorly digested, belching appears, nausea, the patient feels heaviness.
General symptoms
Symptoms of colon cancer appear at later stages, especially if it is localized in the ascending region, when the neoplasm is large, metastasis to neighboring organs and tissues has begun. In a person, the work of the whole organism is disturbed, this leads to a deterioration in the state of health, a violation of many vital processes of the body. General symptoms:
- the development of anemia, appears as a result of internal bleeding, and due to poor absorption of iron elements and vitamin B12;
- a person becomes pale, his hair and nails are dry and brittle;
- fatigue, against the background of developing painful sensations;
- nausea, vomiting, loss of appetite, weight loss.
Diagnostics
The first symptoms of the tumor process appear in the later stages, so it is problematic to diagnose and determine the disease at first. If cancer is suspected, the patient is sent for biochemical blood tests, and if pathological processes occur in the body, then the tumor marker will exceed the norm. In addition to a biochemical blood test, the patient is shown the following diagnosis of colon cancer:
- Colonoscopy is a method that is performed using a colonoscope preparation. This is a flexible tube with a video camera on the end. The tube is inserted into the rectum, it is possible to examine the loops of the ascending and lower sections. In addition to diagnostics using colonoscopy, materials are taken for histological studies.
- Sigmoidoscopy is a method when a special tube with an optical video camera at the end is used, but no histological material is taken. Using this method of research, the doctor examines the mucous epithelium and sees changes, even if they are of small size and are in loops.
- Fluoroscopy is performed in patients with suspected cancer when the above methods are contraindicated. X-ray examination includes computed tomography and magnetic resonance imaging, which reveal the degree of damage to the organ by the tumor and metastases, even if it is located in the intestinal loops. A chest x-ray is indicated for suspected lung metastasis.
Colon cancer is a malignant tumor that is formed as a result of metastatic lesions of the mucous membrane and walls of the large intestine. Most often, colon cancer is diagnosed in men and women aged 50-60 years. It is noteworthy that among vegetarians, diseases of this type are diagnosed much less frequently. On the territory of the CIS countries, this disease ranks fourth among all oncological diseases.
Etiology
Colon cancer can develop due to the following factors:
- improper, unbalanced diet;
- ailments of the colon;
- genetic predisposition;
- advanced age.
If a person's daily diet is dominated by meat products, sweets and starchy foods (especially fresh pastries), but there are no cereals, vegetables and fruits, then the risk of developing colon cancer increases significantly.
Pathogenesis
Most often, tumors are located in the folds of the colon. In view of this, frequent (chronic) can also cause the development of cancer.
The tumor begins to metastasize through the lymphatic tract, affecting the nodes of the abdominal aorta. As a result of this process, an oncological disease begins to develop - colon cancer. The disease may be accompanied.
General symptoms
The clinical picture of the manifestation of the disease depends on the localization of the tumor. In the early stages of colon cancer, there may be no symptoms at all. As the disease develops, the following symptoms may be observed:
- frequent urge to defecate, which does not bring relief;
- swollen abdomen, discomfort in the form of heaviness;
- feces may be with blood;
- aversion to food;
- weakness.
In some clinical cases, unstable temperature and malaise may be added to the general symptoms. It is noteworthy that the patient does not lose weight, but, on the contrary, may gain some weight.
Depending on the patient's condition, the overall clinical picture may be aggravated. The development of acute inflammatory processes is no exception.
The symptoms of colon cancer described above are quite similar to gastrointestinal upset, food poisoning. Therefore, the patient does not seek medical help in a timely manner. In view of this, diagnosing the disease at an early stage is quite difficult.
Classification
According to the form of tumors, colon cancer is:
- saucer-shaped;
- endophytic;
- exophytic.
According to the nature of the development of oncological disease, there are four stages of colon cancer:
- first- the tumor is localized only in the mucosal area. Effective treatment with chemotherapy;
- second- the tumor does not metastasize, the symptoms are already more pronounced;
- third- metastases begin to develop, the tumor is already located on the entire wall of the intestine;
- fourth- the pathological process can affect nearby organs, metastases can be located in the lymph nodes. The prognosis in this case is unfavorable.
But if colon cancer is diagnosed at the first or second stage, then the treatment prognosis can be very favorable.
Possible Complications
Since colon cancer can also affect other organs as it develops, there is a significant risk of complications. The most common is colorectal cancer.
- This is the development of cancer in the rectum. The main risk group is people aged 50–60 years. Recently, however, the disease has begun to affect people of a younger age - 20-30 years. Both men and women are affected with equal frequency.
Etiological factors can be almost any inflammatory process associated with the gastrointestinal tract. In addition, the following factors can provoke colorectal cancer:
- alcohol abuse;
- sedentary lifestyle;
- frequent consumption of red meat;
- lack of vegetables, fruits and whole grains in the diet.
Just like colon cancer, colorectal cancer can be caused by a genetic predisposition.
The symptoms of colorectal cancer are almost identical to those of colon cancer. But here it is worth noting that the symptoms are very similar to diseases such as:
- ulcer;
- ulcerative colitis.
Therefore, it is impossible to self-medicate, even with folk remedies. This can only exacerbate the situation. In the early stages, colorectal cancer is well treated with medication, diet, and chemotherapy.
Diagnostics
When diagnosing a disease, not only general symptoms are taken into account. The doctor takes into account the entire medical history, personal and family history. The history of the disease, if cancer is suspected, gives quite a lot of useful information - what diseases a person has already had, whether he has a genetic predisposition, and so on. That is why the medical history should always be with the patient.
The lifestyle of the patient is also taken into account. Only after a personal examination, a detailed study of the history of past diseases, the doctor can prescribe a diagnostic program.
The standard program includes laboratory and instrumental studies. Required laboratory tests include the following:
- general analysis of feces.
Instrumental studies include the following methods:
- x-ray examination of the abdominal organs;
- laparoscopy;
- biopsy.
As for the biopsy, this instrumental diagnostic method is used only in the third stage of the development of the disease, when there is a suspicion of the development of the pathological process in other organs.
Only on the basis of all the tests performed, the patient's medical history and general medical history, the doctor can make an accurate diagnosis and prescribe the correct treatment.
Treatment
Treatment of colon cancer depends on what exactly caused the formation of the disease, the nature of the localization and the stage of development of the disease. It is almost always an operable intervention.
Before the operation, the patient is carefully prepared for this process. For 3-4 days, the intestines should be completely cleansed - the patient adheres to a strict diet and slag-free nutrition. In addition, two days before the operation, a daily enema and castor oil are prescribed. Along with this, the patient is prescribed special antibiotics.
After the operation, the patient should strictly adhere to the diet. Meals should be carried out only strictly on time. On the second day after the operation, the patient can drink and eat liquid food. The patient should adhere to such a diet until complete recovery.
In the first stage of the development of the disease, chemotherapy and drug treatment are sometimes used. But, this is only if there is no genetic predisposition to the disease and suspicions of the development of complications. In general, the prognosis at this stage of cancer is favorable.
Diet
Colon cancer treatment involves following a diet both before and after surgery. If a patient is diagnosed with a genetic predisposition to this disease, then the diet must be followed constantly. By the way, proper nutrition is a good measure for the prevention of this kind of disease.
The diet for this oncological disease excludes the intake of such products:
- animal fats;
- sweet (should be, if not excluded, then at least minimized);
- products with dyes, chemical additives;
- spicy, too salty and smoked.
Be sure to include foods that contain selenium in the patient's diet. It is this element that actively fights infected cells. Therefore, the diet should include such products:
- sea fish of low-fat varieties;
- liver;
- eggs;
- seafood;
- cereals (rice, buckwheat, wheat);
- legumes, dried fruits;
- broccoli, parsnips, parsley.
The nutrition of the patient with such a diet will be balanced, which gives positive results. If you adhere to such a diet and all the doctor's prescriptions, the prognosis will be very optimistic.
Prevention
The main preventive measures are the timely treatment of all diseases associated with the gastrointestinal tract. In addition, you should adhere to proper nutrition, do not abuse alcohol and lead a healthy lifestyle. This is especially important if a person has a genetic predisposition to cancer.
With the symptoms described above, it is better to consult a gastroenterologist, rather than self-medicate. The sooner colon cancer is diagnosed, the greater the chance of a full recovery.
Is everything correct in the article from a medical point of view?
Answer only if you have proven medical knowledge
One of the most common cancers in Russia is colon cancer. The first symptoms, however, the patient does not begin to experience immediately.
Approximately every eighth case of oncology concerns this area. Mostly older people suffer - up to 55 years of colon cancer occurs quite rarely. Such a disease, which occurred before the age of 45, can only be hereditary.
Such a disease does not affect all parts of the intestine equally: most often the tumor occurs 30-40 centimeters from the anus, in the colon or rectum. Otherwise, malignant neoplasms in this area are called colorectal cancer by physicians.
There are special cases of such a disease: cancer of the anal canal and cancer of the small intestine, but they are rare.
Cancer is a general term for all malignant neoplasms. Doctors call them tumors. But not every tumor in the gut is malignant and therefore colon cancer. There are many benign neoplasms, such as polyps in the intestines. However, if left untreated, cancerous tumors can also develop from them, so they are considered as precursors of colon cancer.
Cancer cells are so altered that they divide very quickly. This allows them to grow beyond the tumor - to neighboring tissues and organs. In addition, cancer cells can be transmitted through the blood or lymph to other parts of the body, where they form secondary tumors (metastases).
How does colon cancer develop?
Cancer cells are body cells that divide and grow uncontrollably. Usually the body strictly regulates their growth, but cancer cells avoid this "check". They grow in tissues and gradually destroy them.
When cells divide, DNA (genes) are copied from another cell. The older the person, the higher the risk that the new cell's genes will mutate and become cancerous if the body fails to make it harmless. If the intestinal cell undergoes this, then colorectal cancer occurs.
Causes of colorectal cancer and risk factors
It is very difficult to name the exact causes of this disease. Most often they lie in the way of life of a person: his eating habits and physical activity. The two most important influencing factors are tobacco use and being overweight.
Other risk factors:
- hypodynamia;
- chronic inflammatory bowel disease: ulcerative colitis and Crohn's disease;
- diet low in fiber;
- alcohol abuse;
- regular consumption of red meat or sausages made from it.
People with close relatives who suffer or have suffered from colorectal cancer also have an increased risk of developing such a tumor.
The tumor in most cases slowly develops from benign precursors, such as Their cells can mutate, and a malignant neoplasm will begin to develop. Therefore, it is important to remove polyps immediately after detection.
People with type 2 diabetes have a higher risk of developing colon cancer. Experts see the reasons for this in the typical changes in hormone levels that occur at the beginning of the development of the disease. The cells of the body cease to respond normally to insulin - because of this, the pancreas produces it in large quantities. An excess of this hormone can also lead to bowel cancer.
For people at risk, it is important to be examined regularly. Oncoscreening, or early detection of tumors, will be a good method. Thus, the whole body is checked for the presence of various tumors and metastases.
Oncologists say that the number of cases of colorectal cancer can be significantly reduced if more people choose a healthy lifestyle. This, unfortunately, will not guarantee that the disease will not occur at all, but will reduce the risks of its occurrence.
Colon Cancer Symptoms
Colon cancer often causes no symptoms for a long time. At the beginning, the signs are very atypical - they can indicate various diseases and problems with the intestines. There are no specific symptoms that clearly indicate cancer.
Possible symptoms of colon cancer, which should be considered as the first warning signs:
- pain and cramps in the abdomen;
- strong false urge to defecate;
- constipation, diarrhea or their alternation;
- pain during bowel movements;
- an altered appearance of the stool - for example, the appearance of blood, mucus, thin feces in it (occurs when the intestine narrows with a tumor);
- indigestion accompanying the above signs: flatulence, bloating, rumbling, heartburn, nausea, heaviness in the stomach;
- enlarged lymph nodes in the abdomen.
These first symptoms of colon cancer are very non-specific. They can also occur with irritable bowel syndrome, which is much more common.
Symptoms of irritable bowel syndrome are similar to those of colon cancer
Other symptoms that can occur with both colon cancer and other diseases are:
- decrease in working capacity;
- increased night sweats;
- fever.
Symptoms that may indicate the active development of the disease:
- anemia, if the bowel tumor bleeds regularly;
- pallor;
- fatigue;
- unintentional rapid weight loss;
- compaction in the stomach with a large tumor size;
- intestinal obstruction.
If secondary tumors have formed (cancer “let go” of metastases) in other organs, then other symptoms may develop, which depend on the location of the secondary neoplasm.
Table 1. Symptoms of colon cancer with metastases
Diagnosis of colon cancer
If there is a suspicion of a tumor in the intestine, with the help of diagnostics it turns out:
- its exact location;
- benign or malignant;
- how much the disease has progressed and whether there are metastases in other organs.
Several examinations are required to make an accurate diagnosis.
Primary examination
When complaining of long-term problems with digestion, a person must first contact a local therapist. With prolonged discomfort in the lower abdomen, it is better for women to go to a gynecologist. To complete the history, the doctor asks several questions.
- What are the complaints: for example, changes in stool, abdominal cramps, nausea?
- How long do symptoms last?
- What is your diet? Does it include meat?
- Do you suffer from any chronic inflammatory bowel disease?
- Have you previously had colon polyps?
- Do you have relatives who currently or have suffered from colon cancer?
The answers to these questions can help the doctor build the primary clinical picture. Then the specialist examines the patient, probes the stomach. If rectal or anal cancer is suspected, a specialist will perform a digital rectal examination. Thanks to this, you can feel the tumor itself if it is close to the anus. This examination option is effective, however, with this method it is impossible to determine the nature of the tumor, so additional diagnostics will be required.
Examination by a gastroenterologist
The patient needs to be examined by a gastroenterologist who will check the condition and functioning of the gastrointestinal tract. A fecal occult blood test will be ordered. True, it does not always give a true result: if a person often eats meat products, blood can be found in his stool even in the absence of cancer. In addition, it is possible that the blood came from intestinal polyps, enlarged hemorrhoids, or harmless mucosal injuries in the anus. Therefore, in this case, it is impossible to make an accurate diagnosis without another type of diagnosis.
Colonoscopy
reference. Colonoscopy is a method of examining the large intestine, which uses an endoscope - an optical device that looks like a flexible hose with a mini-camera at the end. Diagnostics takes place under visual control: the image is displayed on the screen. This method is absolutely safe, since the so-called “cold” light is used during shooting, which eliminates the burn of the mucous membrane.
To obtain reliable results, preparation is needed: during the day, the intestines are cleansed with laxatives or enemas, the patient follows a diet. During the procedure, the doctor inserts the endoscope into the patient's rectum and "pushes" it to the colon. Thus, he can examine the condition of this area, and if suspicious places are found, tissue samples (biopsy) can be taken with an endoscope. If colon polyps were found during the examination, they are removed directly during the colonoscopy. Thanks to this diagnostic method, an accurate diagnosis will be made and the treatment of the disease will begin. However, it is important to be aware of complications, such as bleeding during the procedure, which can occur when polyps are removed. They rarely occur, but for people with blood diseases, this method may be contraindicated.
Other diagnostic methods
With the help of a blood test, the level of tumor markers is checked. If it is elevated, then this may indicate the development of colon cancer, however, their presence can also be detected in a healthy person, so this type of diagnosis is not completely reliable. However, a blood test is necessary to keep abreast of general health.
Ultrasonography
Imaging methods of research will also help to draw up a general clinical picture and outline the path of treatment:
- ultrasound examination (ultrasound);
- computed tomography (CT)
- magnetic resonance imaging (MRI);
- positron emission tomography (PET).
Video - Colon cancer: prevention and diagnosis
Preventive examinations
For people who do not belong to any risk group, who do not have complaints and specific suspicions of cancer, the mandatory medical examination includes the following diagnostic methods to rule out colon cancer:
- from the age of five: once a year, a stool test for occult blood (rapid test for colorectal cancer);
- from the age of eighteen: every two years, either a colonoscopy or a fecal occult blood test.
There are several types of stool tests. With a rapid test, stool samples for different days are collected in small containers, and then examined in the laboratory by adding a special solution to them. The appearance of a blue color indicates the presence of blood in the stool. Despite the fact that such an analysis is not completely reliable and it is impossible to accurately determine the presence of a tumor, it can make it clear to the patient that normal processes are disturbed in his body and you should consult a doctor.
Other methods of preventive examination include:
- capsule endoscopy. A person swallows a special capsule equipped with a small camera that transmits a video signal. So you can find out about the state of the gastrointestinal tract;
- virtual colonoscopy. This is an examination of the colon without the introduction of an endoscope using MRI or CT;
- sigmoidoscopy. This is a visual examination of the mucous membrane of the anal canal, rectum and part of the sigmoid colon. It is carried out using a sigmoidoscope.
Colon cancer treatment
In the case of colon cancer, the chances of recovery largely depend on how early the tumor is found. If it has grown only superficially on the mucous membrane, then it is easy to remove it with a colonoscopy. In the future, it will only be necessary to be examined once every six months to check whether the neoplasm will reappear.
If it is not possible to completely remove the tumor with a colonoscopy, further steps are needed. Depending on how far the tumor has spread, different therapies may be used. Typically used:
- operation;
- chemotherapy;
- radiation therapy;
- a combination of chemotherapy and radiation therapy (radiochemotherapy);
- immunotherapy.
If the patient has the last - terminal - stage of cancer, complete disposal of it is unlikely. Doctors can only prolong the life of the patient through intensive care. 30% of patients with the fourth stage of cancer live up to 5 years.
Some colon cancer patients have the opportunity to participate in clinical trials that test new drugs. For people with end-stage metastatic colorectal cancer with little chance of recovery, new drug developments could be a great way to get back to normal life.
Psychological support is also important. For many patients, such a terrible diagnosis causes shock and depression, even when the chances of recovery are very high. This condition can accelerate the development of the disease and worsen the physical condition of a person.
Life after illness
Even after getting rid of colon cancer, it is necessary to undergo regular examinations in order to monitor the state of your body and avoid recurrence.
- undergo a colonoscopy six months after the removal of the tumor, and then with an interval of two years;
- annually conduct a complete examination of the body;
- once every six months to take a general analysis of blood, urine and feces;
- follow a diet.
Diet
Diet plays an important role in colon cancer and after getting rid of it. Cancer and its treatment is a big burden on the body. Therefore, it is important to provide it with the necessary energy.
Many people with colorectal cancer have difficulty maintaining their weight. With such a disease, it is important to control it: it is impossible for it to decrease too much. Patients undergoing chemotherapy or radiation therapy especially often struggle with side effects such as loss of appetite, nausea, or vomiting. In addition, there may be a violation of taste or smell. In this case, it is important to listen to the body and eat what you want.
The doctor will prescribe an individual nutrition plan for the patient, which will help saturate the body with the necessary vitamins and maintain a good physical condition. For those who are unable to feed normally due to rejection or other complications, artificial feeding with a gastric tube may be an option.
Cancer diets are gaining popularity. Often patients ask themselves: will they help improve the condition of the body and stop the development of the disease?
Most often they talk about the so-called ketogenic diet, in which carbohydrates are almost completely excluded. Unfortunately, it has not been proven by doctors that it helps to get rid of such a disease: perhaps this happened only in special cases. In addition, if it is observed, a person most likely will not remain full, which will negatively affect his condition. It is important to remember that each organism is individual, and what can help one person can harm another. Therefore, it is worth discussing your diet with a doctor - he will definitely say what is suitable for a particular patient.
- Distribute food throughout the day - many small meals (5-6 per day) are easier to digest than several large ones.
- To ensure good digestion, it is important to drink plenty of water. With diarrhea and vomiting, you can also compensate for the loss of minerals with good mineral water.
- In case of loss of appetite, it is not recommended to drink water during meals, so as not to fill the stomach.
- You need to chew your food thoroughly. This will make your bowel work easier.
- Keep a food diary to monitor the reactions of your body and your condition after a particular product.
- In case of constipation, it is better to take only natural laxatives.
- Food and drinks should not be too hot or too cold.
- Dry foods, such as crackers or crispbread, can help with nausea.
Conclusion
Colon cancer is a dangerous disease, but it is not a death sentence. It is quite possible to get rid of it if treatment is started in time. To completely avoid such a disease, it is recommended to undergo a complete examination of the body at least once a year - this will help to detect possible diseases at an early stage.
Even if a diagnosis such as colorectal cancer has been made, do not despair. It is important to follow the doctor's instructions and seek psychological help. Cancer can be defeated, the main thing is to make an effort. read on our website.
colon cancer is one of the most common tumors. Among cancerous lesions of the digestive tract, colon cancer ranks third after cancer of the stomach and esophagus. Among patients in surgical departments, such patients range from 0.2 to 0.9%. Men get colon cancer slightly more often than women. Colon cancer is more common in patients aged 40 to 60 years. In more than 50% of cases, colon cancer occurs on the basis of single polyps and colon polyposis. This process selectively affects a number of areas of the intestine: the hepatic and splenic flexures of the colon are most often affected, then the caecum, descending colon and sigma, and much less often the ascending colon and the transverse part of the colon.
It is customary to distinguish between two forms of colon cancer: exophytic, when the tumor grows into the intestinal lumen and leads to partial or complete closure of it, and endophytic, when the tumor spreads towards the peritoneum. Exophytic tumors, which often have a tuberous form, include polypoid and villous forms of cancer. Endophytic tumors have the character of ulcers, annularly covering the intestinal wall. Exophytic cancerous tumors are more often observed in the right half of the colon, and endophytic - in the left. If the tumor is located near the Bauhinian valve, then stenosis develops quite early. The progressive growth of a cancerous tumor towards the peritoneum causes a response from nearby organs (loop of the small intestine, omentum), which are soldered to the tumor and form a large conglomerate. Further development of the tumor can lead to its perforation into the free abdominal cavity, which entails the development of peritonitis. Ulceration of the tumor from the intestinal mucosa can lead to massive bleeding.
Multiple colon cancer is rare (from 0.6 to 7%) and occurs mainly with polyposis, less often on the basis of nonspecific ulcerative colitis. Its course is more malignant than a single cancer.
With regard to the microscopic structure of colon cancer, adenocarcinomas are predominant (80%), then mucous colloidal (12-15%) and medullar cancers.
Symptoms of colon cancer differ depending on the shape and structure of the tumor and its location. Sometimes colon cancer is asymptomatic for a long time or is manifested by nonspecific symptoms that are also characteristic of other diseases of the gastrointestinal tract. With different localizations and forms of the disease, eructations appear, sometimes fetid, aversion to food, alternating constipation and diarrhea with mucus, especially the smelly smell of stools with a lot of flatulence. This "gut discomfort" should lead to suspicion of colon cancer. According to B. L. Bronshtein (1950), symptoms of discomfort are noted in 14% of cases. Pain refers to constant and relatively early signs of the disease: patients first complain of heaviness in the abdomen, then the pain intensifies, and with intestinal obstruction they become persistent, periodic and cramping. When viewed only in malnourished patients, a large tumor can be detected, swelling of the intestine proximal to the tumor. Percussion is of little help in determining the tumor. Palpation allows you to determine the size of the tumor, its localization, mobility. Sometimes patients themselves feel a tumor in their abdomen. In 20% of patients with colon cancer, blood is determined in the feces, and in the early stage of the disease it is only in 7% (B. L. Bronshtein). Abundant bleeding in colon cancer is rare, but they are sometimes among the first signs of the disease. "Uncaused anemia" of the hypochromic type and accelerated ESR give grounds to suspect a cancerous tumor. Anemia is more common when the tumor is located in the proximal colon. In 37% of cases of colon cancer, fever is observed - and not only with an extensive cancerous lesion with decay, but also with a moderate tumor development in combination with an inflammatory reaction. With the help of sigmoidoscopy, a tumor of the sigmoid colon can be detected and a biopsy can be performed, as well as a cytological examination of smears taken from suspicious areas for cancer.
An important role in the diagnosis of colon cancer is played by a contrast x-ray examination of the colon.
Currently, surgery is the only radical way to treat colon cancer at an early stage, that is, when not only the tumor, but also regional lymph nodes are removed by resection of a part of the intestine.
If radical operations are impossible due to the severity of the patient's condition or in the presence of metastases, palliative operations are performed to eliminate the phenomena of intestinal obstruction, which consist in turning off the part of the intestine affected by the tumor and in applying bypass anastomoses.
Colon sarcoma is rare and accounts for 1 to 3% of cases of colon tumors. Colon sarcoma is observed at all ages - from 7 months to 63 years, but most often at the age of 20 to 40 years. Abdominal trauma is often noted in the anamnesis. The caecum is most commonly affected. The size of the tumor ranges from the size of a small apple to the head of an adult. Colon sarcoma is often in the form of a dense, bumpy node, soldered to neighboring organs and to the anterior abdominal wall. Often, colon sarcoma is in the form of a muff, while the intestinal wall is evenly thickened over a considerable extent. The narrowing of the lumen of the intestine with its sarcoma is less common than with cancer. Sarcoma develops from the submucosal layer, later grows into the peritoneum. In the colon, round cell sarcomas predominate, followed by lymphosarcomas and spindle cell sarcomas. Colon sarcomas grow rapidly. The duration of the disease is up to a year.
At first, the disease is usually asymptomatic, and only with advanced development of the process does anorexia occur, as well as diarrhea, alternating with constipation. Often, colon sarcoma simulates chronic appendicitis. With a decaying tumor, the temperature rises to 39.7 °.
Anemia and cachexia are less common than in cancer. Common complications include tumor invasion into adjacent organs, perforation into the abdominal cavity, and less commonly, intestinal obstruction, as well as intussusception. Intestinal bleeding is rare. Sarcoma can compress the inferior vena cava or portal vein and cause ascites and peripheral edema, and when the ureter is compressed, hydronephrosis (I. Ya. Deineka, 1960).
The diagnosis of colon sarcoma is difficult. The thought of a sarcoma should arise in the presence of a rapidly growing, painless, bumpy tumor that does not cause intestinal stenosis, especially in young people.
Treatment of colon sarcoma is surgical and consists in possibly early resection of the affected segment of the intestine with the removal of regional lymph nodes and tissue. The prognosis is unfavorable.
Benign tumors of the colon very diverse: these are polyps, fibromas, lipomas, hemangiomas, fibroids, leiolipomas, etc. These tumors retain their small size for a long time and do not manifest themselves. As the tumor grows, symptoms of narrowing or invagination may appear.
Colon polyps and polyposis deserve special attention. Polyps are: hyperplastic with excessive development of the mucous membrane, inflammatory - with chronic inflammation (dysentery, tuberculosis) and adenomatous, or true polyps, which are based on tumor growths of the glands of the mucous membrane. The caecum is most often affected by polyps. Polyps are found predominantly in young people. The size of polyps ranges from the size of a millet grain to the fist of an adult. Polyps can be located on a wide base or have a narrow stalk.
The symptoms of polyps and polyposis are not the same and depend on the number of polyps, their location and structure. Single polyps may not manifest themselves for a long time. At the same time, adenomatous forms are accompanied by loose stools mixed with mucus and blood, often along the colon there are pains in combination with constipation, and when the sigmoid colon is damaged, tenesmus occurs. Patients lose weight, become anemic. In some cases, it is possible to note small pigment spots of the mucous lips, cheeks, palate, wings of the nose (Petz-Jaeger syndrome). With sigmoidoscopy, polyps of the sigmoid colon are visible of various sizes, shapes and colors. The diagnosis of polyposis of the colon is not so difficult with a thorough X-ray examination.
Treatment is surgical and consists of excision of single polyps and resection of the affected part or the entire colon. The prognosis is serious due to the fact that cancer can develop on the basis of polyps and polyposis.
Of the benign tumors of the colon, lipomas are in the first place in frequency. They are located under the mucous membrane (in this case they are called internal) and above the serosa (external). More often they are located on a wide base, but sometimes they have a leg and are then called polypoid lipomas. Lipomas come in various sizes: from a pea to a man's fist; occur predominantly in people over 40 years of age.
Lipomas are asymptomatic for a long time. With a generally satisfactory condition, patients develop constipation, alternating with diarrhea, sometimes with mucus and blood. Lipomas that have reached a significant size can be palpated through the abdominal wall and move freely during palpation. Bowel intussusception is possible. The prognosis for lipomas of the colon is favorable with the timely removal of the lipoma. The operation consists in resection of a section of the intestine with a lipoma.
Colon fibroids are very rare.
