What is it?

Colorectal cancer, also known as colon, rectum, or bowel cancer, is a tumor that develops in the large intestine. The disease, which develops from polyps (benign lesions) that grow on the wall of the large intestine, is treatable and, in most cases, curable, if detected early.

According to data from the National Cancer Institute (INCA), colorectal cancer is the third most common among men, after prostate and lung cancer. Among women, it is the second most common, second only to breast cancer.

Dr. Rodrigo Melão Martinho, from Cancer Institute Brazil, highlights that “the onset of CRC may be influenced by sporadic factors, which represent 70% to 80% of cases, and genetics”. According to data from the World Health Organization (WHO), 70% of cases could be prevented by changing habits and accessing colonoscopy, which allows, in addition to early diagnosis, the resection of polyps (precursor lesions).

Among the lifestyle-related risk factors highlighted by the doctor are: Obesity, sedentary lifestyle, excessive alcohol consumption, smoking, diet rich in red meat and processed foods. There are also factors that we cannot control, such as: age, family history, inflammatory bowel disease, and ethnicity. For this reason, Dr. Rodrigo warns “practice physical activity, eat a healthy and balanced diet, control excess weight and do not use drugs”.

Signs and symptoms

Unfortunately, in most cases, colorectal cancer has no symptoms, only 40% of colorectal cancers are diagnosed at an early stage.

However, some symptoms that may occur are:

• Diarrhoea or constipation.
• Feeling that the intestine is not completely emptied.
• Presence of blood in the stool.
• Cramping abdominal pain, a feeling of abdominal bloating.
• Tiredness and fatigue.
• Weight loss for no specific reason.

It is necessary to be aware, as these symptoms may also be associated with other diseases. However, if you have any of these symptoms, a doctor should be consulted for an accurate diagnosis and initiation of treatment if necessary.

(Source: Oncoguia)

Diagnosis and treatment

As colorectal cancer can be confused with other diseases and has a low diagnosis rate in its early stages, it is essential not to ignore the signs and symptoms. This is because investigating immediately and having an early diagnosis is essential for a more effective treatment.

Therefore, when experiencing the symptoms and seeking a specialist, the specialist can investigate the case and arrive at a diagnosis based on imaging tests, such as colonoscopy and rectosigmoidoscopy, and through a stool examination, which will search for the presence of hidden blood in the stool.

Surgery for colorectal cancer

Oncological surgery plays a fundamental role in the fight against cancer, since up to 90% of patients with oncological diseases will require some type of surgical procedure, either for treatment or diagnosis.

According to Dr. Diego Greatti Vaz da Silva, member of the Scientific Committee of the Brazilian Society of Regional Oncological Surgery of São Paulo (SBCO-SP), surgery on colorectal cancer patients is also necessary. “Treatments with curative intent against this disease include surgery to remove the affected intestinal segment. This surgical procedure is one of the most widespread among surgeons who treat cancer. Initially carried out in 1900, it underwent several technical and technological advances over the last few decades, becoming very safe and with low complication rates,” she explains.

Nowadays, minimally invasive surgery (videolaparoscopy and robotics) for the treatment of colorectal cancer is safe and preferred for most cases. Dr. Diego clarifies that with it, the abdominal incision and surgical trauma are smaller, expediting surgical recovery. In robotic surgery, the procedure is performed by a qualified surgeon controlling the clamps of a robot, which execute the movements delicately and with greater precision on the patient. When available, this route facilitates surgery mainly on tumors located in the lower rectum, closer to the anus.

What's new in colorectal cancer research

Dr. Caio Rocha Lima, oncologist, researcher, and clinical oncology professor at Wake Forest University - North Carolina, highlights two promising initiatives in cancer research colorectal: immunotherapy and DNA technology.

In immunotherapy, Dr. Caio explains that the solution is focused on colon cancer with microsatellite instability. This type affects around 5% of patients with metastatic colon cancer and around 15% of patients with stage 2 and 3 cancer. This type of cancer may be related to genetic (Lynch syndrome) or somatic (non-genetic) predisposition. Immunotherapy treatment consists of boosting the immune system so that it can fight diseases such as cancer.

Another important research area cited by Dr. Caio is dedicated to detecting the recurrence of circulating cancer cells (ctDNA) with DNA technology. This technology is superior in detecting recurrence compared to monitoring recurrence with radiology (CT scan, MRI, or PET scan) or with tumor markers, such as CEA.

The content of this text is informational and does not replace the medical report. If you experience any of the symptoms described above, a doctor should be consulted.