March 26th, 2021
What is colorectal cancer?
Colorectal cancer, also known as colon, rectal or bowel cancer, is a tumor that appears 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, when detected early.
According to data published by the Brazilian National Institute on Cancer (INCA), the colorectal cancer is the third most frequent type of cancer among men, following prostate cancer and lung cancer. Among women, it is the second most frequent, following just breast cancer.
Dr. Rodrigo Melão Martinho, from the Instituto do Câncer Brasil, reveals that “the occurrence of colorectal cancer can be influenced by sporadic factors, which represent 70% to 80%, in addition to genetic factors.” According to data published by the World Health Organization (WHO), 70% of cases can be prevented by changing habits and accessing colonoscopy, which allows, in addition to early diagnosis, the resection of polyps (precursor lesions).
Among the risk factors related to lifestyle highlighted by Dr. Rodrigo, we find: obesity, physical inactivity, excessive consumption of alcohol, smoking, a diet rich in red meats and processed foods. There are still factors that are out of control, such as: age, family history, inflammatory bowel disease and ethnicity. For such reason, Dr. Rodrigo alerts “practice physical activity, have a healthy and balanced diet, control excess weight and do not use drugs”.
Signals and Symptoms
Unfortunately, in most cases, the colorectal cancer does not present symptoms; only 40% of the cases are diagnosed at initial stage. However, the following symptoms might occur:
• Diarrhea or constipation
• Feeling that the intestine is not completely emptied
• Presence of blood in feces
• Colic-type abdominal pain, feeling of abdominal bloating
• Tiredness and fatigue
• Weight loss without a specific reason
You need to be aware, as these symptoms might also be associated with other diseases. If you experience any of these symptoms, please visit a doctor to obtain an accurate diagnosis and, if necessary, to initiate a treatment.
Diagnosis and treatment
As colorectal cancer might be confused with different other diseases and has a low rate of diagnosis in its initial phase, it is essential not to ignore the signs and symptoms. Immediate investigation and early diagnosis are essential for a more effective treatment.
Whenever an individual presents the symptoms and looks for a specialist, that professional will be able to investigate his/her case and achieve a diagnosis based on imaging exams, such as colonoscopy and recto-sigmoidoscopy, and through examination of feces to check the presence of occult blood.
Surgery in colorectal cancer
The oncological surgery has a fundamental role in the fight against cancer, since up to 90% of patients with cancer diseases will need some type of surgical procedure, either for treatment or for diagnosis.
According to Dr. Diego Greatti Vaz da Silva, member of the Scientific Commission of the Brazilian Society on Oncological Surgery – Sao Paulo Regional (SBCO-SP), surgery in patients carrying colorectal cancer is also necessary. “Curative treatments for such disease include surgery to remove the affected intestinal segment; such surgical procedure is one of the most widespread among surgeons who treat cancer. Initially carried out in 1900, it has undergone several technical and technological advances during the last decades, becoming very safe and with low complication rates”, he explains.
Nowadays, minimally invasive surgery (laparoscopy and robotics) for the treatment of colorectal cancer is safe and preferred in most cases. Dr. Diego explains that in that type of surgery the abdominal incision and the surgical trauma are smaller, speeding up the surgical recovery. In robotic surgery the procedure is performed by a qualified surgeon controlling a robot’s clamps, which perform the movements gently and with greater accuracy within the body of the patient. Whenever available, that route facilitates surgery, especially in tumors located in the lower rectum, closer to the anus.
News in researches addressing colorectal cancer
Dr. Caio Rocha Lima, oncologist, researcher and professor of clinical oncology at the University of Wake Forest, North Caroline, points out two promising researches addressing colorectal cancer: immunotherapy and DNA technology.
Dr. Caio explains that in immunotherapy 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 can be related to genetic predisposition (Lynch syndrome) or somatic (not genetics). Immunotherapy treatments enhance the immune system so that it can fight diseases such as cancer.
Another important area of research mentioned by Dr. Caio is dedicated to detecting the recurrence of circulating cancer cells (ctDNA) with DNA technology. This technology has a better performance to detect recurrence when compared against radiology (CT scan, MRI, or PET scan) or with tumoral marker, such as CEA.
This text contet is intended only for information purposes and does not replace medical report. If you have any of the symptoms described above, a doctor should be consulted.