Colorectal Cancer

Symptoms of Colorectal Cancer

What are the symptoms of colon cancer?

Colon cancer symptoms can be vague, including dull abdominal pain, fatigue and anemia. Other colon cancer symptoms include rectal bleeding and changes in bowel habits.

If I don’t have symptoms, why should I have a colonoscopy?

Early colon cancers and polyps that can develop into cancer often produce no symptoms. Early detection also means that cancer is less likely to have spread to nearby lymph nodes and other organs.

Most common symptoms of colorectal cancer

The following are the most common symptoms of colorectal cancer. However, each individual may experience symptoms differently.

People who have any of the following symptoms should check with their doctors, especially if they are over 50 years old or have a personal or family history of the disease:

  • A change in bowel habits such as diarrhea, constipation, or narrowing of the stool that lasts for more than a few days
  • Rectal bleeding, dark stools, or blood in the stool
  • Cramping or gnawing stomach pain
  • Decreased appetite
  • Vomiting
  • Weight loss
  • Weakness and fatigue
  • Jaundice—yellowing of the skin and eyes

The symptoms of colorectal cancer may resemble other conditions, such as infections, hemorrhoids, and inflammatory bowel disease. It is also possible to have colon cancer and not have any symptoms. Always consult your doctor for a diagnosis. Make an appointment today with us if you think your symptoms may be a sign of colorectal cancer.

Adenocarcinoma

Adenocarcinomas are tumors that start in the lining of internal organs. “Adeno” means gland. These tumors start in cells with glandular properties, or cells that secrete. They can form in many different organs, such as the lung or the breast. In colorectal cancer, early tumors start as small adenomatous polyps that continue to grow and can then turn into malignant tumors. The vast majority of colorectal cancers are adenocarcinomas.

Gastrointestinal Stromal Tumors (GIST)

These are tumors that start in the muscle tissue of the digestive tract, although they rarely appear in the colon. They can be benign (noncancerous) at first, but many do turn into cancer. When this happens, they are called sarcomas.

Lymphoma

A lymphoma is a cancer that typically starts in a lymph node, which is part of the immune system. However, it can also start in the colon or rectum.

Familial Colorectal Cancer (FCC)

Up to 15% of colorectal cancer patients have family members with colorectal cancer, but do not have a known colorectal cancer syndrome such as  familial adenomatous polyposis (FAP) or  hereditary nonpolyposis colon cancer (HNPCC). Colon cancer in these families may appear to follow an autosomal dominant pattern of inheritance. As genetic research continues, genes may be identified to explain these family histories.

Juvenile Polyposis Coli

This rare, childhood-onset disease is an autosomal dominant disorder that results from mutations in various cancer susceptibility genes, including the SMAD4/DPC4 and BMPR1A genes. The condition is associated with the development of hamartomatous polyps (few to numerous) that can be present throughout the gastrointestinal tract.

Symptoms can include:

  • Diarrhea
  • Hemorrhage
  • Protein-losing enteropathy

Juvenile polyposis is associated with an increased chance for gastrointestinal and pancreatic cancers. Most patients appear to be sporadic cases (happening for the first time in a family). However, this may actually be the result of decreased penetrance (i.e., the causative gene mutation is present in one of the parents but the symptoms did not develop).

Colorectal Cancer Staging

As colorectal cancer grows, it can spread through the wall of the colon or rectum. Then, like all cancers, it can spread (metastasize) to other parts of the body. The stage of your cancer is a way doctors describe how deep and how far your cancer has spread. Knowing the stage is important. The stage is a primary factor in deciding what treatment to use.

  • Systems for staging
  • The TNM system for colon cancer

Stage groupings

Stage groupings are determined by combining the T, N, and M values from the TNM system. These groupings give an overall description of how advanced your cancer is. A stage grouping can have a value of 0 or a value assigned by a Roman numeral I through IV (1 through 4). The higher the value, the more advanced your cancer is.

These are the stage groupings of colorectal cancer and what they mean.

Stage 0 colorectal cancer

In this stage, cancer is only in the innermost lining of your colon. It has not spread and is in its earliest stage. This stage is also called carcinoma in situ.

Stage 1 colorectal cancer

In this stage, the cancer has spread to the middle layers of the lining of your colon. It has not spread to the lymph nodes or distant sites. This stage is sometimes called Dukes’ A colon cancer.

Stage 2 colorectal cancer

This stage is sometimes called Dukes’ B colon cancer. It is divided into three groups:

  • Stage IIA: In this stage, the cancer has grown into the outermost layers of the colon or rectum but has not gone through them. It still has not spread to the lymph nodes or to distant sites.
  • Stage IIB: The cancer has grown through the wall of the colon or rectum but has not grown into nearby organs. It has not spread to nearby lymph nodes or distant sites.
  • Stage IIC: The cancer has spread outside your colon to nearby tissues or organs. It has still not spread to the lymph nodes or to distant sites.

Stage 3 colorectal cancer

Stage 3 (III) colorectal cancer is sometimes called Dukes’ C colon cancer. It is divided into three sub-stages: stage IIIA, stage IIIB, and stage IIIC.

Stage IIIA: The cancer has spread to the middle layers of your colon wall and has also spread to one to three lymph nodes. It hasn’t spread to distant sites, though.

Stage IIIB: One of the following applies:

  • The cancer has grown into or through the outer layers of the colon or rectum but hasn’t spread to nearby organs. It has spread to one to three nearby lymph nodes. It has not spread to distant sites.
  • The cancer has grown into the middle layers or outer of the colon or rectum and has spread to four to six nearby lymph nodes. It hasn’t spread to distant sites.
  • The cancer has grown into the first or middle layers of the colon or rectum, and has spread to seven or more nearby lymph nodes. It hasn’t spread to distant sites.

Stage IIIC: One of the following applies:

  • The cancer has grown through the outer layers of the colon or rectum but hasn’t reached nearby organs. It has spread to four to six nearby lymph nodes, but not to distant sites.
  • The cancer has grown into or through the outer layers of the colon or rectum but hasn’t reached nearby organs. It has spread to seven or more nearby lymph nodes, but not to distant sites.
  • The cancer has grown into or through the outer layers of the colon or rectum and has reached nearby organs. It has spread to one or more nearby lymph nodes, but not to distant sites.

Stage 4 colorectal cancer

This stage is sometimes called Dukes’ D colon cancer. This stageis divided into two sub-stages:

  • Stage IVA: The cancer may or may not have grown through the wall of the colon or rectum, and it may or may not have reached nearby lymph nodes. It has spread to one distant organ (such as the lungs or liver) or one distant set of lymph nodes.
  • Stage IVB: The cancer may or may not have grown through the wall of the colon or rectum, and it may or may not have reached nearby lymph nodes. It has spread to more than one distant organ (such as the liver or the lungs) or set of distant lymph nodes, or it has spread to distant parts of the peritoneum (the lining of the abdominal cavity).
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