People's Democratic Republic of Algeria

    Ministry of Higher Education and Scientific Research

 University DJILALI LIABES-SBA
  Faculty of Science of Nature and life
       Biology department

Master 1 Applied Biochemistry

Subject:

Colorectal
Cancer and
Made by: Alimentation
NEMMICH Khadra Israe
Teacher :
Mrs CHENNI
ZITOUNI Warda
MAHI Meriem Lamis
 WORK PLAN :
 1- Generality
 2-Introduction
 3-Colorectal cancer symptoms
 4- Colorectal cancer causes and risk factors
 5- Relation between colorectal cancer and
alimentation
 6- Colorectal cancer investigations
 7- Colorectal cancer staging investigations
 8- Treatment
 9-Conclusion

2
 1- Generality:
This figure represent Figure represent the
the anatomy of the histology of the
colon colon

3
 2- Introduction :
colon cancer also know as colorectal
carcinoma is when the malignant arise in
large intestines which include the Colon
and the rectum. It's start with colorectal
polyps and this polyps grow and become
malignant is the most common type of
cancer of the gastro intestinal tract , a
major cause of death in the world.

4
5
 3- Symptoms :
o prolonged diarrhea
o change of the size or shape of the stool
o abdominal pain or cramping pain in lower
stomach
o anal bleeding and the experience of
hematochezia
o pain and weight loss

6
 4- Colorectal cancer causes and risk factors:
4-1Genetic cause:
 Most cases of colorectal cancer happen because of sporadic mutations
but a small number are caused by known genetic mutations that run in a
person’s family an example of this is the adenomatous polyps coli gene or
APC gene(5q22.) which is a tumor suppressor gene

Structural features of the APC protein

 Normally the APC protein identifies when a cell is accumulating a lot of

mutations and forces it to undergo apoptosis , or programmed cell death
but when the APC gene is mutated , the mutated bowel cells don’t die
and instead some start dividing uncontrollably , giving rise to polyps
7
 Overtime, these polyps might accumulate more
mutations in other tumor suppressor genes like the K-RAS
gene or the p53 gene , and ultimately it might become a
malignant tumor meaning that the cells might be able to
invade neighboring tissues
Another well know example are genetic mutations in DNA
repair genes which help fix up mutations , when they are
out of action cells accumulates mutations and overtime
can develop into polyps and eventually adenocarcinomas
so, broadly speaking , adenocarcinomas are the
malignant evolution of polyps and polyps arise when cells
start dividing faster than usual
4-2 Risk factors:
Such as being elderly and male
Inflammatory bowel disease
Smoking cigarettes
Obesity
8
5-1Whole grains: are a source
5- Relation between colorectal cancer and
alimentation

of dietary fiber such many reduce

colorectal cancer risk and they are
also a rich source of various
bioactive compounds including
vitamins E,copper and phenolic
compounds ...many of these
compounds have plausible anticarcinogenic
properties whole grains may also protect againt
colorectal cancer by b by binding and regulating
glycemic .
9
 5-2Dietary fibre: intake colorectal concert
risk include the reduction of internal
transit time and increased facial bulk .
A high-fibre diets may also reduce
insulin resistance which is a risk factor
for colorectal cancer.
5-3Non-starchy vegetables: consumption of
vegetables provides a large number of
potential anti-tumorigenic agents such as
dietary fibre it is possible that acombination of
these nutriments is responsible for the lower
colorectal cancer risks associated with
vegetable consumption.
10
• 5-4Fruit: the evidence for consumption
a fruit was limited but generally
consistent .the dose response
meta-amalysis showed no significant
association with colorectal cancer.
there was evidence of a non-linear
dose response of colorectal cancer and fruit intake
showing significant increased risk at low levels of
intake.
5-5Read meat: showed a positive association
in the dose response meta-amalyses in colorectal ,
colon and rectal cancer .
The result was positive but not significant for colorectal
and rectal cancers and significant for colon cancer with
low heterogeneity .So the consumption of the red meat
11 is probably a cause of colorectal cancer.
5-6 Processed meat: generally consistent
evidence showing an increased risk of
consumption of processed meat.
The dose response meta-amalysis showed a
significant increased risk of colorectal cancer.
• P.S: the evidence suggesting that consumption
of foods contains harm iron increases the risk of
colorectal cancer is limited.
5-7 Fish: experimental studies suggest that long-
chain n-3 polyunsaturated fatty acids (PUFAs)
found in fish suppress the development of
colorectal cancer. Their are limited mechanistic
data for a link between fish consumption and
colorectal cancer risk in humans.
12
5-8Dairy products: the evidence was
 consistent for products , milk cheese
and dietary calcium in showing a decreased
risk of colorectal cancer with higher
consumption . the dose response meta-amalyses of
dairy products were statistically significant with no
or little heterogeneity evidence for cheese was
less strong than for the other exposures .So
consumption of dairy products probably protects
against colorectal cancer.
5-9Alcohol: the association for alcohol as ethanol
was still apparent when stratified by specific
cancer site as significant increased
risk was observed for colorectal
13
,colon and rectal cancer.
 6-Colorectal cancer
investigations
 Investigations performed for patients suspected of
colon cancer or any form of mass includes an
abdominal examination followed by upper rectal
examination and this is done by proctoscope to
check for any of these masses and source of
bleeding such as from hermorrhoids . colonscopy
is then considered which under general anesthesia
and involves the doctor
inserting a colonscope through the back
passage and visualizing the colon , polyps
can be taken out and sampled to check
for malignancy

14
 Colonography can also be performed .finally, we
have blood investigation which include LFT ,FBC
and tumor marker for colon cancer CEA
After diagnosing the cancer it’s important to
stage it for a better treatment
7-Staging investigation: it includes CT scan and
PET scan

15
There are 2 forms of staging itself
1st TNM staging which looks at
T primary tumor N the lymph
node and M metastasis

The 2nd is duke’s staging which

looks at 5 years survival and there
are a total of 4 stages plus stage 0

16
The stages it depends on how deep the tumor is
going , so stage 0 is carcinoma in situ meaning that
tumor has not grown beyond the mucosa there’s a 90
percent five years survival ,
stage 1 when the tumor has grown beyond mucosa
but has not spread to lymph nodes or distant organs,
stage 2 is when the tumor has invaded the whole
colonic or rectal wall ,and may have reached nearby
organs or tissues but still has not spread to lymph
nodes or distant organs
stage 3 is when the tumor had spread to lymph
nodes ,but still hasn’t spread to distant organs
finaly stage 4 is metastatic meaning that the tumor
has spread to distant organs it’s less than 10 percent
five years survival . the most common site of
metastasis for colon cancer is liver and for rectal
17 cancer it’s the lungs
8- Treatment
Passing to the treatment , Colon cancer is potentially
curative with surgical resection of the colon
collectively colectomy with also surgical resection of
the lymph nodes lymphdenactomy
The colectomy is performed depending on where the
tumor located on the colon and when surgically
removing parts of the colon, is important to take into
concederation the blood supply of that part of the
colon as well as the lymph drainage of that part
tumors that occur on the right side of the large
intestine or in the right transit area requires a right
hemicolectomy extended ,tumors occurring on the left
side require left hemicolectomy and while tumor is
occurring in the sigmoid and upper rectum requiring
high anterior section , tumors in the anu rectum
18 require aper
Also during this procedure some patients may
require having temporary or even a permanent
colostomy bag pouches while others get the
colon joined to the other pots to the remaining
parts of the colon eventually . together with
colectomy there is adjuvant chemotherapy
(usually involves a 5floor of uracil ) with or
19
without radiotherapy and finally there is also
  Proctoscope a medical instrument with an integral
lamp for examining the anus and lower part of the rectum
or carrying out minor medical procedures.
LFT blood tests are groups of blood tests that provide
information about the state of a patient's liver
Liver function tests
FBC blood test A complete blood count is a blood panel
requested by a doctor or other medical professional that gives
information about the cells in a patient's blood, such as the
cell count for each blood cell type and the concentrations of
hemoglobin.
CEA blood test A carcinoembryonic antigen (CEA) test is
a blood test used to help diagnose and manage certain
types of cancers
colostomy bag pouches A colostomy bag is a plastic bag
that collects fecal matter from the digestive tract through an
opening in the abdominal wall called a stoma. Doctors attach
a bag to the stoma following a colostomy operation
20
 9-Conclusion

There are some advices to prevent the

colorectal cancer such as :
consume a healthy diet
adopt a Physically Active lifestyle.
eat plenty of fiber
 have enough calcium and vitamin D.

21
 bibliographic references
https://ghr.nlm.nih.gov/gene/KRAS
https://
www.youtube.com/watch?v=Wb0-ginVmtk&t=3
26s
https://
www.youtube.com/watch?v=A6v-y6hr4EQ
https://www.healthline.com/health/cea#:~:targe
tText=A%20carcinoembryonic%20antigen%20(C
EA)%20test,a%20cancer%20treatment%20is%2
0working
.
http://
scholar.google.com/scholar?q=colorectal+cance
22
r+and+alimentation&hl=fr&as_sdt=0&as_vis=1