COLORECTAL

CANCER
Submitted by,
Mithilaa S,
1st MSc Biochemistry.
• colorectal cancer, disease characterized by
uncontrolled growth of cells within the 
large intestine (colon) or rectum (terminal
portion of the large intestine). Colon cancer (or
bowel cancer) and rectal cancer are sometimes
referred to separately.
• Colorectal cancer develops slowly but can spread
to surrounding and distant tissues of the body.
Colon cancer typically affects older adults,
though it can happen at any age.
• It usually begins as small, noncancerous (benign)
clumps of cells called polyps that form on the
inside of the colon. Over time some of these
polyps can become colon cancers.
• Polyps may be small and produce few
symptoms. For this reason, doctors recommend
regular screening tests to help prevent colon
cancer by identifying and removing polyps
before they turn into cancer.
• If colon cancer develops, many treatments are
available to help control it, including surgery,
radiation therapy and drug treatments, such as
chemotherapy, targeted therapy and
immunotherapy.
Symptoms
Signs and symptoms of colon cancer include:
• A persistent change in your bowel habits, including
diarrhea or constipation or a change in the consistency
of your stool
• Rectal bleeding or blood in your stool
• Persistent abdominal discomfort, such as cramps, gas or
pain
• A feeling that your bowel doesn't empty completely
• Weakness or fatigue
• Unexplained weight loss
• Many people with colon cancer experience no
symptoms in the early stages of the disease.
• When symptoms appear, they'll likely vary, depending
on the cancer's size and location in your large intestine.
Causes
• Doctors aren't certain what causes most colon cancers.
• In general, colon cancer begins when healthy cells in the
colon develop changes (mutations) in their DNA. A cell's
DNA contains a set of instructions that tell a cell what to
do.
• Healthy cells grow and divide in an orderly way to keep
your body functioning normally. But when a cell's DNA is
damaged and becomes cancerous, cells continue to divide
even when new cells aren't needed. As the cells accumulate,
they form a tumor.
• With time, the cancer cells can grow to invade and destroy
normal tissue nearby. And cancerous cells can travel to
other parts of the body to form deposits there (metastasis).
Risk factors:
• Older age: majority of people with colon cancer are older than 50.
• African-American race have greater risk than do people of other races.
• A personal history of colorectal cancer or polyps. If you've already had colon
cancer or noncancerous colon polyps.
• Chronic Inflammatory intestinal conditions such as Crohn's disease,
• Inherited syndromes that increase colon cancer risk. Some gene mutations passed
through generations. polyposis and Lynch syndrome(hereditary nonpolyposis
colorectal cancer )
• Family history of colon cancer. 
• Low-fiber, high-fat diet. Eg: red meat and processed meat.
• A sedentary lifestyle. 
• People with diabetes
• Obesity
• Smoking. 
• Alcohol
• Radiation therapy for cancer. 
Prevention
• Screening colon cancer
Lifestyle changes to reduce your risk of
colon cancer
• Eat a variety of fruits, vegetables and
whole grains.
• Drink alcohol in moderation, if at all.
• Stop smoking.
• Exercise most days of the week.
• Maintain a healthy weight

Stages of cancer
Diagnosing colon cancer
 Colonoscopy
If your signs and symptoms indicate that you could have colon cancer,
your doctor may recommend one or more tests and procedures, including:
 Using a scope to examine the inside of your colon
(colonoscopy). Colonoscopy uses a long, flexible and slender tube
attached to a video camera and monitor to view your entire colon and
rectum. If any suspicious areas are found, your doctor can pass surgical
tools through the tube to take tissue samples (biopsies) for analysis and
remove polyps.
 Blood tests. No blood test can tell you if you have colon cancer. But
your doctor may test your blood for clues about your overall health,
such as kidney and liver function tests.
Treatment
• Removing polyps during a
colonoscopy (polypectomy). 
• Endoscopic mucosal resection. 
• Minimally invasive surgery
(laparoscopic surgery).
• Lump node removal
• Chemotherapy
• Immunotherapy
• Targeted drug therapy
• Radiation therapy
Colonoscopy
References:
• Colorectal cancer: Screening and management (adult). Rochester, Minn.:
Mayo Foundation for Medical Education and Research; 2018.
• Colon cancer. Plymouth Meeting, National Comprehensive Cancer Network.
• Feldman M, et al. Colorectal cancer. Sleisenger and Fordtran's
Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis,
Management. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2016.
• Niederhuber JE, et al., eds. Colorectal cancer. In: Abeloff's Clinical Oncology.
5th ed. Philadelphia, Churchill Livingstone Elsevier; 2014.
• Colon cancer treatment (PDQ) Patient version. National Cancer Institute.
• Macrae FA. Colorectal cancer: Epidemiology, risk, protective factors.
• Kandel P, et al. Colorectal endoscopic mucosal resection (EMR). Best
Practice & Research Clinical Gastroenterology.
• Palliative care. Plymouth Meeting, National Comprehensive Cancer
Network. Jan. 30, 2019.
• Moertel CG, et al. Levamisole and fluorouracil for adjuvant therapy of
resected colon carcinoma. The New England Journal of Medicine. 
Thank you.