Carcinoma of the colon is commoner in industrialized countries where meat consumption is high. Regular screening is recommended for those at risk of developing the disease is a procedure used for screening, along with regular physical examinations.

Carcinoma of the colon is cancer of the large intestines or bowels. The colon is like a tube and for this is called a tubular organ. It begins in the lower abdomen, ascends along the right, across the upper abdomen from right to left, then descends along the left side to the anus. It consists of several portions each with its own name. In carcinoma of the colon there is uncontrollable growth of tumor cells in the lining of the longest portion. The cancer may spread to the walls of the intestines, adjacent structures and to other organs.

There are about 100,000 new cases of carcinoma of the colon each year in the USA and about 60,000 deaths. Worldwide there are about 600,000 deaths every year. Carcinoma of the colon affects both women and men.

Risk Factors and Causes
There is a genetic disposition to developing colon cancer. In 20% of cases there is a history of colon cancer in the family. This indicates an inherited gene. In other cases exposure to environmental factors are the causes. For example certain cacinogens such as dietary choices may bring about changes in the cells DNA. Carcinoma of the colon is also commoner in industrialized countries where meat consumption is high. Risk factors include:

• Diet high in saturated fat
• Alcohol consumption
• Low fibre diet
• Obesity
• Smoking
• Inflammatory conditions of the colon
• Age over 50

Signs and Symptoms
Signs and symptoms are usually evident when the tumor gets to a certain size.

• Change in bowels habits
• Blood in the faeces
• Abdominal distension
• Constipation
• Chronic fatigue
• Weight loss
• Anaemia

Diagnosis
If symptoms suggest that a tumor may be present several investigations may be done.

Colonoscopy: This is examination of the entire colon using a lighted tube to examine for the presence of lesions or growths. This procedure is expensive and may be distressing to the patient. It is also the standard test used to screen for colon cancer. A biopsy can be obtained at the time.

Biopsy: In this investigation a specimen of any lesions or tissue is obtained to examine for the presence of cancer cells. This is the most definitive diagnostic procedure, as the tumor can then be identified as benign or malignant.

Barium enema: This is a procedure in which a barium compound is instilled in the rectum and x-rays taken to outline the colon.

Digital rectal Examination(DRE): In this procedure a physician examines the anus and the rectum using a gloved finger. Other investigations may include: stools for occult blood and blood tests for tumor markers.

Treatment
The treatment for stage 1, 2 and 3 cancers is surgery.

Surgery: The first step is the removal of the section of the colon affected, along with the blood supply and lymph nodes. The second step may be one of two procedures

Anastomosis – In this procedure the ends of the remaining colon are joined together by a reconstructive procedure.

Colostomy – If the reconstructive procedure is not possible, a colostomy is performed. This involves bringing the end of the remaining colon through the abdomen and sewing it to the skin. A stoma is created through which faces is excreted. This may be temporary or permanent.

Radiation: Radiation is used following surgery to remove the tumor cells not removed by resection or when there is metastasis.

Chemotherapy: This is the use of anti-cancer drugs. Chemotherapy is used when there is a risk that the tumor will return. It is also used for stage 4 cancers when surgery is not possible. Other possible treatments are Adjuvant therapy and Alternative therapy.

Prevention of Carcinoma of the Colon
Consumption of red meat seems to contribute to the higher incidence of colon cancer in industrialized countries. Developing a healthy eating pattern is therefore an important preventive action. Other preventive measures include:

• Regular screening for those at risk
• Keeping physically active
• Avoiding tobacco
• Keeping weight within limits
• Controlling alcohol consumption
• A high fibre diet

A Guide To A Healthy Eating Pattern
For a detailed guide to a healthy eating pattern and how to measure servings.

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