Bowel cancer is the cancer of the large intestine or colon. Bowel cancer is also known as colorectal cancer as the rectum is usually affected. It takes around ten years for bowel cancer to develop. It is a silent and slowly progressing disease initially. Colorectal cancer is so common that it is the second most common cancer that affects females and third among males globally. It was reported that in 2018, colorectal cancer caused 861000 deaths and 1.8 million new cases were diagnosed. Colorectal cancer is more common in males than in females. Southcentral Asia and Africa recorded the lowest cases of colorectal cancer while the highest are in Australia, Europe, New Zealand, and North America. Doctoroncall is a platform where you can get more information regarding diseases and health.
The risk factors for developing colorectal cancer are:
- Genetic causes
- Family history of colorectal cancer
- Family history of adenomatous polyposis
- Inflammatory bowel disease
- Abdominopelvic radiation
- Cystic fibrosis
- Male
- Acromegaly
- Kidney transplant
- Alcohol
- Cigarette smoking
- Diabetes mellitus
- Obesity
- Consumption of red meat
- High intake of processed meat
Genetic causes play an important role in the development of colorectal cancer. Certain genetic related diseases like Familial adenomatous polyposis (FAP), Gardner syndrome, and Turcot syndrome are at risk to transform into colorectal cancer. It all started with errors with genetics. Lynch syndrome is another and the most common genetic disease that is associated with colorectal cancer.
Inflammatory bowel disease consists of two main diseases which are Crohn disease and Ulcerative colitis. Both diseases may cause bowel cancer. Those who are exposed to radiation in particular at the abdomen and pelvis at a very young age at risk of suffering from bowel cancer later in their lives. Those individuals who are the recipient of a kidney transplant will need a long duration of immunosuppressive medications. They also prove to develop colorectal cancer.
The following are the protective factors against colorectal cancer:
- Garlic in diet
- Coffee intake
- Fish consumption
- Calcium
- Dairy products
- Vitamin D
- Vitamin B6
- Folate
- Folic acid
- High fiber diet
- Active lifestyle
- Certain medications
The medications that lower the risk of bowel cancer are:
- Erlotinib
- NSAIDs
- Aspirin
- Female hormone therapy
- Statins
- Bisphosphonate
- Antioxidants
The clinical features of bowel cancer are:
- Abdominal pain
- Bleeding per rectal
- Melena
- Lethargy
- Pallor
- Constipation or diarrhoea
- Rectal mass
Like other diseases, to establish a diagnosis, a physician will need to take a history from the patient, do a physical examination, and run some tests. History will help a doctor to understand the symptoms better and to have all clues to support the diagnosis later. Physical examination is when a doctor will examine a patient from head to toe and focus more focussing on the region where the disease is suspected. This is very important to elicit as many signs as possible. Signs and symptoms will not only help in concluding a diagnosis but also in choosing appropriate and required tests to confirm a diagnosis of bowel cancer.
The tests that can be done are colonoscopy, abdominal x-ray, tumour markers, computed tomography (CT) scan, and basic blood tests. Later staging will be done. There are four stages. Staging is vital in knowing the prognosis or the chance for a patient to recover. Other than that, it is also important to choose the right treatment. The treatments available for bowel cancer are surgery, chemotherapy, and radiation therapy. The common chemotherapy regimen is the FOLFOX regimen. Chemotherapy is the use of chemicals to kill the cancer cells while radiotherapy is the use of radiation to remove cancer cells. Most bowel cancer in the early stage may improve following surgical removal of the tumour or cancer or certain part of the large intestine.
