Colon And Rectal (Colorectal) Cancer

The colon and rectum are part of the digestive system. The large intestine is the next organ after the small intestine. Colorectal cancers occur in the mucosa, the innermost layer of the large intestine. The risk of developing this cancer increases after the age of 50. It is the most common cancer of the digestive system both in Turkey and in the world. It ranks 4th in men and 3rd in women among the most common cancers in Turkey. With the development of chemotherapy and surgical treatments, increased medical awareness and screening programs, deaths due to colorectal cancer have decreased considerably.

Colon and Rectal (Colorectal) Cancer

Colorectal cancer in a first-degree relative
Some genetic diseases
Hereditary nonpolyposis colorectal cancer (Lynch syndrome)
Familial adenomatous polyposis (FAP) coli syndrome
Male gender
Consuming animal fat. Fibrous foods reduce this effect.
Red meat consumption
Consuming smoked foods
Obesity
Frequent consumption of eggs and processed meat (salami, sausage, sausage, etc.).
Alcohol
Cigarette
Inflammatory bowel disease

Risk Factors for Colon and Rectal Cancer

Bloody stools
Abdominal pain
Feeling of bloating
Weight loss and loss of appetite

Colon cancer involving the right side of the large intestine and colon cancer involving the left side may have different symptoms.

Colon and Rectal (Colorectal) Cancer Symptoms

Assoc.Prof.

Mutlu Ünver

Assoc. Prof. Dr. Mutlu Ünver graduated from Ege University Faculty of Medicine. Mutlu Ünver, who completed his specialty training in Ege University Faculty of Medicine, Department of General Surgery, serves his patients in his own clinic.

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The diagnosis is made by rectal examination, followed by colonoscopy and biopsy of the lesion. Computed tomography and magnetic resonance imaging are helpful in the diagnosis to assess the extent of the disease.

Diagnosis of Colon and Rectal (Colorectal) Cancer

Stage 1: The cancer has invaded the intestinal wall. However, it has not reached all layers of the intestine.

Stage 2: The cancer has involved all layers of the intestine.

Stage 3: Colon cancer has metastasized and spread to regional lymph nodes.

Stage 4: The cancer has spread to distant tissues and organs such as the liver, peritoneum and lungs.

Stages of Colon and Rectal (Colorectal) Cancer

Surgical Treatment of Colon and Rectal (Colorectal) Cancer

Surgical principles vary depending on which part of the large intestine is involved. Removal of the entire colon is called total colectomy, while removal of one half is called hemicolectomy. All colon surgeries can be performed laparoscopically (closed technique), robotic or open technique depending on the extent and location of the disease.

After the affected part of the large intestine is removed, the remaining sections of the large intestine are usually anastomosed (joined) using various techniques. In some cases, the remaining ends of the intestine are usually temporarily attached to the abdominal wall as a stoma. If no recurrent tumor is detected after post-operative follow-up and chemotherapy, a new stoma closure surgery is performed to remove the stomalized intestinal ends back into the abdomen.

In rectal cancer, depending on the stage of the tumor, it may be necessary to try to reduce the extent and stage of the tumor with radiotherapy and chemotherapy before surgery (neoadjuvant treatment). When the tumor becomes suitable for surgery, the operation is performed by resecting (removing) the relevant part of the rectum. In rectal cancer surgeries, the remaining intestinal ends can be anastomosed (joined together) and in some cases temporarily, and in some cases permanently, they can be attached to the abdominal wall in the form of a stoma. This stoma can be closed with a second surgery with postoperative follow-up.

Patients treated for colorectal cancer are at risk of developing the same disease again. This is called local (regional) or systemic recurrence. This is why most patients have a colonoscopy after 12 months. If the entire colon was not examined before surgery, the entire colon should be evaluated after surgery. If everything is normal at the 1st year follow-up, colonoscopy is repeated after 3 years and then after 5 years. Most recurrences occur in the first two years. Patients who can be operated on again when local or distant recurrence is detected should be followed more closely. A blood test for a tumor-specific marker called CEA is checked every 3 months for 2 years.