$Unique_ID{BRK03554} $Pretitle{} $Title{Cancer, Colon} $Subject{Cancer Colon Cancer of the Large Intestine Cancer of the Colon Colonic Cancer Colorectal Cancer Carcinoma of the Colon Adenocarcinoma of the Colon Diverticulitis Ulcerative Colitis Benign Lesions or Tumors of the Colon} $Volume{} $Log{} Copyright (C) 1990 National Organization for Rare Disorders, Inc. 808: Cancer, Colon ** IMPORTANT ** It is possible that the main title of the article (Colon Cancer) is not the name you expected. Please check the SYNONYM listing to find the alternate names and disorder subdivisions covered by this article. Synonyms Cancer of the Large Intestine Cancer of the Colon Colonic Cancer Colorectal Cancer Carcinoma of the Colon Adenocarcinoma of the Colon Information on the following disorders can be found in the Related Disorders section of this report: Diverticulitis Ulcerative Colitis Benign Lesions or Tumors of the Colon General Discussion ** REMINDER ** The information contained in the Rare Disease Database is provided for educational purposes only. It should not be used for diagnostic or treatment purposes. If you wish to obtain more information about this disorder, please contact your personal physician and/or the agencies listed in the "Resources" section of this report. Colon cancer is one of the most common cancers found in the United States. The cause is unknown. It may be related to a high-fat low-fiber diet. In some people, the tendency to develop colon cancer may be inherited. Cancer is a disease in which abnormal cell development occurs, causing destruction of healthy cells. Symptoms of colon cancer may include changes in the shape or color of stools, blood in the stools, constipation and/or diarrhea, abdominal discomfort and sometimes nausea. Surgery is generally performed to correct this type of cancer, usually along with radiation and/or chemotherapy. Symptoms The colon is part of the large intestines. Symptoms of colon cancer may include changes in the shape of stools such as a thin or flattened appearance. Blood may be present in the stool although it may not be visible to the patient. Hard, nodular masses with irregular borders develop into a malignant tumor (such as an adenocarcinoma) which, in some patients, may be detected during a rectal exam. When cancer forms in the right side of the colon, the tumor may become large and ulcerate, causing blood loss which may lead to anemia. The stool may have a reddish-maroon color. Some patients may have pain and trapped gas in the lower right area of the abdomen. Gently pressing or massaging the area may relieve the gas. Small bowel obstruction may also occur. When cancer forms in the left side of the colon, obstruction within the intestine causes constipation and cramping pain in the abdomen. Bleeding can also occur and may be visible in the stool. In advanced stages of the disease, loss of appetite and weight loss tend to occur. There is pain in the abdomen from the obstruction in the intestine. If the disease spreads, cancer may travel (metastasize) to the lymph glands, other areas of the abdomen, or liver via the lymphatic system or bloodstream. In some patients, the cancer may travel to the lung or bone. Potential colon cancer can be discovered by a rectal exam, or examination of the abdomen. Other screening methods are the sigmoidoscope or colonoscope (lighted instruments which allow the physician to see inside the patient's large intestine) and laboratory examination of the patient's stool for occult (hidden) blood. Diagnosis is made by radiography (barium enema x-ray and other imaging techniques) and endoscopy (a sigmoidoscope or colonoscope). When a colonoscope is too large to fit into narrow obstructed passage, a cytology brush can be used to obtain cells to test for cancer. Biopsy is made to confirm malignancy. Causes Like most forms of cancer, the exact cause of colon cancer is not known. It may be related to a high-fat low-fiber diet, although this has not been scientifically proven. In some people, the tendency to develop colon cancer may be inherited. People who have inflammatory bowel disease such as ulcerative colitis, Crohn's disease or patients with benign (noncancerous) intestinal tumors (adenomas, polyps) may have a higher risk of developing colon cancer as well. Surgical removal of adenomas and polyps aids in the prevention of colon cancer. Other people at risk of developing colon cancer are those who have hereditary polyposis syndromes (multiple polyps covering the colon and rectum) such as familial polyposis, Gardner's syndrome, other colon syndromes such as Turcot, Oldfield's, or Peutz-Jeghers syndrome. (For more information on these disorders, choose "polyposis", "Gardner", "and "Peutz" as your search term in the Rare Disease Database). Affected Population Colon cancer is one of the most common types of cancer. It affects men and women equally, usually occurring after the age of 40. It is often diagnosed in patients around the age of 65. People with colon cancer in their family are at higher than normal risk of developing this disorder. Related Disorders Diverticulitis is a common disease of the bowel. It may mimic colon cancer by causing an obstruction, especially in the sigmoid colon (area of the colon near the rectum), by an inflammatory mass. Ulcerative colitis and benign (noncancerous) lesions or tumors of the colon may also be confused with colon cancer. Therapies: Standard Treatment of colon cancer varies from patient to patient. It is important to determine how far the disease has spread since this determines the appropriate treatment program. First, physicians determine what "stage" the disease is in. The stage depends on the number and location of malignant sites, and if it has traveled to other parts of the body. Surgery is generally performed to treat colon cancer, usually along with radiation therapy (radiotherapy). A colectomy is surgery to remove part or all of the large intestine. If necessary, a colostomy (or ileostomy) is done. A colostomy is surgery to create an artificial anus. Sometimes a temporary colostomy quickens the recovery of a patient who had only a section of the large intestine removed. Radiation therapy destroys cancer cells, shrinks enlarged lymph nodes, and aids in prevention of further cancer. For some patients, chemotherapy may be used. Chemotherapy involves the use of "anticancer" drugs. All these drugs may produce adverse side effects and must be carefully monitored by a doctor. The drug 5-flourouracil is often used to treat colon cancer patients alone or in combination with other drugs. Other treatment is symptomatic and supportive. Therapies: Investigational The National Cancer Institute conducts clinical trials on new drugs being tested for colon cancer and other forms of cancer. To learn about locations of these investigations, contact the Cancer Information Service listed in the Resources section of this report. This disease entry is based upon medical information available through August 1990. Since NORD's resources are limited, it is not possible to keep every entry in the Rare Disease Database completely current and accurate. Please check with the agencies listed in the Resources section for the most current information about this disorder. Resources For more information on Colon Cancer, please contact: National Organization for Rare Disorders (NORD) P.O. Box 8923 New Fairfield, CT 06812-1783 (203) 746-6518 American Cancer Society 1599 Clifton Rd., NE Atlanta, GA 30329 (404) 320-3333 NIH/National Cancer Institute 9000 Rockville Pike, Bldg. 31, Rm. 1A2A Bethesda, MD 20892 1-800-4-CANCER The National Cancer Institute has developed PDQ (Physician Data Query), a computerized database designed to give the public, cancer patients and families, and health professionals quick and easy access to many types of information vital to patients with this and many other types of cancer. To gain access to this service, call: Cancer Information Service (CIS) 1-800-4-CANCER In Washington, DC and suburbs in Maryland and Virginia, 636-5700 In Alaska, 1-800-638-6070 In Oahu, Hawaii, (808) 524-1234 (Neighbor islands call collect) References INTERNAL MEDICINE, 2nd Ed.: Jay H. Stein, ed.-in-chief; Little, Brown and Co., 1987. Pp. 160-164. WORLD BOOK MEDICAL ENCYCLOPEDIA: Erich E. Brueschke, M.D., et al., eds; World Book, Inc., 1988. Pp. 147-148.