Colon Cancer Treatment

Colon Cancer Treatment

Diagnosing colon cancer can be overwhelming, but it's important to remember that you are not alone. This article will guide you through the journey of colon cancer, starting from understanding the seriousness of colon cancer to exploring treatment options and finding support with the best institution in Iraq for cancer treatment, Warith International Cancer Institute (WICI).

Colon cancer:

•              Colorectal cancer begins in the colon or rectum. These cancers can also be referred to as colon cancer or rectal cancer, depending on where they originate. Colon and rectal cancer are often grouped because they share many characteristics.
•              The colon is the large intestine, a long tube-like structure located at the end of the waste elimination pathway in the body. Cancer can begin in the lining of the intestine or at its end, called the rectum.

Causes of colon cancer:

1.            Cancer may occur due to genetic mutations that can be hereditary or acquired. These mutations do not guarantee cancer, but they increase the likelihood of developing it.
2.            Some mutations may lead to the accumulation of cells in the lining of the colon, forming polyps. These are small, benign growths. However, untreated polyps can become cancerous.
3.            Colorectal cancers are more common in men. The causes of colon cancer in men are the same as those in women, but men are at a higher risk of developing rectal cancer.
4.            Certain risk factors may increase the likelihood of developing colon cancer. Having these factors does not necessarily mean you will get cancer, but it does increase the risk of malignant colon cancer. Some of these factors include:
o To be over 50 years old.
o A history of colon polyps.
o A family history of colon and rectal cancer.
o The presence of certain genetic syndromes, such as familial adenomatous polyposis (FAP).
o Having inflammatory bowel disease (Crohn's disease or ulcerative colitis).

So, is colon cancer hereditary?

Only about 5% of colon and rectal cancers are inherited as part of a genetic syndrome, which is a group of hereditary conditions associated with an increased risk of cancer. These syndromes, such as Lynch syndrome and familial adenomatous polyposis (FAP), are rare but involve specific genetic mutations that elevate the likelihood of developing cancer. If a family member, especially a parent or sibling, has a history of these syndromes, the risk of colon and rectal cancer is higher.

How do you know if you have colon cancer?

You may have colon cancer without showing obvious symptoms, and if symptoms do appear, they can be mistaken for less serious conditions such as infections, hemorrhoids, irritable bowel syndrome, or inflammatory bowel disease. Therefore, it is important to consult top cancer specialists in Iraq at the Warith International Cancer Institute if you experience any symptoms, to undergo a colon cancer screening for diagnosis.

What are the symptoms of colon cancer?

Symptoms often do not appear in the early stages of cancer. Regular screenings are important for detecting the disease early and starting treatment.
Symptoms of colon cancer include:
• Abdominal pain. 
• Blood in the stool.
• Diarrhea, constipation, or other change in bowel habits.
• Narrow stools.
• Weight loss for no known reason.
• Iron deficiency anemia due to chronic bleeding, which causes fatigue and weakness.

What are the early stages of colon cancer?

Doctors use staging to determine the extent of cancer progression. Knowing the stage of the cancer helps identify the best treatment plan.
Here are the stages of colon and rectal cancer:
• Stage 0: Also known as local carcinoma, this is the earliest stage. At this stage, the cancerous cells are only in the inner lining of the colon or rectum.
• Stage 1: Cancer has penetrated the mucous membrane of the colon or rectum and may have reached the muscular layer. Stage 1 colon cancer has not spread to nearby lymph nodes or other parts of the body.
• Stage 2: The cancer has spread to the walls of the colon or rectum, or through the walls to nearby tissues, but has not affected the lymph nodes.
• Stage 3: The cancer has spread to the lymph nodes but has not yet reached other parts of the body.
• Stage 4: The cancer has spread to distant organs, such as the liver or lungs. This is the most advanced stage.

Early colon cancer symptoms:

Colon cancer often has no symptoms at first. However, colon cancer may show up early with some routine screenings. If you have symptoms in stages 0 to 2, they often include:
• Constipation.
• Diarrhea.
• Changes in stool color.
• Stringy stools.
• Blood in the stool.
• Excess gas.
• Abdominal cramps.
• Abdominal pain.
• Tenesmus, the feeling of needing to empty your bowels, but nothing passes.
Despite the increase in colorectal cancer cases among individuals under 50, they are not routinely screened due to the rarity of the disease in this age group. Previous studies have identified warning signs of colon cancer that could encourage younger adults to seek medical attention earlier. These signs include abdominal pain, rectal bleeding, diarrhea, and iron deficiency anemia.

Symptoms of final stage colon cancer:

Symptoms are more pronounced in stages 3 and 4, which are the most severe stages of colon cancer. In addition to the previously mentioned symptoms, you may also experience the following:
• Fatigue.
• Unexplained weakness.
• Unintentional weight loss.
• Changes in your stool that last more than a month.
• A feeling that your bowels don't empty.
• Vomiting.
If colon cancer has spread to other parts of the body, you may also experience:
• Jaundice, or yellowing of the eyes and skin.
• Swelling of the hands or feet.
• Difficulty breathing.
• Chronic headaches.
• Blurred vision.
• Bone fractures.

When do colon cancer symptoms appear?

• Symptoms of colorectal cancer may be mild or absent during the early stages of the disease, although there may be some early warning signs, as mentioned.
• Symptoms may not appear until colon cancer progresses to stage II or beyond. Therefore, regular screenings for colon or rectal cancer, especially colonoscopy, are recommended as part of a health plan for those over 50 or for individuals under 50 who are at increased risk, have a family history of the disease, or other types of cancer.

Do colon cancer symptoms differ in women?

• The symptoms are the same for everyone. Additionally, if a menstruating woman has anemia caused by colon cancer, she may experience irregular menstrual cycles.
• Symptoms of menstrual cramps and bloating can be confused with those of colon and rectal cancer, but these symptoms are not commonly associated with colon and rectal cancer except depending on the size and location of the tumor. It can be challenging to pinpoint the source of abdominal and pelvic symptoms, as the bleeding may be menstrual or rectal.

Benign colon tumors:

• A benign tumor in the colon or rectum is a non-cancerous growth that does not spread to other parts of the body and is usually not life-threatening. Most of these tumors are polyps that attach to the lining of the colon or rectum and grow toward the center of the hollow tube of the colon.
• Benign tumors in the colon or rectum are usually discovered during a colonoscopy and are removed so they can be examined under a microscope for diagnosis. The standard treatment for benign colon tumors is surgery to remove them.

Rectal cancer:

Rectal cancer typically grows slowly and forms in the inner lining of the rectum, which is the last part of the large intestine. This cancer usually begins as polyps or adenomatous tumors and can transform into a malignant tumor.
The symptoms of rectal cancer are like those of colon cancer, so it is common to group them, such as:
• Rectal bleeding.
• Diarrhea.
• Constipation.
• A sudden change in how and when you have a bowel movement.
• Stool that looks stringy or thin as a pencil.
The doctor uses test results to determine the stage of cancer. Rectal cancer is classified into five different stages (0-4), with stages 3 and 4 being the most advanced and dangerous.

Treatment for rectal cancer:

1. Without surgery: Depending on the patient's condition, the doctor may opt for active surveillance. Active surveillance is sometimes referred to as watchful waiting, where the doctor closely monitors the overall health and symptoms. Other treatment options may include chemotherapy, radiation therapy, immunotherapy, or targeted therapy.
2. Surgery: Surgical removal of tumors is one of the most common treatments for rectal cancer. This includes procedures such as transanal endoscopic microsurgery, where a surgeon removes small cancers from the rectum using a special endoscope inserted through the anus. This treatment is recommended if the tumor is small and unlikely to spread. If the tumor is large, the surgeon may remove the entire rectum or part of it.

Intestinal and colon cancer:

The intestines are divided into the small intestine and the large intestine, which includes the colon, rectum, and anus. Bowel cancer often begins in the large intestine and is also called colorectal cancer. Cancer is usually preceded by the appearance of growths called polyps, which may develop into invasive cancer if not detected. Cancer can also start in the small intestine, but this is rare.
Symptoms of bowel cancer:
When it comes to small bowel cancer, diagnosis can be challenging as its symptoms are like those of colorectal cancer, such as:
• Rectal bleeding.
• Blood in stool.
• Frequent changes in bowel habits.
• Abdominal pain or mass.
Experiencing these symptoms does not always mean you have intestinal or colon cancer, but it is important to consult the best cancer doctors in Iraq at the Warith International Cancer Institute.

Colon and stomach cancer:

The symptoms depend on the type and stage of colon and stomach cancer. Cancer can spread to any part of the digestive system. Because the digestive system is a continuous system that includes the stomach, colon, and rectum, many of these cancers cause similar symptoms.
Symptoms of colon and stomach cancer include the symptoms mentioned above for colon cancer, as well as symptoms of stomach cancer such as:
• Bloating, even after a small meal.
• Blood in the stool. 
• Trouble swallowing.
• Nausea and some other symptoms.

Is there a difference between colon ulcers and cancer?

1. The symptoms of ulcers and colon cancer may sometimes be similar, but they are completely different conditions.
2. Colon ulcers and cancer share some common symptoms, such as abdominal pain, changes in bowel habits, blood in the stool, and fatigue.
Certain types of ulcers may be more closely associated with colorectal cancer than others. Some of these types include:
• Duodenal ulcers, which affect the upper part of the small intestine.
• Ulcers in the colon result from ulcerative colitis (UC), an inflammatory bowel disease (IBD).
3. If you have ulcerative colitis, you may be at a higher risk for colorectal cancer. This condition causes long-term ulcers and inflammation in the lining of the intestines, which increases the risk of cancer. Persistent inflammation can lead to cellular damage, and as the body attempts to repair this damage, cancer may develop.

The difference between symptoms of colon cancer and irritable bowel syndrome (IBS):

1. Irritable bowel syndrome (IBS) and colon cancer may share many symptoms. However, living with IBS does not increase a person's risk of developing cancer.
2. Irritable bowel syndrome (IBS) is a chronic condition that causes abdominal pain and other symptoms. This condition affects the colon like colon cancer and may cause similar symptoms in some individuals.
3. The symptoms of irritable bowel syndrome (IBS) and colon cancer can be similar. However, in cases of colon cancer, a person may experience unexplained weight loss, blood in the stool, or rectal bleeding, which do not occur with IBS.
4. People with irritable bowel syndrome (IBS) may experience some of the following symptoms:
o Abdominal pain is often associated with bowel movements.
o Changes in bowel movements, which may include constipation, diarrhea, or possibly both.

Diagnosis of colon cancer:

• Early diagnosis of colon cancer gives you the best chance for recovery. Since colon cancer does not show symptoms in its early stages, it is often discovered during routine screenings, such as stool tests for colon cancer, which can detect blood in the stool of patients with cancer.
• Routine screenings include a physical exam where the doctor presses on the abdomen to check for any lumps. A rectal exam may also reveal a mass in individuals with rectal cancer, but not in cases of colon cancer.
• If problems are found during a routine screening, the doctor may suggest several additional tests to confirm the diagnosis, such as:
1. Colonoscopy: A thin tube is inserted through the anus into the rectum and colon to examine the area closely. A biopsy can be taken from any mass and examined in the lab to check for cancerous cells.
2. X-rays: A contrast solution containing barium is used. The doctor inserts this liquid into the intestines using a barium enema. The barium coats the lining of the colon, improving the quality of the X-ray images.

Does colon cancer show up in a blood test?

Blood tests are not used to directly diagnose colon cancer, but they can assist in the diagnosis. They can also be used to monitor the disease after diagnosis. These tests include:
1. Complete blood count (CBC): This test measures the different types of cells in the blood and can indicate if you have anemia or a decrease in red blood cells. Some people with colon and rectal cancer develop anemia because the tumor may cause long-term bleeding.
2. Liver enzymes: Blood tests may also be done to check liver function, as colon and rectal cancer can spread to the liver.
3. Tumor Markers: Colon and rectal cancer cells sometimes produce substances called tumor markers, which can be found in the blood. The most common tumor marker for colorectal cancer is a carcinoembryonic antigen (CEA). These tumor markers can sometimes indicate the likelihood of a person having cancer, but they cannot be used alone to screen for or diagnose cancer; this is because tumor marker levels may be normal in someone with cancer and may be abnormal for reasons other than cancer.
4. CRP and colon cancer: C-reactive protein (CRP) is produced in the liver and is associated with risks of cardiovascular diseases or mortality, including cancer. It may be used to predict prognosis in cancer patients. 
• CRP protein levels in the plasma rise during inflammation and among individuals who later develop cancer, supporting the hypothesis that inflammation increases the risk of this cancer. Chronic inflammation can lead to cell damage, and as the body attempts to repair this damage, cancer may arise.
• Although there is laboratory evidence supporting the role of inflammation in colorectal cancer, epidemiological studies are limited. Ulcerative colitis, as a chronic inflammatory bowel disease, is associated with an increased risk of cancer.

Treatment of colon cancer in Iraq:

1. Surgery:

 • Surgery is often the primary treatment for early-stage colon cancer. The type of surgery used depends on the stage of the cancer, the size and location of the tumor in the colon, and the goals of the surgery.
• The surgeon may need to remove part of the colon or rectum and nearby lymph nodes if the cancer has spread to the walls of the intestines. The surgeon might be able to reconnect the remaining healthy part of the colon to the rectum. If this is not possible, a colostomy may be performed. This involves creating an opening in the abdominal wall to remove waste.

2. Chemotherapy sessions for colon cancer:

• Chemotherapy involves using drugs to kill cancer cells. For individuals with colon and rectal cancer, chemotherapy is typically used after surgery to destroy any remaining cancer cells.
• Chemotherapy doses for colon cancer are administered either through intravenous injections or orally. These drugs travel through the bloodstream and reach most parts of the body.

3. Other medications for colon cancer:

• Targeted therapies and immunotherapies work differently from chemotherapy drugs. Targeted therapy is sometimes used when chemotherapy drugs are not effective and often has different side effects. These treatments can be used either in combination with chemotherapy, on their own, or with other targeted therapies.
• Immunotherapy aims to use medications to boost a person's immune system to recognize and destroy cancer cells more effectively.

Warith International Cancer Institute (WICI) is distinguished by its molecular testing for colorectal cancer, which is currently the standard of care for guiding the use of FDA-approved targeted therapies. The test includes 13 genetic analyses aimed at determining the optimal treatment for colorectal cancer using a unique NGS device at the best hospital for colon cancer treatment in Iraq, Warith International Cancer Institute. This contributes to achieving successful outcomes in colorectal cancer cases.

Colon cancer survival rate:

Many people wonder about the survival rates for colon cancer or rectal cancer. Survival rates refer to the percentage of individuals with the same type and stage of cancer who remain alive after a certain period (usually 5 years) following diagnosis.
Although it does not determine the lifespan of a colon cancer patient, it helps in understanding the likelihood of treatment success. These rates are as follows:
1. Localized: The cancer has not spread beyond the colon or rectum.
Colon cancer: The 5-year survival rate is up to 91%. For rectal cancer, it is up to 90%.
2. Regional: The cancer has spread to nearby tissues or nearby lymph nodes.
Colon cancer: The 5-year survival rate is up to 73%. For rectal cancer, it is up to 74%.
3. Distant or metastatic: The cancer has spread to distant parts of the body, such as the liver, lungs, or distant lymph nodes.
Colon cancer: The 5-year survival rate is up to 13%. For rectal cancer, it is up to 18%.

Can colon cancer be cured permanently?

Many people wonder if colon cancer is curable or if colon cancer is fatal. Colon cancer is highly treatable, especially when it is localized in the intestine. Surgery is the primary treatment, and the success rate of colon cancer resection is about 50%. It depends on the stage of the cancer. However, recurrence of the disease after surgery is a significant issue and is often the cause of death.

Is colon cancer fast-spreading?

In most cases, colon and rectal cancers grow slowly over many years. This cancer usually starts as polyps or adenomatous tumors. Removing polyps early can prevent them from turning into cancer.

How can colon cancer be avoided?

Some risk factors for colon cancer, such as family history and age, cannot be avoided. However, lifestyle factors that may contribute to colon cancer are preventable, and changing them may help reduce your overall risk of developing the disease, such as:
• Reduce the amount of red meat.
• Exercise daily.
• Quit smoking.
• Eat a healthy, balanced diet.

Experiences of colon cancer patients:

The experiences of cancer patients vary within the Warith International Cancer Institute (WICI). Let me share my experience with colon cancer, which is one of the cases that successfully recovered from metastatic colon cancer:
• I am Issa Latif Begaye, 29 years old, from the Dhi Qar Governorate. At the beginning of 2022, I began experiencing painful symptoms in various parts of my body. After undergoing tests, it was revealed that I had colorectal cancer, and it was at stage four, having spread to the lymph nodes and abdominal cavity.
• I started treatment immediately and received 6 rounds of chemotherapy at the Haboubi Center in Dhi Qar Governorate.
• After completing the chemotherapy phase, I moved on to radiation therapy. However, I was shocked to learn that the necessary equipment for the treatment was not available in Iraq. My family began searching for a way to travel abroad for treatment. During this time, we heard about the Warith International Cancer Institute in Karbala Governorate.
• When we visited the Warith International Cancer Institute, we discovered they had very advanced technologies for treating my condition. I began treatment there and received excellent care, particularly from the psychological support department. I underwent radiation therapy followed by interventional treatment through surgery. The PET revealed that the disease had been reduced by 88%.
• After the doctors at the Warith Institute discussed my case, I underwent laparoscopic surgery on April 24, 2023, and the procedure was successful. Thank God, my condition is continuously improving.

Remember, you can fight cancer with the Warith International Cancer Institute (WICI), the best institution in Iraq for cancer treatment, offering the latest treatment methods for cancer patients.