Colon (large intestine) cancer, one of the five most common types of cancer in our country, is usually found in people over 50 years of age. However, in the case of some familial diseases such as ulcerative colitis or familial polyposis, it can be seen under the age of 50 or even in the 20s. Pointing out that generally eating excessive oily and consuming fried foods play an important role in the emergence of the disease, General Surgery Specialist Prof. Dr. Özcan Gökçe also points out that obesity and smoking stand out as risk factors.
In some people over the age of 50, small protrusions called polyps begin to appear on the mucosal surface of the large intestine. Colon cancer develops in approximately 20-30% of these structures, called adenomatous polyps. The greater the number, the greater the risk. Pointing out that polyp characteristics determine the risk factors, Yeditepe University Faculty of Medicine Department of General Surgery and Yeditepe University Kozyatağı Hospital General Surgery Specialist Prof. Dr. Gökçe gives the following information: “If the base of these polyps is wide, the probability of cancer formation is high, whereas in fungal formations, that is, if the stem is thinner, the probability decreases. Sessile polyps with a wide base should be removed without delay. Some polyps, called villous adenomas, are also more prone to colon cancer. The conversion rate of these polyps, especially in the last part of the large intestine, to colon cancer is stated as 100 percent. Therefore, in people with villous adenoma, the polyps should be removed at an early stage and treated before they turn into colon cancer. Having polyps in a person does not always mean that they will encounter cancer. For example; While inflammatory polyps do not cause cancer, adenomatous polyps are defined as pre-cancerous. Therefore, if a polyp is found to be adenomatous in the pathological examination, it should be followed carefully.”
SYMPTOMS WITH BLEEDING
Polyps on the left side of the large intestine are manifested by bleeding, and those on the right side with a decrease in the hemoglobin value in the blood. Villous adenomas, on the other hand, give symptoms with the mucus that comes with the stool. In almost all large intestine tumors, especially those located on the left side, the presence of any linear bleeding foci on the stool can be a sign of colon cancer. Stating that the symptoms of tumors on the right and left side are different, Prof. Dr. Gökçe said, “The part up to the middle of the large intestine is defined as the right colon, and the part after the middle is defined as the left colon. Tumors on the left often present with obstructions such as inability to pass stool and constipation, since the diameter of the intestine is smaller in the left colon. The ones on the right do not obstruct because the diameter of the large intestine is wider, but it causes a decrease in hemoglobin in the blood. In general, tumors on the left are diagnosed early, while those on the right are diagnosed late.”
EARLY DIAGNOSIS IS IMPORTANT
In addition to diet, it is important for people over 50 to have a colonoscopy regularly in the prevention of colon cancer. Those with a family history of tumors should have a regular colonoscopy every year, and those who do not have a regular colonoscopy every five years. Because people with a familial history are at least seven times more likely to develop this disease than the rest of the population. Apart from colonoscopy, it is also important for everyone over the age of 50 to have a regular stool occult blood test. If the result of this test is slightly positive, the patient should be evaluated by colonoscopy. However, any bleeding, including hemorrhoids, can be effective in a positive test result.
TREATMENT CAN ALSO BE APPLIED DURING A COLONOSCOPY
Colon cancer can be treated by removing polyps detected at an early stage by colonoscopy. However, for this, there must be one fungal type of polyp and no tumor in the stem. In cases where regular colonoscopy is not performed, these types of colon cancer show themselves in more advanced stages. In these conditions, it may be necessary to perform a basic surgery and remove the entire large intestine. Pointing out that in the presence of familial polyps called multiple polyposis, it may be necessary to remove all of them because the polyp may settle in the entire large intestine. Dr. Gokce; “Such surgeries need to be performed in a wide spectrum, including the lymph nodes as much as possible. In this way, it can be ensured that there is no visible tumor in the body.”
LIVER TUMOR MUST BE REMOVED
Colon cancer can also spread to the liver. However, this does not mean that the patient cannot be treated. Unlike other types of cancer, if there is a spread to the liver, it is recommended that the liver tumor, that is, its metastasis, be removed as much as possible along with the surgical removal of the large intestine tumor in the same session. Especially in tumors called rectum, close to the exit of the colon, its proximity to the breech area becomes important.
CHEMOTHERAPY AND RADIOTHERAPY CAN ALSO BE ADDED TO THE TREATMENT
The vast majority of colon cancer patients treated with surgery can be given chemotherapy and sometimes radiotherapy. This is where the multidisciplinary treatment approach in colon cancer comes into play. Patients are followed up and treated by a team including an oncologist. Emphasizing that the treatment is usually started with surgery, followed by chemotherapy, but if the tumor is located below, close to the anus, the stage of the tumor is reduced with chemotherapy and radiotherapy first. Dr. Gökçe said, “After the tumor reaches the surgical margins, it can be surgically removed. This is called the sandwich treatment. In some cases, chemotherapy is applied first, followed by surgery. Finally, chemotherapy can be combined with radiotherapy when necessary.
Source: (BHA) – Beyaz News Agency
