When bowel cancer is mentioned, the first thing that comes to mind is colon cancer, that is, colon cancer. Uncontrolled proliferation of cells in the inner layer of the intestines causes the development of intestinal tumors. Benign tumors of the intestine are called polypcolonoscopy. When it turns into a malignant state, cancer is mentioned. Polyps do not spread to the surrounding tissues and are easily removed with a method called polypectomy. Bowel cancers usually develop from polyps. For this reason, if polyps are not removed early, they are likely to turn into cancer over time. If the cancer is not treated in the early stages, it is normal for the cancer cells to spread to other organs such as the liver, lung and bone. The spread of cancer cells to other organs is called metastasis. Bowel cancer is common in all societies. The incidence of cancers is third in men and fourth in women. Its incidence in Western countries is higher than in Asian and African countries. The transition of societies to western-style nutrition increases the frequency of bowel cancer.
What are the causes of bowel cancer?
It is not known for every patient. However, it is known that there are some factors that facilitate bowel cancer. Obesity, high-fat diet, having a family history of bowel cancer or polyps, and having a chronic ulcerative bowel disease called polyp or ulcerative colitis in the patient’s bowel are risk factors for developing bowel cancer.
What is the relationship between bowel cancer and diet? Western diet increases the risk of bowel cancer. The most important factor here is associated with a high-fat diet. On the other hand, breads made with fresh vegetables and fruits and cereals that have not been separated from the bran and calcium reduce the risk.
Does every patient with ulcerative colitis get bowel cancer?
No. In cases where ulcerative colitis or similar Crohn’s disease affects the large intestine, the risk of developing bowel cancer increases compared to normal people. This risk increases as the duration of the disease increases, the area retained in the intestine increases, the patient remains untreated, and in cases where a disease called sclerosing cholangitis is associated. Knowing this situation, if the patients are followed within a certain program, the risk can be reduced and even if the cancer will develop, it can be detected very early.
What are the symptoms of bowel cancer? There may be many symptoms, but none of them are specific to bowel cancer. They can also be seen in other diseases. These may include signs of anemia (weakness, tiring), change in toilet habits (newly occurring persistent diarrhea or constipation), change in stool shape, presence of red or dark blood in stool, weight loss, abdominal pain and bloating.
Which tests can be used for diagnosis?
Medicated bowel film and colonoscopy are the main diagnostic methods. Because of its low sensitivity, medicated bowel film does not allow biopsy and polyp removal, it is not used much today. In recent years, colonoscopy with tomography and called virtual has also been used in diagnosis. The sensitivity of this method is high. In addition, if there is cancer, it can be useful in terms of showing whether it has spread to the surrounding tissues. However, repeat classical colonoscopy may be needed for biopsy or polyp removal.
Can the development of colon cancer be prevented?
Unfortunately, nowadays, this predisposition cannot be eliminated in a person who has a predisposition to develop bowel cancer. However, if the risk factors for cancer are known and the patients are followed accordingly, the development of cancer can be prevented. Since most bowel cancers develop from polyps, removing polyps when detected prevents cancer development. In addition, if there is bowel cancer in the family, if the patient has been treated for bowel cancer or polyp before, and if the presence of ulcerative colitis is known, these patients can be checked with colonoscopy at regular intervals to keep the development of bowel cancer under control.
When and how often should colonoscopy be done for control? If there is no colon cancer or polyp in a first degree relative of a person without bowel complaints, it is recommended to have a control colonoscopy at the age of 50. If the intestines are found to be normal in this colonoscopy, it is sufficient to have a colonoscopy every 10 years. If a polyp is detected in the first colonoscopy performed around the age of 50, the next colonoscopy time varies according to the number of polyps and the size of the polyps. This period can be 1, 3 or 5 years.
A person with a first degree relative over the age of 60 with colon cancer should have their first colonoscopy at the age of 40 and then be followed up as normal risk patients. If a first-degree relative with colon cancer is younger than 60 years of age or if more than one relative has colon cancer, colonoscopy should be performed 10 years before the age of the latest relative with cancer or at 40 years of age (whichever comes first), then the colonoscopy should be repeated at 5 years intervals.
People with gynecological cancer before the age of 50 also have an increased risk of colon cancer. These patients should have a colonoscopy every 5 years.
How is colon cancer treated? After the diagnosis of cancer, except in exceptional cases, the treatment is surgery? In the surgery, the tumorous area is removed together with a certain amount of the right area at the edges, and the two exposed intestines are sutured end to end. Depending on the region of the disease and the extent of the disease, chemotherapy and sometimes radiotherapy (radiation therapy) should be added to the treatment. In an early stage cancer, surgical treatment alone is sufficient.
