Colorectal Cancer

  • Overview


    Bowel cancer is cancer in any part of the large bowel (colon or rectum). It is sometimes also known as colorectal cancer.

    Bowel cancer grows from the inner lining of the bowel (mucosa). It may develop from growths on the bowel wall called polyps. Polyps are usually harmless (benign), but they may become cancerous (malignant) over time. Malignant polyps may be small or large, flat or mushroom-shaped.

    If untreated, bowel cancer can grow locally into the deeper layers of the bowel wall. It can spread from there to the lymph nodes (glands). These small, bean-shaped masses are part of the body’s lymphatic system. If the cancer advances further, it can spread to other organs, such as the liver or lungs (metastasis).

    In most cases, it develops fairly slowly and stays in the bowel for months or years before spreading.


    Cancer Council NSW

    Information extracted from the Cancer Council NSW website and reproduced with permission.

    http://www.cancercouncil.com.au/808/b1000/bowel-cancer-11/what-is-bowel-cancer-2/?pp=32240&cc=9561&ct=2

    © Cancer Council NSW 2013


    Symptoms


    In its early stages, bowel cancer often has no symptoms. However, some people may experience the following:

    • a change in bowel habits, such as diarrhoea, constipation, or smaller, more frequent bowel movements
    • a change in appearance of bowel movements (e.g. narrower stools or mucus in stools)
    • a feeling of fullness or bloating in the bowel or rectum
    • a feeling that the bowel hasn’t emptied completely after a bowel movement
    • blood in the stools or on the toilet paper
    • unexplained weight loss
    • weakness or fatigue
    • rectal or anal pain
    • a lump in the rectum or anus
    • abdominal pain or swelling
    • a low red blood cell count (anaemia), which can cause tiredness and weakness.

    Not everyone who has these symptoms has bowel cancer. Other medical conditions, such as haemorrhoids or tears in anal tissue, and some foods or medications, can also cause these changes.

    If you have any of the above symptoms for more than two weeks, see your doctor for a check-up.

    Diagnosis


    Your GP will examine you and refer you to a specialist for further tests. The tests you have depend on your specific situation and may include:

    • general tests to check your overall health and body function
    • tests to find cancer
    • tests to see if the cancer has spread (metastasised).

    Some tests may be repeated during or after treatment to check how well the treatment is working.


    Cancer Council NSW

    Information extracted from the Cancer Council NSW website and reproduced with permission.

    http://www.cancercouncil.com.au/1341/cancer-information/cancer-diagnosis-and-symptoms/cancerdiagnosis/bowel-cancer-diagnosis/?pp=32244&cc=3309&&ct=2

    © Cancer Council NSW 2013


  • Radiotherapy for bowel cancer


    Radiotherapy uses high-energy x-rays or electron beams (radiation) to kill or damage cancer cells. The radiation is targeted to cancer sites in your body, and treatment is carefully planned to do as little harm as possible to your normal body tissue around the cancer.

    Radiotherapy is often part of the treatment for rectal cancer. It can also be given:

    • before or after surgery, to reduce the chance of the cancer coming back
    • instead of surgery
    • at the same time as chemotherapy (chemoradiation)
    • as a palliative treatment.

    During treatment, you will lie under a machine that delivers x-ray beams to the treatment area. Each treatment only takes a few minutes once it has started, but setting up the machine and seeing the radiation oncologist may take more time.

    If radiotherapy is given along with chemotherapy for rectal cancer, you will probably have it once a day, Monday to Friday, for about 5–7 weeks. You may have a shorter course of radiotherapy if it is given by itself. The number of treatments you have depends on your radiation oncologist’s recommendation.

    Side effects

    Radiotherapy can cause temporary and permanent side effects. Side effects of radiotherapy may include:

    • bleeding
    • diarrhoea
    • nausea
    • tiredness or fatigue
    • mild headaches
    • urinary or faecal incontinence
    • redness and soreness in the treatment area
    • reduced fertility.

    People react to treatment differently, so some people may have few side effects while others have many. Tell your treatment team about the side effects you have so they can give you advice about how to manage them.


    Cancer Council NSW

    Information extracted from the Cancer Council NSW website and reproduced with permission.

    http://www.cancercouncil.com.au/75140/cancer-information/cancer-treatment/types-of-treatment/radiotherapy-for-bowel-cancer/?pp=33113&cc=254&&ct=2

    © Cancer Council NSW 2013


    Chemotherapy for bowel cancer


    Chemotherapy is the treatment of cancer with anti-cancer (cytotoxic) drugs. The aim of chemotherapy is to kill cancer cells while doing the least possible damage to healthy cells. If the cancer is contained inside the bowel, surgery is usually the only treatment needed and chemotherapy is not used.

    Chemotherapy may be used for the following reasons:

    • Neo-adjuvant therapy – Some people who have surgery have chemotherapy (and/or radiotherapy) beforehand to shrink the tumour and make it easier to remove during surgery.
    • Adjuvant chemotherapy – Chemotherapy is often recommended for people after surgery if the cancer hasn’t been completely removed or if it has spread into the lymph nodes. Chemotherapy may be given if there is a chance the cancer could come back, or as treatment if the cancer does come back.
    • Palliative treatment – If the cancer has spread to other organs, such as the liver or bones, chemotherapy may be used to reduce your symptoms and make you more comfortable.

    If you have chemotherapy after surgery, you will probably have 6–8 weeks to recover. You will start chemotherapy when your wounds are healed and you are strong enough.

    Chemotherapy drugs are usually injected into a vein (given intravenously) or supplied in tablet form. Some people have a small medical appliance called a port-a-cath or catheter placed beneath their skin through which they receive chemotherapy. You will probably have sessions of chemotherapy over several weeks or months. Your medical team will work out your treatment schedule.Your doctor may advise you to use contraception during chemotherapy, due to the effects of the drugs.


    Cancer Council NSW

    Information extracted from the Cancer Council NSW website and reproduced with permission.

    http://www.cancercouncil.com.au/75139/cancer-information/cancer-treatment/types-of-treatment/chemotherapy-for-bowel-cancer/?pp=33113&cc=254&ct=2

    © Cancer Council NSW 2013


    Side effects

    Some chemotherapy drugs can cause side effects. The side effects depend on the drugs used and the dosage levels. The most common side effects include:

    • tiredness
    • feeling sick (nausea)
    • diarrhoea
    • mouth sores and ulcers
    • loss of appetite
    • sore hands or feet
    • a drop in levels of blood cells
    • skin peeling and increased sensitivity to sunlight, particularly for people who are given a type of chemotherapy
    • called fluorouracil (or 5FU).

    People react to treatment differently – some people may have few side effects while others have many. Most side effects are temporary, and there are ways to prevent or reduce them. Your doctor may prescribe medication to manage the side effects, arrange a break in your treatment, or change your treatment.

    Surgery for rectal and anal cancers

    There are different types of surgery for bowel cancer. The aim of surgery is to remove all the cancer and nearby lymph nodes.


    Cancer Council NSW

    Information extracted from the Cancer Council NSW website and reproduced with permission.

    http://www.cancercouncil.com.au/75136/cancer-information/cancer-treatment/types-of-treatment/surgery-for-rectal-and-anal-cancers/?pp=33113&cc=254&ct=2

    © Cancer Council NSW 2013


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