PREMALIGNANT CONDITIONS leading to COLON CANCER:
Precancerous situations which lead to development of colon cancer are:
- · Polyps
- · Ulcerative Colitis
- · Increasing Age >50 years
- · Previous Colon Cancer Surgery
- · Family history of Colon Cancer or Polyposis
Polyps are usually adenomatous of 3 types:
- tubular adenoma,
- villous adenoma and
- tubulovillous adenomas.
Uncommon inherited conditions causing large number of polyps with multiple cancers are Polyposis Syndromes namely :
- Familial Adenomatous Polyposis (FAP) and
- Hereditary Non Polyposis Colon Cancer (HNPCC)
Video of surgey by auhor for total colonic polyposis with more than 13 localized cancers in a 12 year old is seen at:
SIGNS AND SYMPTOMS OF COLON CANCER:
Bleeding in stools , from rectum
Irregular bowel movements – constipation or diarrhea or both.
STAGING AND PROGNOSIS OF COLON CANCER: (See Fig 1)
- · Stage I Tumor confined to inner most lining of the colon wall only
- · Stage II Tumor confined to the wall of the colon, but not outside
- · Stage III Tumor extending to outer wall, to the lymph nodes
- · Stage IV Tumor extension to far away from colon like liver, umbilicus, neck mass,etc
Prognosis depends on the staging of colon cancer and is given in the above table (Fig1).
TREATMENT OF COLON CANCER:
- Stage I Surgery to remove the tumor and small amount of tissue around the tumor
- Stage II Standard surgery to remove the cancer with lymph nodes and an area surrounding the tumor. Chemotherapy may be required
- Stage III Surgery to remove cance with all involved lymph nodes + Chemotherapy + may need radiotherapy.
- Stage IV Surgery usually ineffective. Exception in the case of liver secondaries ( see table on prognosis).
PREVENTION OF COLON CANCER:(See Fig 2)
- · High risk groups for colon cancer should be screened periodically.
- · Familial groups, ulcerative colitis groups, earlier operated groups of patients should be under supervision.
- · Regular intake of Aspirin in case of polyps, high fibre diet and exercise help.