CARCINOMA OF COLON
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
Intestinal blockage
Abdominal pain
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
Fig 1:
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:
- · 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.
Fig 2.
