General Surgery and Gastroenterology Surgery Specialist Assoc. Dr. Ufuk Arslan gave important information about the subject. The colon and rectum make up the part of the digestive system called the large intestine. The last 15-20 cm is called the rectum, and the part from here to the small intestine is called the colon. It is approximately 1,5 m long in total. Where the colon meets the rectum is the sigmoid colon. The place where the colon meets the small intestine is called the cecum. Partially digested food comes from the small intestine to the colon. The colon separates the water and minerals from the food, and stores the rest for removal from the anus. Colon and rectal cancers develop from the cells that form the layer that covers the inner surface of these organs. According to the statistics of the Ministry of Health, it is among the top 5 most common cancers. Although they can be seen at any age, they are most common after the age of 50. The average age of occurrence is 63. There is not much difference in incidence between men and women. When colorectal cancer grows outside the colon and rectum, cancer cells can often be found in nearby lymph nodes. If cancer cells can reach these lymph nodes, they can reach other glands, liver and distant organs.
Risk Factors in Colorectal Cancers
The risk factors for colorectal cancer are age, polyps, family history of colorectal cancer, hereditary nonpolyposis colon cancer, ulcerative colitis or Crohn's disease, smoking, and those who eat a diet rich in animal fat but low in calcium, folate and fiber have an increased risk of colorectal cancer. A diet poor in fruits and vegetables also increases the risk.
Symptoms in Colorectal Cancers
The signs and symptoms of colon cancers vary according to the stage of the tumor. While the tumor does not give any symptoms when it grows into the intestine, it can give symptoms ranging from the situation when it is completely blocked, to the situation where the patient cannot remove gas and stool. A clinically important situation here is that the diameter of the intestine on the right side is wider than the left and the signs of transit are later. The symptoms observed in tumors on the right side of the large intestine are unnoticed blood loss with stool and anemia due to this bleeding, weakness, shortness of breath, fatigue, and changes in defecation habits. Constipation and diarrhea attacks from time to time, abdominal pain, bloating, thinner stool than usual, weight loss are other findings. The most common location of large intestine tumors is on the left side, which is one of the narrow parts of the large intestine. Therefore, intestinal obstructions are more common in left-sided tumors. The most common finding in tumors on the side of the rectum, that is, near the anus, is blood contamination in the stool. One of the conditions to be considered here is that in the disease called hemorrhoids, blood is observed in the stool and the person may delay the diagnosis and treatment by confusing this situation. Changes in defecation habits, thinning of stool diameter, constipation, incomplete evacuation after defecation, bloating are other findings observed. When you suspect these findings, you should consult a doctor.
Treatment in Colorectal Cancers
Surgical treatment is the main step in the treatment of cancer. But for this, the cancer must not have spread to distant organs (liver, lung, brain, bone, etc.). In the surgical method, the tumor part is removed together with the surrounding healthy tissue. In addition, tissue called mesentery that connects the intestine to the body and lymph nodes are also removed. In rectal cancers, the tumor is removed along with a part of the left side of the large intestine and the two ends are joined together. In cases where joining is not possible, the surgeon mouths the end of the intact intestine to the abdominal wall and closes the other end. This is called a colostomy. In most patients, this is temporary, and is closed when the colon or rectum heals after surgery. Colostomy may be permanent in patients with tumors in the lower rectum, very close to the anus. In recent years, especially in intestinal tumors that spread to the liver and lungs, surgical treatment is now applied in cases where the tumor in that region is completely removed and the results are satisfactory.