LARGE-INTESTINE CANCER

General Information

DEFINITION--Uncontrolled growth of malignant cells in the rectum or colon (large intestine). It is the second most common cancer site (following lung) in the U.S.

BODY PARTS INVOLVED--Large intestine, including the cecum, ascending colon, transverse colon, descending colon and sigmoid colon; rectum (50% of all colorectal cancers occur here).

SEX OR AGE MOST AFFECTED--Adults over 40.

SIGNS & SYMPTOMS

• No symptoms in the early stages (frequently).
• Bloody or black, tarry stools.
• Cramping abdominal pain.
• Feeling of fullness.
• Change in bowel habits, such as diarrhea, constipation or narrow caliber stools.
• Unexplained weight loss.
• Pain in the rectum.
• Anemia.
• Loss of bowel control (sometimes).

CAUSES--Unknown. Both genetic and environmental factors may contribute.

RISK INCREASES WITH

• Adults over 60.
• Ulcerative colitis and some other chronic disorders of the gastrointestinal tract.
• Improper diet that is low in fiber and high in fat.
• Previous rectal polyps.
• Family history of rectal polyps or colorectal cancer.

HOW TO PREVENT

• Eat a diet that is high in fiber and low in fat.
• If you fall into a high-risk group, have annual physical examinations and request rectal and colon exams.
• If you have any of the risk factors listed above, buy from your pharmacy a detection kit for blood in the stool. Check for bleeding every 2 months. Simple-to-use home test kits are available.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory blood studies.
• Sigmoidoscopy; colonoscopy (See Glossary for both).
• X-rays of the colon (barium enema) and kidney (intravenous pyelogram).
• CT scan, and ultrasound (See Glossary for both).

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Surgery to remove the tumor. It is sometimes necessary to divert the bowel through a surgical opening in the abdomen (see Colostomy in Surgery section). If you have a colostomy, you will require special instructions for care of the opening.
• Radiation treatment before and after surgery.

POSSIBLE COMPLICATIONS

• Spread to other body parts and death.
• Complications of surgery (infection, pneumonia, abscess).

PROBABLE OUTCOME--Overall outlook is variable depending on the stage the disease has reached when it is discovered. More than 50% of patients survive 5 years after surgery. The earlier the tumor is detected, the greater the chances for full recovery following treatment.

How To Treat

GENERAL MEASURES--

• The more you can learn and understand about this disorder, the more you will be able to make informed decisions about where to go for your care, the treatments available, the risks involved, side effects of therapy and expected outcome.
• See Resources for Additional Information.

MEDICATION--Your doctor may prescribe:

• Pain relievers.
• Medicine to regulate bowel movements.
• Anticancer drugs, although they are usually not very effective.

ACTIVITY--

• Avoid sports or activities that might injure the stoma (surgical bowel opening).
• Resume your normal activities, including sexual relations, as soon as possible after surgery. A colostomy should not prevent intercourse.

DIET--Eat a low-fat, high-fiber diet (see both in Appendix). Avoiding gas-producing foods may help symptoms (cabbage, beans, onions).

Call Your Doctor If

• You have symptoms of cancer of the large intestine, especially rectal bleeding or a significant change in bowel habits that lasts longer than 7 days.
• You develop anemia (fatigue, paleness and rapid heartbeat).