Our intestine is part of the digestive system. It is made up of:
The colon and rectum are parts of the large intestine. These are parts of our digestive system and are together known as large bowel.
The colon is a U-shaped cavity made of muscle and located right below the stomach. It absorbs large quantities of water, salts, and nutrients from undigested remaining food material as they pass through it. The waste material that remains after being absorbed in the colon goes to the rectum. The rectum is located at the end of the colon and stores faeces and waste material before they are passed out of the body through the anus. Rectum is the last 6 inches chamber of the digestive system.
At the end of the rectum are located sphincter muscles. These sphincter muscles prevent the rectum from emptying out the waste accidentally. When a person is ready for bowel movement, the sphincter muscles relax and, with straining, the waste is pushed out.
The colon and rectum together are about 2 metres (6 feet) in length. Other organs such as the pancreas, spleen, liver, bladder and human reproductive organs are located around the colon.
Colorectal cancer, also known as bowel cancer, colon cancer or rectal cancer, depending on where they start from, is a cancer of the colon and the rectum. It starts in the colon or the rectum. Colon cancer and rectal cancer are often grouped together because many features are common in them.
According to World Health Organization and CDC, it is the second most common cancer worldwide, after lung cancer. According to American Cancer Society, about 1 in 20 people in the US will develop colorectal cancer during their lifetime.
The risk of developing colorectal cancer is slightly higher in men than in women. Most people diagnosed with it are above the age of 60.
Any cancer starts when the growth of cells in our body becomes out of control. Technically, cells in almost any part of our body can become cancer and can divide in an uncontrolled way, and can also spread to other areas of the body.
Mostly, colorectal cancers start as a growth called a polyp on the inner lining of the colon or the rectum. Not all polyps though are cancerous, but some polyps can change into cancer over a period of several years. There are two main types of polyps:
A polyp can grow into the wall of the colon or rectum if a cancer is formed in it. Finding and removing the polyps can help prevent the colorectal cancer.
Polyps may be small and may show no or little symptoms. Therefore, doctors recommend regular screening tests to help diagnose them and prevent their spread before they become colon cancer. To know about signs and symptoms of colorectal cancer, read this article.
The size of these polyps is linked to the development of cancer. Polyps less than 1 centimetre in size have a slightly lesser chance of becoming cancer, but those polyps that are larger than 2 centimetres have significantly higher chance of converting into cancer. Mostly, the colorectal cancers form from polyps in glandular tissues of intestinal linings.
The wall of the colon and rectum is made up of several layers. Colorectal cancer begins in the innermost layer, called mucosa, and can grow outward through other layers. Cancer cells can also grow into blood vessels or lymph vessels from where they can travel to surrounding lymph nodes or to various organs of the body. Based on how deep and far the cancer grows indicates the stage of the colorectal cancer.
If the colorectal cancer is diagnosed early and treated properly, when the tumor is still localized, there are greater chances of getting the cure – with about 5 year survival rates of about 90%. However, if the tumor continues to grow, the colorectal cancer can spread through the bowel wall to nearby lymph nodes, tissues, and organs, and into the bloodstream. In such conditions, successful treatment is difficult. You can read about tests and diagnosis of colorectal cancer here.
If the cancer develops in a polyp, there are high chances that it can grow into the wall of the colon or rectum. Colorectal cancer starts in the innermost layer of the colon called mucosa and advances outward through outer layers of the colon.
Cancer cells can also grow into blood vessels or lymph vessels from where they can travel to nearby lymph nodes or organs or to the distant parts of the body.
The stage of a colorectal cancer defines how aggressively the cancer grows into the wall and if it has spread outside of the original site that is the colon or rectum. When a doctor diagnoses colorectal cancer in a patient, the next step is to assign a stage to the cancer. Treatment of colorectal cancer depends on the stage of the cancer. Read about treatment of colorectal cancer.
Colorectal cancer or bowel cancer can start in the large bowel (colon) or the rectum, as discussed above. It is classified into different types based on the type of cell in which the cancer starts.
The various types of colorectal cancer are:
Adenocarcinomas originate in the gland cells in the lining of the colon wall (bowel wall). These gland cells produce mucus, which makes it easier for the poo (faeces or stool) to pass through the colon. It is the most common type of bowel cancer.
Adenocarcinoma can be of two types:
Squamous cells are skin cells that make up the lining of the colon and the gland cells. These tumors originate from the squamous cells.
Carcinoid is a type of slow growing tumour called a neuroendocrine tumour. They grow in hormone-producing tissue, mostly in the digestive system.
Sarcomas are generally cancers of the cells of bone or muscle. Most sarcomas in the colon are called leiomyosarcomas. They start in smooth muscle.
Lymphomas are cancers of the lymphatic system.
One major reason why cancer is considered so serious is its ability to spread beyond the original site in the body. Colorectal cancer cells can spread locally by moving into nearby normal tissue of the digestive system. Colorectal cancer can also spread regionally, to nearby lymph nodes, tissues, or organs. It can spread to distant parts of the body too. Technically speaking, it can spread to any part of the body.
When colorectal cancer spreads to other body parts (nearby or distant), it is called metastatic colorectal cancer. Sometimes, it is also called stage IV (four) colorectal cancer. This process by which cancer cells spread to other body parts is called metastasis.
It is found that metastatic cancer cells have features to that of the primary cancer and not like the cells of the region where the cancer is spread to. This characteristic of the metastatic cancer cells is used by doctor to understand if a cancer that has spread from another part of the body is a different cancer or a metastatic cancer originated from the primary site.
Any type of metastatic cancer has the same name as the primary cancer. For example, breast cancer that reaches to the lung is called metastatic breast cancer, and not lung cancer. Colorectal cancer that reaches to genital organs is called stage 4 colorectal cancer or metastatic colorectal cancer. It is treated as the stage 4 colorectal cancer is treated, and not as genital organ cancer.
Research epidemiology of metastatic colon and rectal cancer is quite challenging, because cancer registries and documentation often fail to record metastatic sites. Some research has been done on select group of population to identify metastatic spread in colon and rectal cancers and accordingly metastatic sites were identified. It was found that rectal cancer more frequently spread into thoracic organs and the nervous system and less frequently within the peritoneum.
Thoracic metastases are almost as common as liver metastases in cases of rectal cancer with a low stage at diagnosis. Metastatic patterns were found significantly different between colon and rectal cancers.
A research found that with metastatic colorectal cancer, the most common sites of metastasis were the liver, thorax , and peritoneum. In colon cancer, the third most common site was the peritoneum and in rectal cancer, it was bone. Nervous system metastases were also found in some cases of colon cancer and rectal cancer.
Approximately 20% of patients with colorectal cancer (CRC) already have metastases at the time of diagnosis. This figure has been almost same over the last two decades. In some studies, there is found a decreased cancer-specific mortality from CRC in screening groups. One of the reasons for this is that recent progress in metastasis research has greatly enhanced our understanding of metastasis on the cellular and molecular level.
The good news for people suffering with colon and rectal cancer is that the outlook or prognosis of colon and rectal cancer (colorectal cancer) has improved over the years. As stated by Colorectal Cancer Coalition, the survival rate for colon cancer patients has increased by approximately 30% from 1990 to 2010.
Colon cancer survival rates define the outlook or life expectancy of people suffering with colon cancer. Colon cancer survival rates are generally associated with rectal cancer or bowel cancer survival rates. The American Cancer Society (United States) had estimated that over 90,000 people might suffer with colon cancer and about 9,000 can be diagnosed with colorectal cancer in the recent years. Over 50,000 deaths were also predicted to happen due to colorectal cancer or bowel cancer.
Colon cancer is curable only during its early stages. About 90% of the patients have chances of surviving colon cancer. The only problem that arises is that during the initial stage (stage 1 or 2), the chances of diagnosing the cancer is below 40%. This is because the symptoms may not be prominent in the beginning or sometimes it may be due to an individual’s own ignorance.
Stage 2 colon cancer survival rate is about 60 to 65% and stage 3 colon cancer survival rate is approximately 50%. Chemotherapy and surgery improves the stage 3 colon cancer life expectancy. The treatment success rates of colon cancer or bowel cancer are much higher till stage 3.
The chances of survival of stage iv colon cancer patients become very less as cancer spreads to nearby lymph nodes, organs and even to distant body parts, known as metastatic colon cancer. Metastatic colon cancer life expectancy is about 11 % or less and this leads to death in most of the cases. The colon cancer mortality rate, however, has reduced in the recent years to up to half due to better screening techniques.
Colon and rectal cancer prognosis in younger age groups (below age 50) have improved and a study says that this rate has grown better from 6% in 1990 to 11% in 2013.
Studying relative survival rates provide a better and more precise strategy to perform the exact analysis of data. To study the statistics for colorectal cancer or bowel cancer survival rates, the number of patients with colon and rectal cancer are compared to the overall population. Colon cancer prognosis or rectal cancer survival rate is always higher during initial stages.
The 5-year survival rate defines approximate patient percentages (according to the stages) who have survived for a minimum of 5 years after being diagnosed with colon and rectal cancer.
Colon cancer survival rate depends on the time of diagnosis i.e. at what stage has the cancer been detected and how a person’s body responds to any treatment provided. The outlook and prognosis of colorectal cancer depends upon the stage (or extent) of the cancer, age of the person, general health of the person, etc. According to data provided by Surveillance, Epidemiology and End Results (SEER) Program (for cancer statistics) for five years from the 2007–2013, the average survival rate for colon cancer patients was about 65 percent.
Depending on the stage (TNM staging system), National Cancer Institute provided a 5-year estimated data on colon cancer patients:
The prognosis of colon cancer also depends on the age of a person. It is observed that about 65% of the cases are diagnosed in the mid 40s. The average age during diagnosis of colon cancer is about 50-65 years in men and 60 above in women.
Stage 3 colon cancer survival rate by age can be improved with the help of adjuvant therapy i.e. surgery followed by chemotherapy as a treatment option. Advanced bowel cancer life expectancy can also be increased up to 6 months with the help to of adjuvant therapy. Bowel cancer life expectancy has improved to about 50% in last 40 years due to better diagnosis and treatment plans.
Stage 4 colon cancer survival is difficult even at a younger age.
Colon cancer prognosis also depends upon the number of lymph glands affected by the cancer in your body. If a large number of lymph glands and nearby organs such as intestine, lungs or liver are affected due to colon cancer, then colon cancer or intestine cancer survival rate falls down.
If the stage 4 colon cancer spreads to liver or its nearby organs, the life expectancy becomes nil. Cancer can be cured even at stage 4 in some cases but there are high chances of its reoccurrence.
The survival rates of various cancers are only estimates and mathematical predictions; therefore they cannot always be correct. Survival or prognosis of cancer more-often depends on an individual’s body and lifestyle.
Treatment If you have colorectal cancer in, there’s good. . . .
Colorectal cancer does not cause symptoms right away. It. . . .
Colon cancer is cancer of the large intestine. In most cases, it. . . .
Can Colorectal Cancer Be Prevented? There is no way that you confirm. . . .
Diagnosis Colorectal cancer is often noted after symptoms. . . .
Causes It is generally not clear what causes colorectal. . . .