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Colorectal cancer, is a disease of the cells lining the inner lining of the colon. It develops from an initially normal cell that changes and multiplies uncontrollably, forming a mass called a malignant tumor (or cancer).


After prostate and lung cancer, colorectal cancer is the third most common cancer in men.

Cancer Colorectal



Risk factors for colon cancer

It is also about lifestyles:

ü  High consumption of red meat.

ü  A diet too rich in animal fats in particular.

ü  Obesity.

ü  Physical inactivity.

ü  Alcohol consumption.

ü  Smoking.

Age increases the risk of developing colon cancer: 9 out of 10 people with colon cancer are over the age of 50.

A family history of rectal or colon cancer is also a risk factor.


The risk of colon cancer is increased in people with chronic inflammatory bowel diseases (e.g., Crohn's disease and ulcerative colitis), genetic diseases (familial adenomatous polyposis), and Lynch syndrome (or HNPCC).

Symptoms of colorectal cancer

  ü  The presence of abdominal pain.

  ü  Blood in the stool.

  ü  Persistent diarrhea.

  ü  Sudden or worsening constipation.

  ü  Alternating diarrhea and constipation.

  ü  A constant need to defecate.

  ü  Unexplained anemia.

  ü  A Mass on abdominal palpation.

  ü  Unexplained deterioration in general health status, especially weight loss and loss of appetite,                decreased food intake, and fatigue.

Colorectal cancer may also be suspected when the immunological test for blood in the stool, which is performed as part of the national screening program for colorectal cancer, is positive.

Colorectal cancer development

When cancer develops, the cancer cells are initially small in number and confined to the first layer of the wall of the colon, the mucous membrane. This is called cancer in situ.

Over time and if left untreated, the cancer spreads deeper into the wall through the other layers. This is called invasive cancer.

Cancer cells can also break free from the tumor and move through lymph or blood vessels to invade other parts of the body:

ü  Liver, lung, peritoneum, brain, or bone. The new tumors that develop are known as metastases.

ü  Lymph nodes near the colon.

From benign tumors to cancer

In 80% of cases, intestinal cancer develops from a benign, that is, non-malignant tumor. This is called an adenomatous polyp or adenoma.

These benign tumors are very common and usually not serious, but 2-3 % develop, grow and eventually become cancerous. This change is slow and takes more than 10 years on average.

Colorectal cancer diagnosis

        1.       Screening test or koloskopi

The proposed screening method depends on the level of risk:

  ü  People at high or very high risk should have a colonoscopy. This visual examination of the colon           using an endoscope inserted through the anus is the best method for diagnosing colorectal polyps        and colon cancer. During the colonoscopy, the gastroenterologist can take a sample to determine            whether the lesion is benign or malignant and determine its stage.

  ü  People at average risk are offered a stool blood test and a colonoscopy if the result is positive. With       the first generation of fecal tests (Hemoccult®), organized screening has been shown to reduce            colorectal cancer mortality. Now there is a new generation of testing: the fecal immunoassay is much     more effective and detects 2.5 times more cancers (especially stage 1, which is easily treatable) and 4     times more advanced adenomas, benign precursors to cancer, which, when removed, prevent the            cancer from developing.

        2.       Fecal Immunology Test (FIT)

It is easy to perform and consists of taking a stool sample at home with a collection kit and sending it to the appropriate medical/biological laboratory within five days. Results are available within two weeks. If the test is positive (about 4 percent of cases), a colonoscopy is needed because in 1 in 10 cases cancer is detected (usually stage 1) and in 4 in 10 cases an adenoma or polyp is removed during the exam.        

        3.       Colonoscopy

A colonoscopy is not a routine procedure and is therefore only performed in high or very high risk individuals and in 4% of medium risk individuals but with a positive FIT test. It is obviously indicated in patients with symptoms suggestive of colorectal cancer (see warning signs). It should be noted that a so-called "preventive" colonoscopy is also possible from the age of 50 for anyone, even without risk factors, who requests it, after being informed of the possible risks and benefits.


In patients diagnosed with colorectal cancer, CT scans of the chest, abdomen, and pelvis are useful to assess the extent of the cancer as part of the pre-treatment process so that an treatment plan can be developed.

If the cancer is located in the rectum, MRI or, in some cases, endorectal ultrasound can be used to determine whether the cancer has spread to neighboring organs (bladder, prostate, uterus) and whether the lymph nodes (located in the fat surrounding the colon or rectum) have been affected by cancer cells.


Colon cancer treatments

The main treatments are surgery and drug therapy (conventional chemotherapy and/or targeted therapy). They can also be used singly or in combinations.

        1.       Kirurgi

In surgical treatment, the surgeon makes a temporary stoma to divert the flow of stool so that it does not interfere with internal healing.

        2.       Anticancer drugs: Chemotherapy and targeted therapies

Treatment with drugs is not systematic and the protocol varies depending on the site and stage of the cancer. It is important to monitor weight and temperature.

Drugs are designed to destroy all cancer cells, no matter where they are in the body. Several types of drug therapies are used to treat colon cancer: conventional chemotherapy and targeted chemotherapy.
Conventional chemotherapy prevents cell division, while targeted therapy drugs target the mechanisms by which cancer cells develop and spread. When treatment is administered intravenously, an implantable chamber is inserted through which the drug is injected during a small surgical procedure.




After the first treatment, regular follow-up is necessary for the rest of your life. Your professional treatment team plays an important role in this follow-up, along with your personal physician.

Follow-up includes consultations during which your doctor will ask you about your symptoms, examine you, and prescribe certain tests.

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