Colorectal cancer remains one of the most preventable types of cancer yet remains the second highest cause of cancer associated deaths in the United States. This calls for more awareness about the disease and a need to improve our body of knowledge about colorectal cancer. In our last post, we examined the symptoms, causes and risk factors (modifiable and non-modifiable) of the disease. Today, we pay closer attention to the types of colorectal cancer, the stages the disease can present at and the mediums through which medical practitioners diagnose the disease.

Types

Colorectal cancers are of different types and this is based on the type of cells that become cancerous and their origins. The different types include:

• Adenocarcinomas: this is the most common of all colorectal cancer cases. They take origin from mucus producing cells in the colon and or rectum.
• Sarcomas: this takes origin from the muscles of the colon and or rectum
• Lymphomas: they begin from the lymph nodes
• Carcinoids: when hormone producing cells in the intestinal tract become cancerous, they present as carcinoids.

Diagnosis

The diagnosis of colorectal cancer can only be made by a trained medical professional. It is often recommended that people who have higher risk of colorectal cancer begin screening early, as statistics tell us that 11% of colorectal cancer cases are often diagnosed at screening with these patients having no symptoms. Their prognosis is a whole lot better because it is often discovered at a very early stage which makes treatment more effective.

On consultation, your medical doctor will ask questions regarding your medical and family history, perform some clinical physical examinations on your abdomen, he would then send you for some tests to confirm or rule out suspicions of colorectal cancer. The tests include:

• Blood Tests: The blood test gives a picture of your overall health including the function of essential organs like the kidney and liver. it provides the doctor a clearer idea of what might be responsible for your symptoms. The level of chemical substances like the Carcinoembryonic antigen, CEA which is produced by colorectal cancers are also checked in the blood to help reach a diagnosis and monitor treatment response.
• Colonoscopy:This remains the gold standard for diagnosis of colorectal cancer. It involves the use of a long slender tube fitted with light and camera at the end. The doctor is able to view every aspect of the colon and rectum for polyps and cancerous lesions. Surgical tools can also be guided through the tube to take tissue samples for biopsy analysis.
• Stool test:Patient collects stool samples and submit for investigation. The stool is often checked for blood, hidden blood in the lower colon, DNA markers from colon cancers or polyps, etc.
• X-Ray scan: The X-ray scan is aided with the use of Barium enema dye which improves contrast when viewing the colorectal structures and helps detect any abnormal features.
• Sigmoidoscopy:Similar to colonoscopy, but restricted to examination of the sigmoid colon and rectum.
• The doctor could also request for other imaging scans such as Magnetic Resonance Imaging (MRI), Computed Tomography (CT) scan or Ultrasound scan to check level of cancer metastasis (spread).

Staging

Once diagnosis has been made about colorectal cancer, staging is the next line of action to determine the necessary treatment modalities to be taken. Staging involves determining how far cancer has spread. The staging is as follows:

• Stage 0: This stage is also called Carcinoma-in-situ meaning cancer is restricted to only the inner layer of the colon or rectum. This is usually the earliest presentation, often picked up during routine screening.
• Stage 1:Here, cancer has not spread outside the wall of the colon or rectum, remaining confined.
• Stage 2:Cancer cells have breached the wall of the colon or rectum but yet to reach surrounding lymph nodes.
• Stage 3:Cancer cells at this stage have reached surrounding lymph nodes, other parts of the body are still spared.
• Stage 4:This is the last stage where cancer has metastasized to other body sites such as the kidney, liver, etc.

With the knowledge of all these at the fingertips of you and your medical doctor, proper treatment and management procedures can be reached to help manage colorectal cancer.