Colon Cancer: Spot the 10 Warning Signs - MalaysiaChronic Conditions

Colon Cancer: Spot the 10 Warning Signs

Colon cancer is the most common cancer in Malaysia. In this article, we cover the 10 warning signs of Colon cancer, from the early stages to advanced and when you should see a doctor

What is Colon Cancer?

Like other cancers,colon canceroccurs when abnormal cells mutate and subsequently multiply uncontrollably and more rapidly than normal cells do. These abnormal cells will deprive healthy cells of nutrients and oxygen, causing healthy cells to die. If left uncontrolled, the cancer cells may eventually travel to other parts of the body like the bones or other organs and start to grow there as well.

Colon cancer is sometimes referred to ascolorectal cancer, or bowel cancer. It refers to cancer that affects the colon, which is located towards the end of your large intestines, and/or the rectum, the chamber that connects the colon to the anus. Most (but not all) colon cancers begin as polyps, which are noncancerous, or benign, cell clusters that form inside the colon.

In theWorld Health Organization’s Cancer Country Profile for 2020, colon cancer had an incidence rate of 14% in Malaysia. It is the most common cancer among Malaysian males and is the third most common for Malaysian females.

It is important to learn about prostate cancer and its warning signs, as early detection can lead to immediate treatment that can save lives.

Stages of Colon Cancer

There arefive stagesof colon cancer. Depending on the stage, doctors will need to formulate different treatment plans to effectively treat the cancer.

Do note that this is a summary of the stages of colon cancer to help you understand how it changes and affects you or your loved one.

Stage 0: This is when the cancer is considered to be in its early stages (cancer in situ). The cancer is still within the mucosa, the innermost layer of the colon.
Stage I: The cancer has grown into the mucosa, and has invaded the muscular layer (submucosa) of the colon or rectum. It has not yet spread to nearby tissue or lymph nodes.
Stage II: The cancer has now invaded the submucosa. As the cancer progresses, it will slowly affect the outer layers of the colon, other nearby tissue, the lining of the abdomen, or other organs or structures.
Stage III: The tumour is growing rapidly and is likely to grow, spread, and develop in other parts of your body. At this stage, the cancerous tumour will have grown to affect nearby lymph nodes, but not distant areas of your body.
Stage IV: At this stage, the cancer cells have spread beyond the colon and into other parts of the body, such as the lungs or liver.

There is also the possibility of the cancer recurring after treatment, either in the colon or affecting another part of the body.

Warning Signs

Colon cancer may be confused for other infections or diseases that affect the digestive tract because of similar symptoms. This includes haemorrhoids, irritable bowel syndrome (IBS) or inflammatory bowel disease. Moreover, because of how benign the tumour starts out, it will take time before it grows to a size that causes pain when it pushes against whatever is in its way. Early detection becomes important to find out if you or your loved one may have colon cancer.

However, if you or your loved one do experience any of the following warning signs, be sure to take notes of any observations you can make before you see a doctor for a diagnosis.

Significant Bowel Changes

You may find yourself having to use the washroom more frequently than usual. This may be more noticeable if you only experience a few bowel movements in a day; note, however, that there is no “normal” amount to how many a person experiences. Bowel movements can also change due to a number of reasons, such as positive or negative changes to your overall health.

If you suddenly find yourself experiencing persistent diarrhea and/or constipation that lasts a few days, you should consult your doctor as soon as possible. It is possible that the polyps have obstructed or even damaged the colon, thus causing these changes in bowel habits.

Sudden Weight Changes

Weight changes can go hand in hand with changes to you or your loved one’s bowel habits. Frequent trips to the washroom might trigger a response to eat more, thus gaining weight. Conversely, you might find that eating normal portions does not prevent or slow down inexplicable weight loss.

This can happen due to the cancer cells stealing nutrients from your body to continue growing and multiplying. It could also be due to your immune system needing more energy from your cells to fight off the cancer. Together, your body is burning up more energy than you can replenish from meals.

Moreover, the tumour growing in the colon could obstruct the colon or the intestinal tract, preventing your body from effectively absorbing the nutrients it needs.

Frequent Stomach Aches

You or your loved one might also have frequent aches in your stomach or the surrounding area. This could lead to frequent stomach aches, cramping, abdominal pains or bloating. Any obstructions in the colon, including colon cancer, can prevent you or your loved one from not only passing motion, but passing gas. This also results in the abdominal cramps or pains you have been feeling. Worrying still is the fact that the tumour could cause damage to your digestive tract, which can be life-threatening if left untreated.

Pelvic pain may even manifest, which could hint at either colon or rectal cancer.

Loss of Appetite

The persistent discomforts you feel because of these significant changes to your digestive system can eventually cause you or your loved one to eat less. This particular warning sign is one that cannot be interpreted solely, but if you or your loved one is experiencing a waning appetite because of a feeling of bloating or fullness that hinders you from eating, you should have it checked immediately.

Constant Fatigue

Being unable to eat or having difficulty doing so, along with the other pains you may experience, will inevitably lead to you or your loved one feeling more tired than usual. With your body’s energy going either to the cancer cells to multiply, or used by your body to fight the growing cancer, you or your loved one are going to have difficulty doing everyday tasks, concentrating on work, or even have any desire to partake in any of your favourite activities.

Normal amounts of rest might not even be enough to alleviate this tiredness you feel. Even so, chronic fatigue could be a potential sign of an underlying medical condition that is not colon cancer. Consider having a doctor check you or your loved one’s condition soon, especially if normal rest does not help either of you to recover.

Onset of Anaemia

Anaemiamight seem like a surprising sign that points to colon cancer. However, your tiredness may actually be due to blood loss and/or an iron deficiency, in your body. This can be due to internal bleeding originating from the cancer tumour, or there could be bleeding somewhere along the digestive tract.

Bleeding is what causes anaemia where colon cancer is concerned. The growing tumour releases specific chemicals that stimulate the formation of new blood vessels, which then help to “feed” the tumour. As the tumour grows, these vessels can burst, which thus causes internal bleeding.

In some cases, anaemia might be the first sign of colon cancer. However, you may not see blood in the stools as the blood dries before leaving the colon.

Rectal Bleeding

In the case ofrectal bleeding, you may find bright red blood on the stools after passing motion. However, this is also a symptom of haemorrhoids, which can occur infrequently; in colon cancer, this can progressively become worse over time.

Rectal bleeding causes stools to turn into a reddish colour, which can indicate where the bleeding occurs. For example, bright red blood could indicate bleeding in a lower area of the colon or rectum. In some cases, blood may not be observable by the naked eye. The severity of it varies from person to person, with some reporting just a few drops of blood when they pass motion.

Change in Stool Consistency

Normal stools should be easy to pass and are typically brown in colour. However, having colon cancer (or other digestive conditions) can cause abnormal changes to stool consistency. This may include:

Back, tarry stools
Clay-coloured stools
Deep red stools (a sign of rectal or internal bleeding)
White-coloured stools
Pus or mucus in stools
Narrow stools

These changes can happen in conjunction with other symptoms such as changes in bowel habits. Be mindful that these changes can still be indicators of other digestive medical conditions, and not necessarily colon cancer.

Tenesmus

Tenesmusis the term to describe a feeling of incomplete emptying of bowel motion. It is the sensation you experience after a bowel movement, but you feel as though you still need to pass motion. It may also cause you discomfort when passing motion or feeling like you cannot pass any motion but results in small stool amounts being passed. On top of this, you may also experience cramps and pains around your stomach/intestinal area.

Tenesmus is supposedly caused when certain nerves in the bowel are affected. Overstimulation of these nerves will make you feel the urge to relieve yourself, as the contractions that occur simulate the onset of bowel movement.

Pain in Other Areas

This is harder to pinpoint on its own, so if you have any of the abovementioned symptoms, and you also begin to have pains in areas close to your digestive tract, it would be wise to get screened immediately. While it might seem rather concerning to obsess over other symptoms that may appear (and are seemingly unrelated to your current health worries), the least you can do is to get it checked out by a medical professional. By determining the cause early, you are giving yourself, or your loved one, ample time to get the treatment that can help alleviate your medical woes, while also guaranteeing peace of mind that you know what it is and how to treat it effectively.

The Importance of Early Screening

Some colon cancers may begin without showing any signs of physical symptoms. In such cases, early screening can save lives by detecting the underlying symptoms that indicate colon cancer and get it treated immediately.

Having certain risk factors also makes it important to get an early screening. Do note, however, that having any of these risk factors does not mean youwilldevelop colon cancer.

Old age, especially those above 50 years of age
Other bowel diseases or infections
Family history of colon cancer
Genetic disorders
Lifestyle factors, e.g. poor eating habits

To determine if it really is colon cancer, you or your loved one will need to undergo screening. This can be done via colonoscopy, or through a variety of tests.

Colonoscopy

A colonoscopy involves the use of a long, slender and flexible tube with a light and camera attached to it. This is called a colonoscope. The procedure will require the doctor to insert the colonoscope into your colon via the rectum. From there, the doctor will be able to use the camera to find any polyps in the colon and even extract tissue samples for analysis.

There is another procedure similar to a colonoscopy, which issigmoidoscopy. This procedure also uses a long, flexible tube to examine your colon, but the main difference is that a sigmoidoscopy only examines the inner lining of the rectum and lower part of the colon. A colonoscopy, in comparison, can examine both the rectum and the lower and upper parts of the colon.

Digital Rectal Exam (DRE)

This test is a simple check by your doctor to determine the size, firmness and texture of your rectum. Using a gloved, lubricated finger, the doctor will feel the rectum itself. The test aims to look for any hard areas, lumps or growths that may have spread beyond the colon or may be growing in the rectum. If you or your loved one feels any pain while the doctor is performing the check, inform them as well.

Faecal Occult Blood Test (FOBT)

This test is used to find hidden blood, or occult blood, in stools, which are an early sign of colon cancer.Occult bloodis passed in very small amounts and can only be detected with specific chemicals used in the FOBT. The test is only done to detect if there is bleeding, and cannot detect the origin of the bleeding. Thus, follow up tests will need to be done to accurately determine where the bleeding starts.

There are two types of FOBTs. The first is the guaiac FOBT or gFOBT. This test provides special test cards that require you to collect stool samples from multiple bowel movements, normally on consecutive days. The collected samples are then tested with a chemical. The results will later be analysed by the medical team.

The other test is the immunochemical FOBT, or iFOBT or FIT. This test can also be done at home by collecting stool samples in special tubes, which is then stored in a collection container that comes with the test kit. The collected samples will then be returned to the doctors and tested at a lab.

The FIT is generally preferred over the gFOBT, due to the former being more sensitive and does not impose dietary restrictions before collecting samples.

Imaging Tests

Normally done after an FOBT, or at the doctor’s request, imaging tests such as CT or MRI scans can be done to help establish the diagnosis from the previous test results.

Prevention is always better than cure, as the saying goes. Be sure that you or your loved one gets an early screening to help you treat the cancer before it becomes serious.

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