Stages And Symptoms Of Colon Cancer

Colon cancer ranks thirteenth in India and poses a significant health concern, affecting the colon (large intestine). The WHO estimated over 1.9 million new cases of colorectal cancer worldwide in 2020. This cancer type can impact anyone, regardless of age or gender, but early detection is challenging due to subtle symptoms, often resulting in few early warning signs. For example, abdominal pain may only appear in advanced stages, highlighting the need for timely diagnosis.

Early detection of colon cancer is important for effective treatment. Regular screenings, like colonoscopies, are necessary. Staging the tumour guides treatment, while awareness of lifestyle factors highlights the need for early intervention.

What is the significance of staging cancer?

Staging is important in cancer treatment as it helps doctors develop a personalised treatment plan and forecast the likely outcomes. By assessing how far the cancer has spread, staging informs treatment options and provides estimates of survival rates. This helps patients better understand their situation. Knowing the stage of colon cancer allows patients and their families to make informed decisions about their care. 

What is the TNM stage of cancer?

Colon cancer stages 1 to 4 are usually based upon the TNM staging by the American Joint Committee. Here are the colon cancer stages in the TNM system.
 

• T (T stands for tumour): This describes how big the original tumour is and how far it has grown into the colon wall.
   
• N (N stands for node): It describes if cancer has spread to the nearby lymph nodes or not.
   
• M (M stands for metastasis): It describes whether cancer has metastasised or spread from the colon into the surrounding organs or not.

What are the stages of colon cancer?

There are five stages of colon cancer. They are:

Stage 0: Stage 0 is called cancer in situ or carcinoma in situ. This stage of colon cancer represents cancer in its early stages. According to stage 0, the cancer cells are present in the inner lining of the colon (mucosa).

Stage 1: Stage 1 of colon cancer means that cancer has grown beyond the inner lining into the submucosa and the muscular layer of the colon. However, it has not invaded the surrounding lymph nodes.

Stage 2: Stage 2 cancers are classified into the following stages:

• Stage 2A:  In this stage, colon cancer has grown through the colon wall. However, it has not spread into the nearby lymph nodes and tissues.

• Stage 2B: Cancer has spread through the muscle layers and into the abdomen lining, known as the visceral peritoneum in this stage. However, it has not spread into the nearby lymph nodes.

• Stage 2C: According to stage 2C, colon cancer has grown from the outer layer of the colon and has spread into the surrounding organs and structure. However, it has not spread into the nearby lymph nodes.

Stage 3: Stage 3 is further classified into the following stages:

• Stage 3A: According to stage 3A, colon cancer has grown through or into the colon’s muscular linings and has spread into 1 to 3 nearby lymph nodes. However, it has not spread into the distant nodes and organs.

• Stage 3B: In this stage, cancer has grown into the bowel wall and surrounding organs and spread into 1 to 3 lymph nodes around the colon. However, it has not spread to other body parts.

• Stage 3C: The colon cancer has spread to 4 or more than 4 lymph nodes regardless of how far it has grown. However, it has not spread to other distant body parts.
   

Stage 4: Stage four is further classified into the following:

• Stage 4A: In this stage, cancer has spread to one area or organs like the liver or lung.

• Stage 4B: Cancer has spread to more than one body part in this stage.

• Stage 4C: In stage 4C, cancer has spread to the peritoneum and might have also reached other body parts.

What are usually the first symptoms of colon cancer?

The early signs of colon cancer are: 

• Constipation
• Diarrhea
• Change in colour and shape of stools
• Bloody stools
• Rectal bleeding
• Fatigue
• Unexplained loss of weight
• Excessive gas
• Loss of appetite
• Pain in the abdomen
• Cramps in the abdomen

Recognising these early signs of colon cancer is really important, as they may indicate signs of stage 1 colon cancer. These colon cancer symptoms in men and women can vary, so it's important to consult a healthcare professional if you experience any of them. Early detection can significantly improve outcomes.

What are the final symptoms of stage 4 colon cancer?

The colon cancer stage 4 symptoms can include:
 

• Poor appetite and weight loss
• Difficulty in breathing
• Jaundice
• Swelling in the hands and feet
• Fractures in bone
• Severe headache
• Blurred vision
• Chest infections
• Fluid build-up in the chest and lung
• Coughing blood

Alongside these symptoms, individuals might also notice issues like blood in the stool or abdominal pain, which are important signs of colon cancer. This underscores the need to pay attention to any changes in your health and to seek medical advice when necessary.

What are the most common treatments for colon cancer?

Colon cancer treatment varies depending on the stage of the disease, which can also impact colon cancer survival rates. Here are the most common options:
 

1. Surgery: This is the first step for early-stage colon cancer treatment. The aim is to remove the cancerous section of the colon along with some surrounding tissue.

2. Chemotherapy: This treatment may be used after surgery to eliminate any remaining cancer cells, or it can be the main treatment for more advanced stages.

3. Radiation therapy: This may be used to shrink tumours before surgery or to help reduce symptoms in more advanced stages.
 

4. Targeted therapy: For advanced colon cancer, targeted therapies focus on specific features of cancer cells to slow their growth.

5. Immunotherapy: This colon cancer treatment improves the body's immune system to help it fight cancer and may be suitable for some patients with advanced diseases.

The colon cancer treatment by stage is tailored to each patient, with earlier stages typically requiring less aggressive treatment than later stages, where a combination of therapies might be required, often accompanied by various side effects of colon cancer treatment. If you or a loved one is facing colon cancer, consult with a healthcare professional to explore the best treatment options and manage potential side effects effectively.

Expert’s insight: 
 

Dr Ganesh Nagarajan, Director of Hepatobiliary Pancreatic Gastrointestinal Oncology at Nanavati Max Institute of Cancer Care, highlighted that colon cancer often goes unnoticed in its early stages due to a lack of obvious symptoms.

He stated, "However, some common signs to watch out for include persistent changes in bowel habits such as diarrhoea or constipation, abdominal pain or cramping that doesn't go away, unexplained weight loss, and blood in the stool. Studies have shown an association between the development of colorectal cancer and inflammatory bowel diseases like Crohn's disease and ulcerative colitis."
 

Frequently Asked Questions (FAQs)

1. How curable is colon cancer?

Colon cancer is highly curable, especially when detected early. With proper treatment, many patients can achieve remission and live long and healthy lives.

2. How fast does colon cancer progress?

Colon cancer can progress at different speeds, but it usually develops slowly over several years. In the early stages, there may be few noticeable symptoms, which can make it hard to detect. That's why regular screenings are essential to catch it early before it becomes more serious.

3. What is the difference between stage 2 and 3 colon cancer?

Stage 2 colon cancer means the cancer has grown into the outer layers of the colon but hasn’t spread to nearby lymph nodes. Whereas in stage 3 means that the cancer has spread to nearby lymph nodes, making it more advanced and requiring more aggressive treatment.

4. How do I check my colon cancer?

To check for colon cancer, you can try screening tests such as a colonoscopy, flexible sigmoidoscopy, or a faecal occult blood test. It's important to discuss with your doctor when to start screening based on your age and risk factors.

5. Is colon cancer painful?
 

Colon cancer itself may not cause pain in the early stages, but as it progresses, patients can experience discomfort or pain in the abdomen. Symptoms like cramping, bloating, or changes in bowel habits can also occur. It's essential to consult a doctor if you notice any unusual symptoms or persistent discomfort.

6. What foods prevent colon cancer?

Foods that may help prevent colon cancer include high-fibre options like whole grains, fruits, and vegetables, as well as legumes and foods rich in antioxidants, such as berries and nuts. Incorporating these into your diet can support overall colon health!

Wrapping up

Knowing about colon cancer, its stages, and its symptoms is crucial for catching it early and getting the right treatment. By being aware of the signs and the importance of regular screenings, you can take charge of your health. Don’t hesitate to talk to your healthcare provider about when to start screenings. Taking steps now can really make a difference in your overall well-being.
 

References

1. https://www.ncbi.nlm.nih.gov/books/NBK470380/

2. https://medlineplus.gov/colorectalcancer.html

3. https://pubmed.ncbi.nlm.nih.gov/20524862/

4. https://pubmed.ncbi.nlm.nih.gov/31842486/

5. https://www.iarc.who.int/cancer-type/colorectal-cancer/

Note: The information provided in this blog is intended for general knowledge. It is important to remember that it should not replace professional medical advice. If you have any concerns about cancer or related symptoms, please consult a healthcare provider.