Colorectal Cancer

Colorectal cancer refers to malignant tumors that arise from the inner lining of the colon or rectum. Most cases develop from precancerous growths known as adenomatous polyps, which can slowly transform into cancer over several years. It is one of the most common cancers worldwide and a leading cause of cancer-related deaths.

The disease is highly preventable and treatable when detected early through routine screening such as colonoscopy. It typically progresses in a predictable pattern: from localized lesions to regional lymph node involvement, and eventually to distant metastasis, most commonly to the liver and lungs.

At our Colorectal Cancer Center, we provide specialized care using a multidisciplinary approach that integrates surgery, medical oncology, radiation therapy, pathology, and genetic counseling. We aim to not only achieve oncologic cure but also preserve bowel, urinary, and sexual function whenever possible.

Early-stage disease may be treated with minimally invasive surgery, while advanced or recurrent cancers may require multimodal treatment. Molecular profiling and precision medicine play an increasing role in personalized care.

1.  Colon Cancer

Cancer that originates in the colon (large intestine). It typically begins as benign adenomatous polyps that may become cancerous over time. Most colon cancers are adenocarcinomas.

2. Rectal Cancer

Cancer located in the rectum, the final section of the large intestine. Due to its location within the narrow pelvic cavity, treatment often involves a combination of chemoradiation and surgery.

3. Hereditary Colorectal Cancer Syndromes

• Lynch Syndrome (Hereditary Nonpolyposis Colorectal Cancer, HNPCC): A genetic condition that increases the risk of colorectal and other cancers, often at a younger age.
• Familial Adenomatous Polyposis (FAP): A rare, inherited disorder characterized by the development of hundreds to thousands of colon polyps, often requiring prophylactic colectomy.

1. Changes in bowel habits

• Persistent diarrhea or constipation
• A feeling of incomplete bowel evacuation
• Narrow or ribbon-like stools                                                                                                                                                                              

2. Rectal bleeding or blood in the stool 

• Bright red blood or dark, tarry stools
• May be mistaken for hemorrhoids

3. Abdominal discomfort

• Cramping, bloating, gas, or persistent pain

4. Unexplained weight loss

• Often occurs without changes in diet or physical activity

5. Fatigue or weakness

• May result from chronic blood loss leading to anemia

6. Urgency or change in stool caliber

• Especially in rectal cancer, patients may feel urgency even when the rectum is empty

Most colorectal cancers begin as small, noncancerous polyps (adenomas) that develop on the inner lining of the colon or rectum. Over time, some of these polyps can transform into cancer due to genetic mutations and environmental influences. The exact mechanism is complex and involves both inherited and acquired changes in cellular DNA.

• Age: Most cases occur in individuals aged 50 and older.
• Personal history: Previous colorectal polyps or cancer increase the risk of recurrence.
• Family history: Having a first-degree relative with colorectal cancer, especially at a young age, significantly increases risk.
• Genetic conditions: Lynch syndrome (HNPCC), Familial adenomatous polyposis (FAP)
• Inflammatory bowel diseases: Long-standing ulcerative colitis or Crohn’s disease.
• Lifestyle factors:
  - Diet high in red and processed meats
  - Low intake of fiber, fruits, and vegetables
  - Sedentary lifestyle and physical inactivity
  - Obesity and abdominal fat
  - Smoking and heavy alcohol consumption
• Type 2 diabetes: Associated with a modestly increased risk.

Regular Screening

• Start at age 50 for average-risk individuals
• Colonoscopy every 10 years, or FIT annually
• Earlier screening for high-risk patients (family history, IBD, genetic syndromes)

Healthy Diet

• Increase intake of fiber-rich foods (vegetables, fruits, whole grains)
• Limit red meat and avoid processed meats

Maintain Healthy Body Weight

• Obesity, particularly visceral fat, is associated with higher risk

Physical Activity

• Engage in moderate exercise (e.g., brisk walking) at least 150 minutes per week

Avoid Tobacco and Alcohol

• Quit smoking and limit alcohol to recommended daily limits

Genetic Counseling

• For those with strong family history or known hereditary cancer syndromes