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  • Understanding Adenocarcinoma of Colon: Symptoms, Risk Factors & Treatments

The journey of understanding adenocarcinoma of the colon starts with grasping its complexity and the crucial role of early detection. By diving into the depths of this common cancer type, we unveil the importance of recognizing symptoms, identifying risk factors, and exploring viable treatment options. This blog post will equip you with the knowledge to face the challenges of living with adenocarcinoma of colon, so let’s embark on this educational adventure together.

Key Takeaways

  • Adenocarcinoma of colon is the most common type of colorectal cancer, with two main subtypes and known risk factors for early detection.

  • Screening methods such as colonoscopy can help detect precancerous polyps and aid in prevention. Genetic predisposition and environmental factors also contribute to increased risk.

  • Treatment options include surgical procedures, chemotherapy/radiation therapy, managing physical/emotional challenges, accessing support resources & following up care to manage side effects.

Adenocarcinoma of Colon: Overview and Types

Illustration of colon anatomy with highlighted adenocarcinoma

Adenocarcinoma of colon, the most prevalent type of colon cancer, originates from glandular cells in the colon lining. This type of colorectal adenocarcinoma has two main subtypes: mucinous adenocarcinoma and signet ring cell carcinoma.

Given that the median age at diagnosis for colorectal cancer is 66 years, knowledge of the risk factors and symptoms is vital for promoting early detection and better outcomes.

Mucinous adenocarcinoma

Mucinous adenocarcinoma, a distinct subtype of colorectal cancer, is characterized by:

  • Abundant mucous secretion, which comprises at least 50% of the tumor volume

  • Affects both the colon and rectum

  • Unique features compared to other colon adenocarcinomas, such as a thickened intestinal wall, thickened gut mucosa, and low-density cystic lesions

  • Unfortunately, it is also associated with a poorer response to treatment and prognosis.

This subtype accounts for 10-15% of colon adenocarcinomas, and its diagnosis is made through colonoscopy. During this procedure, polyps are biopsied or removed and subsequently examined under a microscope. Regular screening can help detect and remove these polyps, reducing colon cancer risk.

Typical signs associated with mucinous adenocarcinoma of the colon may include:

  • Abdominal pain or cramping

  • Presence of blood in the stool or rectal bleeding

  • Alteration of bowel habits (like diarrhea or constipation)

  • Abdominal distention

Signet ring cell carcinoma

Signet ring cell carcinoma is a rare and aggressive subtype of carcinoma, with cells resembling signet rings due to the presence of intracellular mucin. It is more difficult to treat colon cancer when it is a signet ring cell carcinoma. This histological appearance, characterized by a large intracytoplasmic vacuole that pushes the nucleus to the edge of the cell, is linked to a more aggressive nature and a poorer prognosis when it affects the colon or rectum.

This subtype is associated with a younger age and may present with a scirrhous appearance and more lymphovascular involvement. High-frequency microsatellite instability, associated with signet ring cell carcinomas, escalates the risk of developing colorectal cancer. In signet ring cell carcinoma, TP53, ARID1A, and CDH1 mutations are observed in gastric signet ring cell carcinoma, while TP53, ARID1A, and APC mutations are observed in colorectal signet ring cell carcinoma. Regular colorectal cancer screening can help detect these mutations and identify individuals at risk.

The prognosis for patients diagnosed with signet ring cell carcinoma of the colon is generally poor. The 3- to 5-year cancer-specific survival rates range from 29.32% to 35.76%, and the overall survival rates range from 25.14% to 32.32%. The estimated overall survival time for signet ring cell carcinoma patients is significantly shorter compared to non-signet ring cell carcinoma patients.

Symptoms and Early Detection

Colonoscopy procedure for colon cancer screening

Symptoms of adenocarcinoma of colon may be absent or vary depending on tumor size and location. Achieving better outcomes heavily relies on early detection through regular screening. The American Cancer Society suggests that average-risk individuals start colon cancer screenings at 45 years of age. Those with increased risk factors, like a family history of colon cancer, might be advised to begin screenings at a younger age.

We should highlight that the incidence rates of colon cancer have been noticeably increasing among younger individuals. Colon cancer incidence rates have been gradually increasing in adults aged 20 to 39 years since the mid-1980s with an increase of 1.0% to 2.4% annually. Adults aged 40 to 54 years have also witnessed a rise with 0.5% to 1.3% annually since the mid-1990s. Addressing this trend necessitates early detection via regular screening.

Screening methods

Various screening methods, such as colonoscopy and stool tests, can help detect colon cancer and rectal cancer at an early stage or even prevent them by removing precancerous polyps. A colonoscopy involves the insertion of a colonoscope through the anus and rectum into the colon. The colonoscope takes images of the interior of the colon to assess for any irregularities or indications of cancer. The procedure is usually conducted by a physician and generally lasts around 30-60 minutes.

Stool tests analyze for indications of colon cancer or precancerous polyps in the stool. These tests are capable of detecting microscopic amounts of blood in the feces that are not visible to the human eye. Stool tests can also evaluate DNA in the stools to detect any cells released by colorectal cancer. These tests are less invasive and simpler to have done in comparison to colonoscopies. The precision of stool tests fluctuates, with FIT fecal DNA tests being 92% accurate at identifying colon cancer.

Colonoscopy is extremely effective in detecting precancerous polyps, and regular screening tests can detect polyps in the colon, which can then be removed to help prevent the development of colon cancer.

Risk Factors and Prevention

Healthy lifestyle choices for colon cancer prevention

Genetic predisposition, environmental factors, and lifestyle choices are all risk factors for adenocarcinoma of colon. Prevention strategies focus on early detection and risk reduction. Individuals with a heightened risk, such as those with a familial history of colon cancer, may consider beginning screening earlier.

Research has indicated a potential association between regular use of aspirin or aspirin-like medicines and a decreased risk of polyps and colon cancer. However, daily intake of aspirin may carry certain risks, such as ulcers and digestive system bleeding, which could potentially exacerbate inflammatory bowel disease.

Genetic predisposition

Genetic factors, such as inherited syndromes like Lynch syndrome, can increase the risk of developing colon cancers. Lynch syndrome, also referred to as hereditary non-polyposis colorectal cancer (HNPCC), is a genetic condition that increases the risk of developing colon adenocarcinoma. Individuals with Lynch syndrome are more likely to develop colon cancer at an earlier age than the general population.

Inherited gene alterations, such as mutations in the APC gene, can raise the likelihood of developing colonic adenomas and colorectal cancer. These gene changes can lead to the growth of polyps in the colon and contribute to the development of the disease.

Environmental factors

Environmental factors, including diet and exposure to certain chemicals, can contribute to the development of adenocarcinoma of colon. Studies have shown that:

  • High-fat diets have been linked to an increased risk of adenocarcinoma of colon.

  • A higher intake of dietary fiber has been correlated with a lower risk.

  • Lifestyle habits related to diet, weight, and exercise are significantly associated with colorectal cancer risk.

Exposure to certain chemicals can increase the risk of adenocarcinoma of the colon. These chemicals include:

  • Air and water pollution

  • Soil and food contaminants

  • Pesticides

  • Benzene

Animal models have also shown that exposure to chemicals such as HCAs and PAHs may increase the risk of colon cancer.

Staging and Prognosis

Staging the adenocarcinoma of colon assists in determining the spread of cancer and guiding treatment decisions. The American Joint Committee on Cancer (AJCC) tumor/node/metastasis (TNM) classification and staging system is employed to determine the stage of colon adenocarcinoma. This system considers the size and extent of the tumor, involvement of nearby lymph nodes, and the presence of metastasis.

The stage at diagnosis influences the variation in prognosis. For instance, more than 90% of individuals treated for early-stage colon cancer, such as stage ii colon cancer, were alive five years after diagnosis.

Stage I-IV

Stages I-IV denote the progression of colon cancer, where stage I is the earliest and stage IV signifies metastasis to distant organs. The American Joint Committee on Cancer (AJCC) tumor/node/metastasis (TNM) classification and staging system is used to determine the stage of colon adenocarcinoma. This system assesses the size and extent of the tumor (T), the involvement of nearby lymph nodes (N), and the presence of distant metastasis (M). The staging process is used to evaluate the extent of the cancer and inform treatment decisions.

When adenocarcinoma of the colon has metastasized, it implies that the cancer has extended beyond the colon to other regions of the body. The most typical site of metastasis for colon cancer is the liver, yet it can also spread to other organs such as the lungs, bones, or lymph nodes. Metastasis is an indication that the cancer is in an advanced stage and may necessitate more intensive treatment approaches.

The 5-year survival rate for colorectal cancer patients in the United States is estimated to be 64.6%. This includes all stages of the condition. The 5-year relative survival rates for localized, regional, and distant colorectal cancer are 90.2%, 71.8%, and 14.3%, respectively.

Treatment Options

Chemotherapy treatment for adenocarcinoma of colon

The treatment options for adenocarcinoma of colon, which depend on the stage and individual factors, include:

  • Surgery

  • Chemotherapy

  • Radiation therapy

  • Targeted therapies

Surgical resection, such as colectomy, is the primary treatment for localized non-metastatic stage colon cancer.

To manage advanced cases or reduce the risk of recurrence, chemotherapy and radiation therapy may be used as supplementary treatments.

Surgical procedures

Surgical procedures, such as colectomy, are the primary treatment for colon cancer, with the goal of removing the tumor and surrounding tissue. Colectomy is the primary surgical procedure used in the treatment of colon cancer, with the intention of eliminating the tumor and adjacent tissue. The available types of colectomy operations include hemicolectomy, partial colectomy, or segmental resection. The selection of the specific type of colectomy procedure is based on the extent of the cancer and the individual’s condition.

The success rate of colectomy in treating adenocarcinoma of the colon is promising. The average five-year survival rate is approximately 73.7%, while the five-year disease-free survival rate is approximately 80.1%. Surgical resection for colon adenocarcinoma entails the removal of the tumor and any adjacent lymph nodes. This is typically achieved through a partial colectomy or segmental resection, which involves the excision of the cancerous portion of the colon along with some of the healthy tissue in the vicinity. The aim of the surgery is to completely eradicate the tumor and any affected lymph nodes.

Chemotherapy and radiation therapy

Chemotherapy is typically recommended for the treatment of colon adenocarcinoma in the following scenarios:

  • Adjuvant chemotherapy may be utilized after surgery if the cancer is sizable or has spread to the lymph nodes.

  • Chemotherapy is generally employed in combination with surgery to treat stage 4 colon cancer.

  • It may also be employed as the primary choice of treatment, such as the drug 5-fluorouracil (5-FU), for colorectal cancer.

Radiation therapy for colon adenocarcinoma involves utilizing high-energy rays or particles, such as x-rays, to eradicate cancer cells. It is a viable treatment option for colon cancer, particularly when combined with other treatments like chemotherapy. Radiation therapy may be used to destroy cancer cells and reduce tumor size, while targeted therapies are medications that target particular molecules in cancer cells to impede their growth and dissemination.

Treatment for adenocarcinoma of colon may result in the following potential side effects:

  • Fatigue

  • Nausea

  • Vomiting

  • Diarrhea

  • Constipation

  • Hair loss

  • Changes in appetite

Additionally, radiation therapy may result in skin irritation at the site where radiation beams were aimed.

Living with Adenocarcinoma of Colon

Support group for individuals with adenocarcinoma of colon

Living with adenocarcinoma of colon necessitates dealing with the physical and emotional challenges that the disease presents, managing follow-up care, and handling potential side effects of treatment. Individuals living with adenocarcinoma of colon may encounter physical and emotional challenges such as:

  • Sleep disturbances

  • Pain

  • Alterations in sexual functioning

  • Fear of cancer

  • Depression

  • Anxiety

These difficulties can significantly affect mental health and wellbeing.

For individuals with colon cancer, effective management of follow-up care is key. For example, after treatment for Stage 0 or Stage I colon cancer, colonoscopies should be conducted one year, three years, and five years after surgery. For individuals with Stage II or Stage III colon cancer, follow-up visits should be scheduled every three to six months for the first two years after treatment, and typically be monitored for five years from the date of surgery.

Support and resources

Resources like support groups and educational materials can assist patients and their families in coping with the challenges that come with living with colon cancer. Fight Colorectal Cancer and the American Cancer Society are recommended support groups for individuals with colon adenocarcinoma. Online forums, such as the Macmillan Cancer Support Bowel (Colon, Rectum) Cancer Forum, provide a platform where patients diagnosed with colon adenocarcinoma can share experiences and access advice.

Reliable and educational material about colon adenocarcinoma can be found on reputable websites such as UpToDate, National Center for Biotechnology Information (NCBI), American Cancer Society, National Cancer Institute, and Mayo Clinic. There are a number of resources available to assist families with a member suffering from adenocarcinoma of the colon. These include the Colorectal Cancer Alliance, CancerCare, American Cancer Society, and the Colon Cancer Foundation. These organizations provide support, financial assistance, resource guides, and online support groups to help patients and their families.

Summary

In conclusion, adenocarcinoma of colon is a complex disease that requires understanding its subtypes, symptoms, risk factors, and treatment options. Early detection through regular screening is essential for better outcomes, and various treatment options are available, depending on the stage and individual factors. Living with adenocarcinoma of colon involves coping with physical and emotional challenges, managing follow-up care, and utilizing available resources and support.

Facing the challenges of colon cancer may seem daunting, but with the knowledge acquired in this blog post, you are better equipped to navigate the complexities of this disease. Remember that understanding is the first step to conquering adversity, and by being proactive and vigilant, you are already on the path to a healthier future.

Frequently Asked Questions

What is the survival rate of adenocarcinoma of the colon?

The five-year relative survival rate for colon cancer is 63%, with 91% survival rate if diagnosed at a localized stage. If the cancer has spread to surrounding tissues or organs and/or the regional lymph nodes, the 5-year relative survival rate is 72%.

Is adenocarcinoma of the colon curable?

Adenocarcinoma of the colon is often curable if detected early. Surgery is typically used and offers a cure rate of 50%. Despite complete surgical removal, recurrence of the cancer is still a major problem.

Is adenocarcinoma of the colon aggressive?

Signet ring cell adenocarcinoma, a type of adenocarcinoma of the colon, is typically aggressive and may be more difficult to treat.

Where is the first place colon cancer spreads?

Colon cancer typically spreads to the liver first, but can also spread to other organs such as the lungs, brain, and abdominal lining. Surgery is usually not an effective treatment for these metastasized tumors.

What are the subtypes of colon adenocarcinoma?

Mucinous adenocarcinoma and signet ring cell carcinoma are the two main subtypes of colon adenocarcinoma.



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