Colorectal Surgery including cancer

What is Colorectal Cancer?

Colorectal cancer starts in the colon or rectum, often developing from polyps—small growths on the inner lining of the intestine. While most polyps are benign, some can become cancerous over time.

Risk Factors

Several factors increase the risk of colorectal cancer:

• Diet – High consumption of processed meats and low fiber intake.
• Obesity – Excess weight is linked to inflammation and hormonal changes that promote cancer growth.
• Smoking & Alcohol – Both contribute to DNA damage and increase cancer risk.
• Genetics – Conditions like Lynch syndrome and familial adenomatous polyposis (FAP) raise the likelihood of developing colorectal cancer.
• Gut Microbiota – Recent studies suggest that certain bacteria, like E. coli producing colibactin, may contribute to early-onset colorectal cancer.

Colorectal cancer can develop silently, but when symptoms do appear, they often include:

• Changes in bowel habits – Persistent diarrhea, constipation, or narrowing of stools.
• Blood in stool – Bright red or dark-colored stool may indicate bleeding in the colon.
• Abdominal pain or discomfort – Cramps, bloating, or unexplained pain.
• Unexplained weight loss – Losing weight without trying.
• Fatigue or weakness – Often due to anemia caused by internal bleeding.
• A feeling of incomplete bowel emptying – A persistent sensation that you need to pass stool even after doing so.

In Australia, the Faecal Occult Blood Test (FOBT) is a key screening tool for detecting early signs of bowel cancer. It is part of the National Bowel Cancer Screening Program, which provides free home test kits to eligible Australians aged 50 to 74 every two years. The test detects small amounts of blood in stool that may indicate bowel cancer or precancerous growths.

The primary type of FOBT used in Australia is the immunochemical FOBT (iFOBT), which does not require dietary or medication changes before testing. If blood is detected, further diagnostic tests like colonoscopy may be recommended.

Stages of Colorectal Cancer

Colorectal cancer progresses through different stages:

1. Stage 0 (Carcinoma in situ) – Cancer is confined to the inner lining.
2. Stage I – Cancer has grown into the deeper layers but hasn’t spread.
3. Stage II – Cancer has spread beyond the colon or rectum but not to lymph nodes.
4. Stage III – Cancer has spread to nearby lymph nodes.
5. Stage IV – Cancer has spread to distant organs (e.g., liver, lungs)

Treatment Options

Treatment depends on the stage and may include:

• Surgery – Removing the tumor or affected part of the colon.
• Chemotherapy – Using drugs to kill cancer cells.
• Radiation Therapy – Targeting cancer cells with high-energy rays.
• Targeted Therapy – Drugs that specifically attack cancer cells without harming normal cells.

Emerging Research & Prevention

• Nuts & Seeds – Studies show that walnuts, flaxseeds, and pistachios contain compounds that may reduce colorectal cancer risk.
• Vitamin D – Higher vitamin D levels have been linked to lower colorectal cancer risk, though research is ongoing5.
• Lifestyle Changes – Regular exercise, a diet rich in fruits, vegetables, and whole grains, and routine screenings can significantly lower risk.