Caregiver

Cancer type

WHAT IS COLON CANCER

Colon cancer is a type of cancer that starts in the colon, which is part of the large intestine. It happens when the cells in the lining of the colon grow out of control and form a tumor. This cancer can spread to other parts of the body if not treated early. It often begins as small growths called polyps, which can sometimes turn into cancer over time. Regular screening can help detect and prevent colon cancer.

TYPES OF CERVIX CANCER

There are different types of colon cancer based on where it starts and the type of cells involved. Here are the main types:

Adenocarcinoma (Most Common)
  • This cancer starts in the cells that make mucus in the lining of the colon.
  • It is the most common type, making up about 95% of colon cancers.
Neuroendocrine Tumors
  • These cancers start in hormone-producing cells of the colon.
  • They can grow slowly (low-grade) or quickly (high-grade).
Lymphoma
  • A rare type that starts in the lymphatic tissue of the colon.
  • It is more common in other parts of the body but can occur in the colon.

Gastrointestinal Stromal Tumors (GIST)

  • These are rare cancers that begin in the wall of the colon.
  • They come from specific cells called interstitial cells of Cajal and are usually found in other parts of the digestive system.

Squamous Cell Carcinoma

  • A very rare type of colon cancer that starts in the squamous cells, which are flat cells lining certain areas of the colon.

Key Point

Most colon cancers are adenocarcinomas, but there are rarer types that need different treatments. Early detection through screening can help identify and treat them effectively.

CAUSES AND RISK FACTORS OF COLON CANCER

Colon cancer happens when the cells in the colon (large intestine) start growing abnormally. The exact cause isn’t always known, but several factors can increase the risk.

Causes
  • Gene Changes (Mutations): Changes in the DNA of colon cells can make them grow out of control and form a tumor.
  • Polyps: Small growths in the colon can sometimes turn into cancer if not removed.
  • Family History: Certain inherited gene conditions, like Lynch syndrome, increase the chance of colon cancer.
Risk Factors

Things You Can’t Control:

  1. Age: Most people with colon cancer are over 50, but it can happen earlier.
  2. Family History: If close family members have had colon cancer, your risk is higher.
  3. Genetic Conditions:
    • Inherited syndromes like Lynch syndrome or familial adenomatous polyposis (FAP).
  4. Medical History:
    • Having inflammatory bowel diseases like Crohn’s or ulcerative colitis increases risk.

Things You Can Control:

  1. Diet:
    • Eating lots of red or processed meats (like bacon or sausage) increases risk.
    • A diet low in fiber, fruits, and vegetables can also contribute.
  2. Lack of Exercise: Being inactive can raise your risk.
  3. Obesity: Being very overweight increases the likelihood of developing colon cancer.
  4. Smoking: Tobacco use damages cells in the colon.
  5. Alcohol: Drinking too much alcohol regularly can increase your risk.
  6. Diabetes: People with poorly controlled diabetes are at a higher risk.
Other Factors:
  • Radiation Exposure: Past radiation therapy to the abdomen can increase risk.
  • Ethnicity: African Americans and Ashkenazi Jews have a higher risk.

Key Point

While some risk factors like age and genetics can’t be changed, healthy lifestyle choices like eating well, staying active, and avoiding smoking or heavy drinking can help lower the chance of colon cancer. Regular screening is also important for catching it early.

TREATMENT

TREATMENT OF COLON CANCER

The treatment for colon cancer depends on how advanced the cancer is, where it is located, and the person’s overall health. Here are the main ways colon cancer is treated:

Surgery
  • For Early-Stage Cancer: The doctor removes the cancerous part of the colon and may also remove nearby lymph nodes to check if the cancer has spread.
  • For Advanced Cancer: A larger part of the colon might be removed, and the healthy parts are reconnected. Sometimes, a colostomy (an opening for waste) is needed temporarily or permanently.
Radiation Therapy
  • Uses high-energy beams to target and kill cancer cells.
  • When It’s Used:
    • Sometimes used before or after surgery, especially for rectal cancer (cancer in the last part of the colon).
Chemotherapy
  • Uses special drugs to kill cancer cells or stop them from growing.
  • When It’s Used:
    • After surgery, to kill any remaining cancer cells.
    • For advanced cancer, to slow its growth or shrink tumors.
Targeted Therapy
  • Uses drugs to attack specific parts of cancer cells without harming normal cells.
  • Examples:
    • Drugs that stop the cancer from growing new blood vessels.
    • Drugs that target changes in cancer cell genes.
Immunotherapy
  • Helps your immune system recognize and attack cancer cells.
  • When It’s Used:
    • Mostly for advanced colon cancer with specific genetic features.
Palliative Care
  • Focuses on relieving symptoms and improving quality of life, especially in advanced cases.
  • Examples:

Pain relief, managing bowel problems, and providing emotional support.

Key Point

Many people with colon cancer can be treated successfully, especially if it’s caught early. Treatment plans are often personalized, and combining different treatments can give the best results. Regular follow-ups after treatment help monitor for any signs of recurrence.

PREVENTION

Preventing colon cancer involves making healthy lifestyle choices and staying proactive about screenings. Here are some simple steps to reduce your risk:

 Get Regular Screenings
  • Why It’s Important: Colon cancer often starts as polyps (small growths) in the colon that can be removed before they turn into cancer.
  • When to Start: Most people should start screening at age 45, but if you have a family history or other risk factors, your doctor may recommend starting earlier.
Eat a Healthy Diet
  • Foods to Include:
    • Fruits, vegetables, and whole grains for fiber and nutrients.
    • Foods rich in calcium and vitamin D (e.g., dairy, leafy greens).
  • Foods to Limit:
    • Red and processed meats like bacon, sausages, and hot dogs.
    • High-fat and sugary foods.
Stay Physically Active
  • Regular exercise helps keep your digestive system healthy and lowers your risk of colon cancer.
  • Aim for at least 30 minutes of moderate activity, like walking or cycling, most days of the week.
 Quit Smoking
  • Smoking damages the cells of the cervix and makes it harder for the body to fight HPV infections.
  • Quitting smoking can lower your risk.
Maintain a Healthy Weight
  • Being overweight, especially having belly fat, increases the risk of colon cancer.
  • Losing excess weight can lower your risk.
Avoid Tobacco
  • Smoking increases the risk of many cancers, including colon cancer.
  • Quitting smoking is one of the best ways to improve overall health.
Limit Alcohol
  • Heavy drinking raises your risk of colon cancer.
  • If you drink, do so in moderation (one drink per day for women, two for men).
Treat Chronic Conditions
  • Inflammatory Bowel Disease: If you have Crohn’s disease or ulcerative colitis, work with your doctor to manage it, as these conditions increase cancer risk.
  • Diabetes: Keeping blood sugar levels under control can also help.
Know Your Family History
  • If colon cancer runs in your family, talk to your doctor about genetic testing or starting screenings earlier.
Consider Aspirin (if advised by your doctor)
  • For some people, low-dose aspirin may reduce the risk of colon cancer. Only take it under medical supervision.

Key Point

Colon cancer is one of the most preventable cancers. Regular screenings, a healthy lifestyle, and knowing your family history can significantly reduce your risk. Talk to your doctor about the best prevention plan for you.

Recent advancements in colon cancer research have led to significant improvements in diagnosis, treatment, and patient outcomes. Key developments include:

Targeted Therapies

KRAS-G12C Inhibitors: The U.S. Food and Drug Administration (FDA) has approved adagrasib (Krazati®) in combination with cetuximab (Erbitux®) for treating advanced colorectal cancer with the KRAS-G12C mutation. This marks the first KRAS-targeting drug approved for colorectal cancer, offering new options for patients with this specific genetic alteration.

Immunotherapy

Botensilimab and Balstilimab Combination: Clinical trials have shown that combining these two immunotherapy drugs can cause tumors to shrink or remain stable in 61% of patients with microsatellite stable metastatic colorectal cancer (MSS mCRC), a form typically resistant to other treatments. This combination has been described as “game-changing” and offers hope for patients with limited options. 

Bacterial Therapy

Modified Salmonella Bacteria: Researchers have engineered a form of Salmonella bacteria that can target and suppress tumor cells without hindering the immune system. This approach involves modifying the bacteria to prevent depletion of asparagine, an amino acid essential for T cell function, allowing the immune system to effectively combat cancer cells. This discovery holds promise for developing bacterial therapies to fight cancer. 

 Personalized Medicine

Precision Oncology: Advancements in genetic profiling enable treatments tailored to the individual genetic makeup of a patient’s tumor, improving the effectiveness of therapies and reducing side effects. This personalized approach allows for more targeted and efficient treatment strategies. 

 Early Detection

Liquid Biopsies: Innovative blood tests are being developed to detect circulating tumor DNA, allowing for earlier diagnosis and monitoring of colon cancer recurrence. These non-invasive tests can identify cancer-related genetic mutations in the bloodstream, facilitating timely intervention. 

These advancements reflect a multidisciplinary approach to combating colon cancer, integrating targeted therapies, immunotherapy, bacterial therapy, personalized medicine, and early detection techniques to improve patient outcomes.