Colorectal Cancer Part 1: Some Basic Facts You May Want to Know
By Chris Teo, Ph.D.
Colorectal cancer is a disease due to the cancerous growth found in the large bowel, the end portion of the digestive tract which holds the undigested food that is waiting to be eliminated. The colon is about 5 to 6 feet long and 2.5 inches in diameter. The rectum is the last 6 to 8 inches of the colon which ends at the anus.
Cancer involving the upper part of the digestive tract or the small bowel (intestine) is rare. But cancer of the large bowel is very common. Colorectal cancer is said to be the fourth most common cancer worldwide. It is second only to lung cancer as a cause of death from cancer in the US. According to the American Cancer Society's publication -- Cancer Facts & Figures 2006 -- in 2006, approximately 148,610 new cases (72,800 men and 75,810 women) of colorectal cancer will be diagnosed in the US. And an estimated 37% or 55,170 people (27,870 men and 27,300 women) will die from it.
Colorectal cancer is predominantly a disease of people 50 years and older. Less than 6% of this cancer occurs in those below 50 years old. However, the incidence of colorectal cancer increases after age 50 and continues to increase until age 75.
Diet
Dietary factors are considered to be responsible for 80% to 90% of all cases of colorectal cancer.
1. Colorectal cancer is common in population with high intake of meat products and relatively low level of dietary fibre.
2. Diet high in animal fat is associated with increased rate of colorectal cancer.
3. Diet high in vegetable and cereal fibers decreased colorectal cancer rate. It is suggested that large quantities of vegetables and cereal fibers increase stool bulk, bacterial fermentation and hasten large bowel transit rate.
Symptoms of Colorectal Cancer
This cancer is often called the silent killer. In most people the cancer does not show any obvious symptoms at its early stage. One early symptom, in some patients, is bleeding. The tumour may bleed on and off giving out a small amount of blood. Sometimes, such bleeding is hardly noticeable. It is when the disease has progressed and becomes advanced that symptoms develop, such as:
1. Changes in bowel habits. This can manifest in constipation, diarrhoea, bowel incontinence, and feeling of unfinished bowel movement.
2. Production of narrower stools than normal.
3. Presence of blood in stools. Take note, however, that not all bleeding is due to cancer. Other problems such as hemorrhoids (piles), ulcers, ulcerative colitis, etc. can also produce blood in stools.
4. Anemia. This is the shortage of red blood cells.
5. Abdominal discomforts. This may be manifested in feelings of discomforts, bloatedness, fullnes, cramps or pains in the abdomen.
6. Weight loss.
7. Fatigue or feeling of extreme tiredness.
8. Vomiting.
Staging of Colorectal Cancer
Stage 0 (or carcinoma in situ): Tumour is in innermost lining of colon wall.
Stage I (Dukes A): Tumour in innermost lining, second and third layers of colon wall.
Stage II (Dukes B): Tumour grows through colon wall.
Stage III (Dukes C): Tumour grows out and spreads to lymph nodes.
Stage IV (Dukes D): Tumour has spread to other parts of the body.
Recurrent Cancer: The cancer has come back after being treated.
Prognosis
The prognosis of the disease is poor if the cancer has spread to other parts of the body. This is considered as Stage 4. The five-year survival is only 5%. However, if the cancer is at its early stage, e.g., Stage 1 and 2, the five-year survival is 90% and 85% respectively. Therefore, the stage at diagnosis greatly impacts survival rates of colorectal cancer.
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