Your Health A-Z

Colorectal cancer, know the symptoms

Colorectal cancer is the fourth most prominent cancer in South Africa and the sixth most lethal. Dr Mariza Tunmer, a specialist radiation oncologist at the Wits Donald Gordon Medical Centre, explains what we should know.

An article in the South African Medical Journal (SAMJ) presents further worrying details about colorectal cancer: 25% of patients will have a synchronous metastatic disease at the time of their primary diagnosis, which means patients will have developed a spread of colorectal cancer by the time they are diagnosed. As with other cancers, the earlier the disease is detected the better the chances of recovery.

What is colorectal cancer?

It’s a cancer of the large intestine, which we know as the colon, the last part of the digestive tract. Most cases of colon cancer begin as small, noncancerous (benign) clumps of cells called adenomatous polyps and over time some of these polyps can develop into colon cancer.

These polyps don’t necessarily produce symptoms and it’s important to detect these growths early on in regular screening tests. The removal of these polyps before they become cancerous is crucial.

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What to look out for

Tunmer advises you look for the following symptoms:

  • Rectal bleeding
  • Abdominal cramping
  • Change in bowel habits
  • Pelvic pain

“The above are the most common symptoms, but there could also be difficulty passing stool and nausea (obstructive symptoms),” she warns. Loss of weight can also be an indication, however, she notes that these are usually late symptoms.

Consult our men’s decade-by-decade guide to the annual health checkup 

Diagnosis

  1. An initial examination is usually done by a doctor by way of a colonoscopy to assess the lining of the rectum and colon, Tunmer explains.
  2. Should there be anything suspicious, the doctor would then perform a biopsy of the area to confirm if cancer is present.
  3. Scans and blood tests follow the above procedures as part of the staging and workup for treatment.

Treatment

“Colorectal cancer that hasn’t spread to many other sites in the body is usually managed by surgical removal,” says Tunmer, “however, sometimes chemotherapy or radiotherapy are also used, either before or after, depending on the stage and other factors.” Many patients are curable if the cancer is found before it has spread, she says.

According to the previously mentioned SAMJ article, chemotherapy can be used throughout most stages of the disease, but surgical intervention – of both a primary tumour and metastases – remains the most effective way of curing colorectal cancer or prolonging survival.

What can you do?

* Number one: stop smoking, says Tunmer.

  • Family history is a big risk factor. “Go for your first screening colonoscopy at age 45 or earlier if you have a family history of colorectal cancer,” she says. “Some other cancers may also point towards risks that are associated with this cancer, such as pancreatic and other upper gastrointestinal cancers, endometrial and ovarian cancer in ladies, among others.” If you have a strong family history of cancer, seek medical advice to establish your risk so a medical professional can advise on a plan to mitigate these risks, she notes.
  • “Dietary risk factors are controversial when it comes to colorectal cancer, but generally speaking it is good practice to follow a healthy lifestyle with a well-balanced diet and enough exercise,” she says.

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