Colorectal Colon Cancer Diagnosis, Symptoms, and Treatment Options in Turkey
What is Colorectal Colon Cancer?
Colorectal Colon Cancer (also known as anal canal cancer) develops in the tissues of the anus or the lining of the anal canal. The anal canal connects the anus (the opening) to the rectum (the lower part of your digestive system). The anus is where stool exits the body. Healthcare providers can treat Colorectal Colon Cancer if it is detected and managed early.
Types of Colorectal Colon Cancer
There are two types of Colorectal Colon Cancer: squamous cell carcinoma and adenocarcinoma. Squamous cell carcinoma is the most common type of anal cancer. Squamous cell carcinoma in the anal region differs from skin cancer, which starts in the upper layer of the skin.
What Are the Symptoms of Colorectal Colon Cancer?
Colorectal Colon Cancer symptoms may resemble common conditions like persistent anal itching. Other symptoms may include:
- Bleeding, especially during bowel movements.
- A lump or mass (an anal cancer lump may appear at the anus).
- Pain.
- Changes in bowel movements, such as increased frequency or altered stool consistency.
- Stool leakage.
- A persistent urge to defecate.
Many conditions can cause these symptoms. Having one or more of these symptoms does not necessarily mean you have anal cancer. However, you should consult a healthcare provider if these symptoms worsen or do not go away after a few days.
It is natural to feel some embarrassment or discomfort when discussing certain Colorectal Colon Cancer symptoms, such as anal itching, with a healthcare provider. However, there are many possible causes of anal cancer, and you should know that there is nothing shameful about its symptoms. Healthcare providers are here to help you with all your health concerns, including Colorectal Colon Cancer symptoms.
What Causes Colorectal Colon Cancer?
The exact cause of anal cancer is unknown. However, certain risk factors are associated with the disease. For example, most cases of anal cancer are linked to specific types of human papillomavirus (HPV). However, it is important to note that the vast majority of people infected with HPV do not develop anal cancer.
Risk Factors
In addition to HPV, several other risk factors may increase the likelihood of developing anal cancer, including:
- Taking immunosuppressants – These are medications that prevent the immune system from attacking healthy cells.
- Having human immunodeficiency virus (HIV) – HIV increases the risk of anal cancer because it weakens the immune system. Additionally, HIV infection may result from unprotected anal intercourse, which is a risk factor.
- Engaging in anal intercourse – This applies to both men and women. In general, having multiple sexual partners increases the risk of HPV infection, which in turn raises the risk of anal cancer.
- Not being vaccinated against HPV – Certain types of HPV are common causes of anal cancer.
- Advancing age (55 years or older) – Doctors typically diagnose anal cancer in individuals within this age group.
- Smoking – Smokers are at a higher risk of developing multiple types of cancer, including anal cancer.
- Having a disease or taking medications that weaken the immune system – For instance, individuals who undergo organ transplants must take immunosuppressive drugs to prevent organ rejection.
- Having an anal fistula – This is an abnormal opening that connects the anus to the surrounding skin.
- A history of other cancers – Such as vulvar, vaginal, or cervical cancer.
What Are the Complications of Colorectal Colon Cancer?
If left untreated, anal cancer can spread (metastasize) to nearby tissues. In rare cases, it may spread to the lungs or liver.
How Is Colorectal Colon Diagnosed?
Your healthcare provider will ask about your symptoms, including how long you have been experiencing them. They will also inquire about your medical history, including any conditions affecting your immune system. Additionally, they may ask about your sexual activity.
What Tests Are Used to Diagnose This Condition?
Your provider will perform a digital rectal exam and may also conduct an anal Pap test or a biopsy to collect cells for examination under a microscope by a pathologist. (Women may also undergo a pelvic exam.) Further diagnostic procedures include endoscopic examinations and imaging tests.
Endoscopic Examinations
Healthcare providers perform endoscopic exams to inspect the inside of the rectum and anus. These procedures involve specialized instruments—thin, flexible tubes equipped with lights, lenses, and video cameras. They may also collect tissue samples (biopsy) for analysis by a pathologist. Common endoscopic tests include:
- Anoscopy – Uses a short, illuminated tube called an anoscope to examine the anus and lower rectum.
- Flexible sigmoidoscopy – Used to check for tumors and abnormal growths in the rectum and anus.
- Colonoscopy – A comprehensive examination of the entire colon to detect tumors and abnormal growths.
Imaging Tests
Imaging tests help healthcare providers learn more about tumors, including the tumor’s size and specific location. Imaging tests may include:
- Magnetic resonance imaging (MRI).
- Endorectal ultrasound.
- Computed tomography (CT) scan.
- Positron emission tomography (PET) scan.
Stages of Colorectal Colon Cancer
Healthcare providers use cancer staging systems to plan treatment and determine likely expectations after treatment. They take into account factors such as the size of the tumor, the presence of cancer in the lymph nodes, and whether the tumor has spread or metastasized. There are five stages of anal cancer:
- Stage 0: Abnormal cells are present in the anal mucosa, the deepest layer of the anal canal. These cells are not cancerous but may become so. Stage 0 anal cancer is also known as “high-grade squamous intraepithelial lesion” (HSIL).
- Stage 1: Cancerous cells have formed and formed a tumor that is 2 centimeters or smaller, about the size of a peanut.
- Stage 2: The tumor is larger than 2 centimeters but smaller than 5 centimeters.
- Stage 3: The tumor is 5 centimeters, about the size of a lime, but has not spread from the anal canal.
- Stage 4: The tumor is 5 centimeters or smaller but has spread to lymph nodes in the anal canal or groin.
- Stage 5: Anal cancer has spread to nearby organs such as the vagina, urethra, or bladder.
- Stage 6: Cancerous cells are present in nearby organs and have spread to lymph nodes near the anus or groin.
- Stage 7: Cancer is present in lymph nodes distant from the anus and in distant organs such as the lungs or liver.
How is it treated?
Treatment for anal cancer depends on the type and stage of cancer, and may include:
Radiation therapy
- Caregivers treat anal cancer using external beam radiation therapy. Types of external radiation therapy include:
- Intensity-modulated radiation therapy IMRT) directs multiple energy beams of different strengths to the tumor.
- Somatoform stereotactic radiation therapy (SBRT), which targets small tumors without damaging nearby healthy tissue.
- This is a three-dimensional radiation therapy (3D-CRT) that creates a three-dimensional image of the tumor.
- The nature of internal radiation therapy (Brachytherapy)
Chemotherapy treatment
- Caregivers often combine chemotherapy and radiation as the initial treatment for anal cancer. Often, combined therapy eliminates cancer, eliminating the need for surgery.
- If you need surgery, you may receive chemotherapy before surgery to shrink the tumor (adjuvant chemotherapy before surgery), or after surgery to eliminate any remaining cancer cells (adjuvant chemotherapy after surgery).
Surgery
Laparoscopic laparotomy is used as a minimally invasive surgical procedure for the treatment of anal cancer that has returned (recurred) or has not responded to radiation or chemotherapy. This procedure involves the removal of the anus, rectum and colon. If you have this surgery, the surgeon will perform a permanent colostomy so that you can get rid of the stool in a bag or pouch that is attached to your body.
Immunotherapy
If you have late-stage anal cancer, your caregiver may recommend immunotherapy to help you control your symptoms. Immunotherapy helps your body fight cancer.
What are the side effects of treatment?
Most cancer treatments may cause side effects. For example, side effects of chemotherapy and radiation therapy may include skin irritation, pain in the anal area, fatigue, brain fog caused by chemotherapy, nausea and vomiting.
What are the complications of treatment?
Caregivers may treat anal cancer with surgery. Complications of surgery may include:
- A reaction to anesthesia.
- There is excessive bleeding.
- It’s an infection.
The difference between anal cancer and anal dysplasia
Anal dysplasia is not cancer, but it may pave the way for its development. In the case of anal dysplasia, the cells in the anus become abnormal. Over time, these abnormal cells may begin to multiply, leading to the formation of cancerous tumors.
How does anal cancer differ from rectal cancer and colon cancer?
The anus, rectum and colon are all parts of the digestive system, but the cells that make up the tissues of each part differ from each other significantly. This means that healthcare providers treat these types of cancer in different ways based on the type of cells affected.
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