Colorectal cancer
"Multidisciplinary treatment of colon cancer brings great benefits to the patient".
DR. JAVIER RODRÍGUEZ
SPECIALIST. GASTROINTESTINAL CANCER AREA
What is colon cancer?
Colon cancer is one of the most common types of cancer worldwide. It is the third most commonly diagnosed tumour in men and the second in women, according to data from the World Health Organisation (WHO). Colon cancer originates in the large intestine, or colon, when polyps (abnormal tissue growth) develop in the mucosa lining this organ. Some of these polyps degenerate over time and cancer develops.
This malignant tumour can grow locally (invading the layers of the wall of the digestive tract and can reach the organs contained in the abdomen), by lymphatic spread (reaching nearby lymph nodes) or by haematogenous spread, i.e. through the blood reaching vital organs such as the liver, lung, bones and brain.
If the tumour is detected early, it is curable in more than 90% of cases. For this reason, early detection is vital as it is a common cancer. In recent decades, both incidence and mortality rates have fallen thanks to prevention.
The Clínica Universidad de Navarra offers an Early Detection Programme for Colorectal Cancer, which aims to detect cancer in its early stages in order to improve prognosis. It also has a Gastrointestinal Cancer Area, a multidisciplinary team specialising in the diagnosis and treatment of diseases of the digestive tract.
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What are the symptoms of colon cancer?
The symptoms of colon cancer vary depending on its location. There are also other non-malignant diseases of the large intestine that can cause similar symptoms.
Occult blood in the stool
This is one of the most common symptoms of colon cancer, and anaemia may occur.
Change in the rhythm of bowel movements
Some people, with a previously normal bowel rhythm, experience diarrhoea or constipation.
Narrowed stools
This is because the tumour is narrowing the bowel and not allowing normal passage of stool.
Abdominal pain
When the tumour closes the intestinal tract, an obstruction occurs, in which case urgent medical assistance is required.
Mucus in the stool
The presence of mucus in the stool can be a sign of inflammation, although it is not always associated with colon cancer.
Tenesmus or sensation of incomplete evacuation
This is the sensation of having the need to defecate, but most of the time there is little or no bowel movement.
Do you have any of these symptoms?
If you suspect that you have any of the above symptoms,
you should consult a medical specialist for a diagnosis.
What are the causes?
Seventy percent of colorectal cancer cases are sporadic and therefore associated with the individual characteristics of each person, as well as with different environmental factors. Diet is a causal factor that has a considerable influence on this pathology.
25% of patients with colon cancer have a family member with the disease. Overall, 5-10% of colorectal cancers (cancer of the colon and/or rectum) are hereditary.
The presence of a first- or second-degree family history of colon cancer or a personal history of adenomatous polyps is a risk factor for developing colorectal cancer.
Patients diagnosed with inflammatory bowel disease also have a higher risk of developing colon cancer.
At the Clínica we have a High Risk Prevention and Consultation Unit for Digestive Tumours that has extensive experience and the latest technology to detect this genetic risk.
Risk factors and prevention
Advanced age, visceral obesity, smoking, sedentary lifestyle and dietary factors, such as a high intake of red meat and ultra-processed foods, have been identified as risk factors for the development of polyps and colorectal carcinomas.
This is why different medical societies advise people over the age of 50 to adopt a healthy lifestyle and a varied Mediterranean diet, as well as to participate in early detection programmes.
In addition, there are some risk groups such as people with a first-degree family history of colon cancer and those suffering from inflammatory bowel diseases such as Crohn's disease and ulcerative colitis.
How is colon cancer diagnosed?
Colon cancer is one of the most common cancers. However, it is curable in 90% of cases if diagnosed early.
There are different tests available for early diagnosis. The Clínica has the latest diagnostic technology to be able to detect it, even non-invasively using capsule endoscopy for more delicate patients.
In order to diagnose colorectal cancer, it is necessary to directly visualise the colon to assess whether there are lesions and, if so, to take a sample for analysis:
Colon cancer treatments
Surgery is primarily aimed at removing the tumour along with related structures to ensure adequate removal. This includes:
- The tumour: with margins wide enough to prevent recurrence.
- Main blood vessels: arteries and veins that nourish the affected intestinal segment.
- Regional lymph nodes: to analyse the possible spread of the cancer.
Resection or removal can be performed conventionally or laparoscopically, the latter with a smaller incision and a quicker postoperative period.
Types of surgery:
- Right hemicolectomy: for tumours in the cecum or ascending colon.
- Left hemicolectomy: for tumours in the descending colon or sigma.
- Segmental colectomies: for tumours in the transverse colon or splenic angle.
Once the tumour has been removed, it is analysed in the Pathology Department. Depending on its characteristics, it may be necessary to complement the treatment with chemotherapy and/or radiotherapy.
Treatment depends on the stage of the disease. Chemotherapy is administered intravenously or orally, although there are other forms depending on the case.
Types of chemotherapy administration:
- Neoadjuvant treatment: Before surgery to reduce the size of the tumour and facilitate the intervention.
- Adjuvant treatment: After surgery to eliminate possible remaining cancer cells and prevent relapse.
- Palliative treatment: To reduce tumour burden, improve symptoms and prolong quality of life.
In some cases, patients with liver or lung metastases may respond well to treatment, allowing subsequent surgery.
Each case is evaluated in a multidisciplinary committee to define the best therapeutic strategy.
Options for non-surgical patients:
- Intra-arterial chemotherapy: Allows the drug to be administered directly into the foci of metastatic disease, achieving higher drug concentration with fewer side effects.
- Radioembolisation: Used to treat liver lesions that cannot be surgically removed, consolidating the results obtained with chemotherapy.
Colorectal cancer is not a single disease, but a collection of tumours with important genetic differences. This means that it can develop in different ways depending on the alterations in the DNA of the affected cells.
Molecular classification makes it possible to identify these genetic differences, which is crucial for predicting how the disease might evolve and what treatments might be most effective for each patient.
In other words, it helps both to understand prognosis and to personalise treatment. In our clinic we have a Genomic Medicine Unit equipped to perform advanced genetic analyses.
These studies allow us to better characterise each tumour, identify possible cases of hereditary cancer and discover new therapeutic options adapted to the specific needs of each patient.
What clinical trials do we have on colon cancer?
Treatments for lung cancer
A multidisciplinary team is essential in the treatment of lung cancer.
The Gastrointestinal Cancer Area
of the Cancer Center Clínica Universidad de Navarra
The Gastrointestinal Cancer Area is composed of a multidisciplinary team of experts in the diagnosis and treatment of diseases of the digestive tract.
It includes specialists in the digestive system, radiology, pathological anatomy, surgery and medical and radiotherapeutic oncology and nursing support.
What diseases do we treat?
Why at the Clinica?
- Integral evaluation of the patient.
- Cutting edge technology.
- Expert professionals who are a national reference.
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Our team of professionals
