Colorectal cancer
The multidisciplinary treatment of colon cancer has many benefits for the patient, in that we can offer them the best and fastest treatment possible for their situation.”
DR. JAVIER RODRÍGUEZ
SPECIALIST. GASTROINTESTINAL CANCER AREA
The colon or large intestine is the final part of the intestine. It is shaped like a tube and its interior is covered with a mucosa formed by cells. When one of these cells becomes malignant and multiplies uncontrollably, colon cancer develops.
The formation of colon cancer is a staged process that begins with the appearance of a polyp that becomes malignant.
This malignant tumor 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 to the lymph nodes or by hematogenous spread (through the blood, preferably to the liver, lung, bone and brain).
If the tumor is detected at an early stage, it is curable in more than 90% of cases. For this reason, early detection is vital, as it is a common cancer. Eighty percent of cases are sporadic and 20% are genetically influenced.
At the Clinica, we have the Gastrointestinal Cancer Area, composed of a multidisciplinary team of experts in the diagnosis and treatment of diseases of the digestive tract. It includes specialists in digestive tract, radiology, pathological anatomy, surgery, medical and radiation oncology and nursing support.
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What are the symptoms of colon cancer?
The symptoms of colorectal cancer vary depending on the location.
If you experience any symptoms, we recommend visiting a gastroenterologist for diagnosis and to start any necessary treatment.
There are other nonmalignant diseases of the large intestine that may cause similar symptoms.
- Blood in the stool: one of the most common symptoms of colorectal cancer. Reddish or black in color. If bleeding persists, anemia may develop.
- Sensation of incomplete emptying of the bowel (tenesmus): usually occurs in cases of tumors located toward the end of the colon, or in the rectum.
- Change in digestive habits: diarrhea or constipation occurs intermittently in people who previously had normal bowel habits.
- Narrow stools: usually because the tumor is causing a narrowing of the bowel, not allowing normal passage of stool.
- Abdominal pain: nonspecific pain that improves after passing gas or stool.
- Extreme fatigue or weight loss with no apparent cause: these are general and unspecific symptoms that usually occur due to certain diseases such as cancer.
Do you have any of these symptoms?
You may have colon cancer
What are the causes?
The development of colorectal cancer depends on an interaction between genetic and environmental factors.
Environmental factors
These are the predominant factors in most cases of colon cancer. If these factors can be identified, many cases of colorectal cancer could be prevented. The most important causal factors seem to be related to diet.
Hereditary factors
Twenty percent of colorectal cancer patients have a close relative (parent, sibling or child) who has been diagnosed with the disease. To check for genetic factors, a genogram is prepared on the basis of the family’s history of cancer (not just colorectal but also other related cancers, such as those affecting the stomach, ovaries, endometrium, brain, kidney or bile duct). Familial adenomatous polyposis and nonpolyposis colorectal cancer can be hereditary.
The Hospital has a High-Risk Gastrointestinal Tumor Prevention and Response Unit that draws on extensive experience and cutting-edge technologies to identify this genetic risk.
Risk factors and prevention
Each person’s individual colorectal cancer risk depends on several factors. Some have become well established.
Risk is assessed as normal if you are over 50 and do not have any of the following risk factors:
- Personal family history of colorectal cancer or adenomatous polyps.
- Family history (parents, siblings and/or children) with colorectal cancer or adenomatous polyps.
- Family history of multiple cancers, particularly of the breast, ovaries and endometrium (womb).
- Diagnosis of inflammatory bowel disease (ulcerative colitis, Crohn’s disease).
How is colon cancer diagnosed?
Colorectal cancer is the third most common type of cancer. However, it is curable in 90% of cases if diagnosed early.
There are different tests for early diagnosis. The Hospital has state-of-the-art diagnostic technologies for detection, including noninvasive means such as capsule endoscopy for frailer patients.
To diagnose colorectal cancer, the colon must be directly visualized to assess whether lesions are present. If so, a sample is taken for analysis.
How is colon cancer treated?
Surgical treatment: conventional or laparoscopic removal of the tumor
The surgery seeks to remove:
- The tumor, with sufficiently wide margins
- The main arterial and venous vessels that nourish the intestinal segment where the tumor is located
- Regional lymph nodes
Resection can be performed in conventional surgery or via laparoscopic surgery, with a smaller incision and a faster postoperative recovery.
Types of surgery:
- Right hemicolectomy (tumor in the cecum or ascending colon)
- Left hemicolectomy (tumor in the descending colon or sigmoid colon)
- Segmental colectomy (tumors in the transverse colon or splenic flexure)
After removing the tumor, the Pathology Department will analyze it. Depending on the tumor’s characteristics, treatment with chemotherapy and/or radiation therapy may be necessary as a complementary treatment to surgery.
Metastatic cancer
When colorectal cancer has spread, one area where metastases are often found is the liver.
The aim of treatment is to surgically remove the liver metastases and the primary tumor, which improves patient survival rates.
If the metastases are inoperable, other treatments may be used to control the disease:
- Chemotherapy combined with new biological therapies, depending on the cancer’s molecular expression.
- Intra-arterial chemotherapy to reach metastatic foci more selectively. This achieves higher drug concentration without increasing toxicity and boosts response.
- Radioembolization for liver metastases with yttrium microspheres. Enables consolidation of liver lesions after chemotherapy where they cannot be surgically removed.
The aim is to administer a combination of drugs to achieve an optimal balance between tolerating the treatment and controlling the disease, based on each patient’s individual characteristics.
From the genetic point of view, colorectal cancer is highly heterogeneous as it can develop by different pathways. Molecular classification provides valuable information both from a prognostic and predictive point of view, as well as allowing a better individualization of treatment.
In our center we have a Genomic Medicine Unit with the possibility of performing wide molecular panels with the aim of a better tumor characterization, detection of hereditary tumors as well as possible therapeutic targets.
Surgical treatment: conventional or laparoscopic removal of the tumor
The surgery seeks to remove:
- The tumor, with sufficiently wide margins
- The main arterial and venous vessels that nourish the intestinal segment where the tumor is located
- Regional lymph nodes
Resection can be performed in conventional surgery or via laparoscopic surgery, with a smaller incision and a faster postoperative recovery.
Types of surgery:
- Right hemicolectomy (tumor in the cecum or ascending colon)
- Left hemicolectomy (tumor in the descending colon or sigmoid colon)
- Segmental colectomy (tumors in the transverse colon or splenic flexure)
After removing the tumor, the Pathology Department will analyze it. Depending on the tumor’s characteristics, treatment with chemotherapy and/or radiation therapy may be necessary as a complementary treatment to surgery.
Metastatic cancer
When colorectal cancer has spread, one area where metastases are often found is the liver.
The aim of treatment is to surgically remove the liver metastases and the primary tumor, which improves patient survival rates.
If the metastases are inoperable, other treatments may be used to control the disease:
- Chemotherapy combined with new biological therapies, depending on the cancer’s molecular expression.
- Intra-arterial chemotherapy to reach metastatic foci more selectively. This achieves higher drug concentration without increasing toxicity and boosts response.
- Radioembolization for liver metastases with yttrium microspheres. Enables consolidation of liver lesions after chemotherapy where they cannot be surgically removed.
The aim is to administer a combination of drugs to achieve an optimal balance between tolerating the treatment and controlling the disease, based on each patient’s individual characteristics.
Surgical treatment: removal of the tumor by conventional or laparoscopic means.
The aim of surgery is to remove:
- The tumor, with sufficiently wide margins.
- The main arterial and venous vessels that nourish the intestinal segment in which the tumor is located
- The regional lymph nodes.
Resection can be performed conventionally or by laparoscopic surgery, with a smaller incision and a faster postoperative period.
Types of surgery:
- Right hemicolectomy (tumor in the cecum or ascending colon).
- Left hemicolectomy (tumor in the descending colon or sigma).
- Segmental colectomies (tumors in the transverse colon or splenic flexure).
Once the tumor has been removed, it is analyzed in the Department of Pathological Anatomy. Depending on the characteristics of the tumor it may be necessary to administer treatment with chemotherapy and/or radiotherapy as a complement to surgery.
Tumor with metastasis
When colon cancer has spread, one of the areas where it most frequently metastasizes is the liver.
The goal of treatment is surgical resection of the liver metastases and of the primary tumor, since this increases the patient's survival.
If the metastases cannot be operated on, other types of treatment can be used to control the disease:
- Chemotherapy combined with new biological therapies, depending on the molecular expression of the tumor.
- Intra-arterial chemotherapy to reach more selectively the foci of metastatic disease. It achieves higher drug concentration without increasing toxicity and favors a greater response.
- Radioembolization of liver metastases with Ytrium spheres. It allows consolidation of liver lesions after chemotherapy that are not amenable to surgical removal.
> Read more about radioembolization
The aim is to administer a combination of drugs that achieves the best balance between tolerance and disease control, according to the characteristics of each patient.
Where do we treat it?
IN NAVARRA AND MADRID
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.
Our team of professionals
