Colon Cancer

Faculty of nursing
Zagazig university
Dr / Ahmed Raafat
 Colon Cancer

Colon cancer:

is cancer of the large intestine (colon), which is the final part of digestive tract. Most
cases of colon cancer begin as small, noncancerous (benign)
clumps of cells called adenomatous polyps. Over time some of
these polyps can become colon cancers.
Polyps may be small and produce few, if any, symptoms. For
this reason, doctors recommend regular screening tests to help prevent colon cancer by
identifying and removing polyps before they turn into cancer.

Symptoms

Signs and symptoms of colon cancer include:

A change in bowel habits, including diarrhea or constipation or a change in the

consistency of stool, that lasts longer than four weeks
Rectal bleeding or blood in stool
Persistent abdominal discomfort, such as cramps, gas or pain
A feeling that bowel doesn't empty completely
Weakness or fatigue
Unexplained weight loss

Many people with colon cancer experience no symptoms in the early stages of the disease.
When symptoms appear, they'll likely vary, depending on the cancer's size and location in
your large intestine.

Risk factors

Factors that may increase risk of colon cancer include:

Older age. The great majority of people diagnosed with colon cancer are older than 50.
Colon cancer can occur in younger people, but it occurs much less frequently.
African-American race. African-Americans have a greater risk of colon cancer than do
people of other races.

Dr / Ahmed Raafat
 A personal history of colorectal cancer or polyps. If there is already colon cancer or
adenomatous polyps, there is a greater risk of colon cancer in the future.
Inflammatory intestinal conditions. Chronic inflammatory diseases of the colon, such
as ulcerative colitis and Crohn's disease, can increase risk of colon cancer.
Inherited syndromes that increase colon cancer risk. Genetic syndromes passed
through generations of family can increase risk of colon cancer. These syndromes
include familial adenomatous polyposis and hereditary nonpolyposis colorectal cancer,
which is also known as Lynch syndrome.
Low-fiber, high-fat diet. Colon cancer and rectal cancer may be associated with a diet
low in fiber and high in fat and calories.
A sedentary lifestyle. Getting regular physical activity may reduce your risk of colon
cancer.
Diabetes. People with diabetes and insulin resistance have an increased risk of colon
cancer.
Obesity.
Smoking. People who smoke may have an increased risk of colon cancer.
Alcohol. Heavy use of alcohol increases risk of colon cancer.
Radiation therapy for cancer. Radiation therapy directed at the abdomen to treat
previous cancers increases the risk of colon and rectal cancer.

Prevention of colon cancer:

1) Get screened for colon cancer:

High-sensitivity fecal occult blood tests (FOBT). Both polyps and colorectal cancers
can bleed, and FOBT checks for tiny amounts of blood in stool that cannot be seen
visually. (Blood in stool may also indicate the presence of conditions that are not cancer,
such as hemorrhoids.)
Sigmoidoscopy. In this test, the rectum and sigmoid colon are examined using a
sigmoidoscope. This instrument is inserted through the anus into the rectum and
sigmoid colon as air (or carbon dioxide) is pumped into the colon to expand it so the
doctor can see the colon lining more clearly. During sigmoidoscopy, abnormal growths
in the rectum and sigmoid colon can be removed for analysis.

Dr / Ahmed Raafat
 Colonoscopy. In this test, the rectum and entire colon are examined using a
colonoscope, a flexible lighted tube with a lens for viewing and a tool for removing
tissue. Like the shorter sigmoidoscope, the colonoscope is inserted through the anus into
the rectum and the colon as air (or carbon dioxide) is pumped into the colon to expand it
so the doctor can see the colon lining more clearly. During colonoscopy, any abnormal
growths in the colon and the rectum can be removed, including growths in the upper
parts of the colon that are not reached by sigmoidoscopy.
2) Make lifestyle changes to reduce your risk:

Steps to reduce your risk of colon cancer by making changes in everyday life. Take steps to:

Eat a variety of fruits, vegetables and whole grains. Fruits, vegetables and whole grains
contain vitamins, minerals, fiber and antioxidants, which may play a role in cancer
prevention. Choose a variety of fruits and vegetables so that you get an array of
vitamins and nutrients.
Stop smoking. Talk to your doctor about ways to quit that may work for you
Exercise most days of the week. Try to get at least 30 minutes of exercise on most days.
If you've been inactive, start slowly and build up gradually to 30 minutes. Also, talk to
doctor before starting any exercise program.
Maintain a healthy weight.

Colon cancer stages:

Once colon cancer have been, doctor will order tests to determine the extent (stage) of
cancer.
Staging helps determine what treatments are most appropriate. The stages of colon
cancer are:
1) Stage I.
The cancer has grown through the superficial lining (mucosa) of the colon or rectum
but hasn't spread beyond the colon wall or rectum.
2) Stage II.
The cancer has grown into or through the wall of the colon or rectum but hasn't
spread to nearby lymph nodes.

Dr / Ahmed Raafat
 3) Stage III.
The cancer has invaded nearby lymph nodes but isn't affecting other parts of your
body yet.
4) Stage IV.
The cancer has spread to distant sites, such as other organs — for instance, to your
liver or lung.

Treatment

The type of treatment recommended will depend largely on the stage of cancer.

The three primary treatment options are surgery, chemotherapy and radiation.

1) Surgery for early-stage colon cancer:

If colon cancer is very small, doctor may recommend a minimally invasive approach
to surgery, such as:
Removing polyps during a colonoscopy.
Endoscopic mucosal resection.
Minimally invasive surgery. Polyps that can't be removed during a colonoscopy may be
removed using laparoscopic surgery.
2) Surgery for invasive colon cancer:
If the cancer has grown into or through colon, your surgeon may recommend:
Partial colectomy.
Surgery to create a way for waste to leave body. When it's not possible to reconnect the
healthy portions of colon or rectum, may need an ostomy.
Lymph node removal. Nearby lymph nodes are usually also removed during colon
cancer surgery and tested for cancer.
3) Chemotherapy
4) Radiation therapy
5) Targeted drug therapy
6) Immunotherapy
7) Supportive (palliative) care

Dr / Ahmed Raafat
Gerontological Nursing Interventions for Colorectal Cancer

(1) Prepare the patient for surgery, as indicated.

(2) Provide comfort measures and reassurance for patients undergoing radiation therapy.

(3) Prepare the patient for the adverse effects of chemotherapy and take steps to minimize
these effects.

(4) Use strict aseptic technique when caring for I.V. catheters.

(5) Have the patient wash his hands before and after meals and after going to the bathroom.

(6) Listen to the patient's fears and concerns, stay with him during periods of severe stress
and anxiety.

(7) Encourage the patient to identify actions and care measures that will promote his comfort
and relaxation.

(8) Monitor the patient's bowel patterns.

(9) Monitors the patient's diet modification, and assess the adequacy of his nutrition intake.

(10) Direct the patient to follow a high fiber diet.

(11) Caution him to take laxatives or an antidiarrheal medication only as prescribed by the
doctor. Inform the patient about screening and early detection.

Quizzes

1) Common risk factors of colon cancer in the Elderly……….……

2) Signs and symptoms of colon cancer include: ……….………….…………….
3) The stages of colon cancer are: …………………. ……… …….

Dr / Ahmed Raafat