Adenocarcinoma of the colon

Colon adenocarcinoma is a cancerous disease that occupies one of the leading places among oncological lesions of internal organs. Let's consider the features of this disease, symptoms, stages, treatment methods and prognosis for recovery.

The concept of colon cancer includes malignant tumors of various natures, which are localized in the anal canal, cecum, rectum and colon. The disease develops from epithelial tissues and metastasizes with the flow of lymph, so a favorable prognosis is possible only in the early stages. The danger is that it is almost impossible to recognize cancer in the early stages.

Most often, the disease is diagnosed in elderly patients. The risk of developing the disease increases significantly if a person is over fifty years old. But timely detection and correct differentiation of adenocarcinoma facilitates the treatment process. There are several degrees of cancer differentiation, which are included in the international classification of intestinal tumors, let's consider them:

• Highly differentiated.
• Moderately differentiated.
• Poorly differentiated (mucinous adenocarcinoma)
• Undifferentiated cancer (aggressive course and poor prognosis).

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Causes of colon adenocarcinoma

The causes of colon adenocarcinoma are determined by many factors. By identifying the cause of the disease, its development can be prevented. There are a number of factors that significantly increase the risk of developing oncology:

• Hereditary predisposition.
• Old age.
• Poor nutrition (deficiency of vitamins, minerals and microelements).
• Human papillomavirus infection.
• Adverse effects of various medications.
• Anal sex.
• Long-term constipation.
• Diseases of the large intestine (fistulas, tumors, colitis, polyps).
• Nervous disorders.
• Harmful working conditions, including working with asbestos.

Of course, most often there are several factors that cause the disease. By limiting yourself from predisposing factors, you can prevent the development of oncology.

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Symptoms of colon adenocarcinoma

Symptoms of colon adenocarcinoma at an early stage of the disease are vague. The patient complains of periodic abdominal pain, constipation and diarrhea, poor appetite and even nausea. However, none of these symptoms directly indicate an oncological lesion of the colon. At the first stage of the disease, bloody and mucous traces appear in the feces, which are later replaced by purulent ones. Such phenomena are constant, but do not reach a significant degree. Over time, all the above symptoms increase. During examination by a doctor, a specialist can palpate a tumor through the abdominal wall, it is mobile, dense and lumpy.

Main symptoms:

• Periodic aching pain in the abdominal area.
• Poor appetite, nausea, rapid weight loss.
• General weakness and elevated body temperature.
• Alternating constipation and diarrhea.
• Flatulence, difficulty defecating.
• Paleness of the skin.
• Blood, mucus and pus in the stool.

Against the background of the above-described manifestations of the disease, stomach ailments appear - nausea, a feeling of heaviness, heartburn, vomiting. As the tumor grows, the pain becomes more intense. Its increase is associated with the fusion of the malignant neoplasm with surrounding tissues and organs. Due to local specific conditions, that is, fecal matter and regular mechanical and chemical exposure, the tumor ulcerates. Against this background, an infection develops, which intensifies local symptoms, causes a rise in temperature, intoxication and changes in the blood composition. If the infection spreads to the retroperitoneal tissue, then painful sensations in the lumbar region and peritoneal phenomena appear.

In the early stages, cancer looks like overhanging mushroom-shaped formations. The tumor is divided into three types: ring-shaped, mushroom-shaped and infiltrating forms. When cut, its surface can be granular, hard or grayish-white. If we consider the disease from the point of view of the spread of the tumor process, then four stages are distinguished with the following symptoms:

• The tumor does not extend beyond the submucosa and mucous membrane.
• It protrudes into the internal lumen of the intestine, but does not metastasize. If metastases appear at this stage, they affect the entire thickness of the intestinal wall.
• Metastasizes to regional lymph nodes.
• The neoplasm reaches large sizes, affecting neighboring organs, metastasizing to the lymph nodes and distant organs.

Differentiated adenocarcinoma of the colon

Differentiated adenocarcinoma of the colon responds well to treatment, unlike other histological variants of the tumor. If the disease is detected at an early stage of development, then chemotherapy or radiation therapy is used for treatment. This helps slow the growth of the tumor and prevent metastasis. Later, the patient undergoes surgery and completely removes the malignant tumor with subsequent restoration of the integrity of the intestine.

Differentiated cancer has a positive prognosis of five-year survival for patients of all ages. To prevent its development, it is necessary to undergo regular medical examinations, and at the first pathological symptoms, do not postpone a visit to the doctor.

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Well differentiated adenocarcinoma of the colon

Highly differentiated colon adenocarcinoma has the most favorable prognosis and course. Oncology of this type has a minimum number of malignant cells. During the pathological process, the affected cells increase in size, and their nuclei lengthen.

The five-year survival rate of patients with this type of disease is at the level of 50%. Elderly people have a positive prognosis, since cancer practically does not metastasize and does not affect neighboring organs. But young patients have a 40% chance of recovery and five-year survival. There is a high risk of relapse in the first year after surgery and distant metastasis.

Moderately differentiated adenocarcinoma of the colon

Moderately differentiated adenocarcinoma of the colon is the most common form of malignant lesion of this organ. The progression of the disease leads to serious consequences, as the overgrown epithelial cells fill the entire lumen of the intestine, causing intestinal obstruction. If the tumor reaches large sizes, this can cause rupture of the intestinal walls and severe internal bleeding.

Treatment should be carried out from the earliest stage, since with progression, damage to nearby organs begins. Very often, the disease leads to the formation of fistulas and peritonitis, which significantly worsens the prognosis and the general course of the disease. Oncology is difficult to treat due to the difficulties in selecting effective drugs for chemotherapy. Radiation irradiation or surgery do not bring the desired results without additional treatment. Therefore, the prognosis completely depends on the early diagnosis of the disease.

Poorly differentiated colon adenocarcinoma

Low-differentiated adenocarcinoma of the colon is characterized by pronounced cellular polymorphism. The neoplasm grows and metastasizes quickly, so it has a poor prognosis. This form of cancer is much more dangerous than other differentiated types. Unlike mucous, colloid or squamous cell cancer, which have an aggressive course, the prognosis and course of the low-differentiated form are much worse.

The treatment does not bring positive results, so the survival prognosis is unfavorable. The only thing that can help a patient with this disease is symptomatic therapy. It is aimed at reducing painful sensations, to alleviate the patient's condition.

Tubular adenocarcinoma of the colon

Tubular adenocarcinoma of the colon has long been undetectable. This is due to the fact that in the early stages it has no pronounced symptoms, but with further progression it causes hidden intestinal bleeding and anemia. In certain cases, the neoplasm is capable of producing a large amount of protein-rich and potassium-rich mucous substrate, which provokes the development of hypokalemia and hypoproteinemia. Most often, this type of tumor is discovered by chance, for example, during an X-ray examination.

The tabular form has a characteristic structure embedded in fibrous stroma and branched. Tumor cells can be cylindrical and sometimes cubic. The disease is difficult to treat and has an unfavorable prognosis.

Metastases from adenocarcinoma of the colon

Metastases in colon adenocarcinoma affect other organs, as well as lymph nodes. Metastasis occurs in several ways: during implantation and tumor growth into surrounding tissues and organs, hematogenous and lymphogenous. Hematogenous spread of tumor cells is observed in 10% of patients, and lymphogenous in 60% of cases. Most often, metastases are found in patients with cancer in the last stages.

In addition to metastases, cancer may be complicated by ulcers, bleeding, and decay, which cause secondary infection and, in some cases, cachexia. Infectious lesions lead to abscess formation and subsequent perforation of the necrotic area of the tumor. About 40% of patients suffer from partial or complete obstruction. The pathological process may have a negative effect on the urinary system. Fistulas may form between the large intestine and the bladder, ureter, prostate, or female genitals.

Diagnosis of colon adenocarcinoma

Diagnosis of colon adenocarcinoma begins with collecting anamnesis. The doctor asks the patient about complaints, conducts an external examination and palpation. To accurately determine the disease, the patient is prescribed a contrast X-ray of the colon, blood, urine and stool tests, digital and endoscopic rectal examinations. Many of the above procedures are unpleasant, but very important. Based on the results obtained, the doctor will be able to make a diagnosis, conduct therapy and give a prognosis for recovery. In some cases, the diagnostic results completely refuted the previously made diagnosis.

Main diagnostic methods:

• Rectomanoscopy is an examination of the surface of the intestinal mucosa using an endoscope. This method is especially effective in the early stages of the disease.
• Contrast X-ray. The main signs of the tumor are: disturbances in the mucosal relief, filling defect (serrated, single, uneven), dilation of the intestine above the tumor, increased peristalsis.
• Ultrasound examination – used to detect the source of cancer and distant metastases. Depending on the clinical picture, endorectal or transcutaneous ultrasound can be used.
• Biopsy – performed using endoscopy. The obtained materials are used to determine the type, stage and degree of differentiation of the tumor lesion.
• Colonoscopy – visualizes neoplasms in any part of the large intestine.
• MRI, CT – have high accuracy, determine the features of the structure and location of the tumor, signs of damage to neighboring organs and the prevalence of the pathological process.

Particular attention is paid to differential diagnostics with other diseases of the intestine, abdominal organs and retroperitoneal space. The tumor is differentiated from polyps, which are most often found in children. In this case, contrast radiography is of decisive importance. Fecal stones in any part of the large intestine can simulate a neoplasm. But in the process of anamnesis, that is, upon palpation, they have a soft consistency and the so-called "pit symptom". When recognizing colon cancer with diseases of the abdominal organs, special attention is paid to congenital anomalies of the kidneys, ovaries, liver, spleen and ureters.

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Treatment of colon adenocarcinoma

Treatment of colon adenocarcinoma depends on its stage and form. Combination therapy is most often used, as cancer is sensitive to radiation. After a course of radiation, the tumor shrinks in most patients, as malignant cells die. Radiotherapy improves the results of surgery by reducing the likelihood of tissue inflammation and tumor cell transfer. Drug therapy and a special diet are mandatory.

Let's consider the main methods of treating malignant lesions of the colon:

1. Chemotherapy – a combination of 5-fluorouracil with Leucovorin or Irinotecan is used. Capecitabine, Fluorofur and Raltitrexide are effective. The listed drugs can be used in combination.
2. Radiation is rarely used to treat colon cancer, as all of its sections except the rectum are very mobile and change their position in the abdominal cavity depending on the patient's position. Radiation can be used as a preparation for surgery or after it. It reduces the volume of the tumor and suppresses the appearance of metastases.
3. There is no special diet for patients with this type of cancer, but there are a number of nutritional recommendations. The diet should contain a lot of fruits and vegetables. Particular attention should be paid to vitamin therapy. If the patient has undergone bowel resection, the diet should include light food that does not linger in the stomach, does not cause flatulence and nausea. It is necessary to eat according to the regimen, maintaining water balance.

There are folk methods of treatment, they can be used as an auxiliary therapy. But before starting to use them, you need to consult with your doctor.

• Mix a spoon of calamus root, three and a half spoons of potato flowers, one and a half spoons of calendula flowers and four spoons of wormwood root. Pour boiling water over the mixture and leave for 5-6 hours. The resulting infusion should be filtered and taken 100 ml before each meal.
• Tumor lesions are treated with enemas. For these purposes, purified water with copper sulfate is used (two liters of water per 100 ml of copper sulfate concentrate). The duration of treatment should not exceed 14 days.
• Pour 200 ml of boiling water over a tablespoon of celandine herb and leave for 20-30 minutes. Strain the decoction and take 1 spoon 2-3 times a day before meals.
• Gopher fat has anti-cancer properties. Eat 4 spoons of fat a day or cook all your food with it. Such therapy significantly improves the patient's condition within a month.

Surgery for colon adenocarcinoma

Surgery for colon adenocarcinoma is considered the most effective method of therapy. During the operation, not only the tumor is removed, but also tissues affected by metastases. Before the operation, the patient undergoes special preparation, which includes a slag-free diet, taking laxatives and cleansing enemas 3-5 days before surgery. In addition, it is possible to wash the digestive tract with a special agent, Lavage or Fortrans.

During the operation, it is very important that the tumor cells are not carried with the bloodstream throughout the body, so the neoplasm is not touched. For these purposes, the blood vessels are clamped and the affected section of the intestine is cut off. In case of distant metastases, removal is not effective, but the operation is still performed. Surgical intervention is necessary to prevent possible complications, i.e. bleeding, inflammation and pain syndrome. If the disease is severe, then the operation is necessary to normalize the intestine by forming a colostomy.

If cancer causes complications, then surgery is performed urgently. At the first stage, the tumor is removed and complications are eliminated. At the second stage, a colostomy is formed, it can be single-barreled or double-barreled. In the first case, the process of excretion of feces occurs through the colostomy, and in the second, fecal movement is possible in a natural way. Normal bowel function is restored 2-7 months after surgery.

Prevention of colon adenocarcinoma

Prevention of colon adenocarcinoma is aimed at preventing malignant disease. Preventive measures begin with an examination by a proctologist, who will help solve problems with the colon at early stages. Treatment of diseases of the gastrointestinal tract and infectious lesions is mandatory. Healthy nutrition and an active lifestyle are also methods of preventing the disease. Your diet should contain a lot of plant foods rich in fiber.

Hereditary predisposition and anal sex are risk factors, so prevention will not be superfluous in this matter. It is worth knowing that the disease very rarely occurs when exposed to only one risk factor. The less negative impact on your body, the lower the risk of developing the disease.

Prognosis of colon adenocarcinoma

The prognosis for colon adenocarcinoma depends entirely on the stage at which the disease was detected and how the treatment was carried out. The prognosis is based on the extent of the lesion, the presence of metastases, and the stage of disease development. If the patient has undergone surgery, the next 5 years are considered critical, since the disease may return. With radical surgery, which involves removing a large section of the intestine, the survival rate reaches 90%. But the higher the stage and prevalence of the disease, the fewer patients survive for 5 years after surgery. If the cancer has metastasized to the lymph nodes, the survival rate is 50%.

The main factors influencing the survival of patients:

• Size, stage, depth of tumor growth.
• Results of histological analysis.
• Presence of regional metastases.
• Degree of tumor differentiation.

Survival prognosis for colon adenocarcinoma of different grades:

1. Highly differentiated – has the most favorable prognosis. Five-year survival rate of patients is 50%. In elderly patients, the tumor practically does not metastasize and does not affect neighboring organs. But the survival rate of young cancer patients is 40%.
2. Moderately differentiated – difficult to treat, as it is difficult to find an effective drug for chemotherapy. Surgical intervention is possible with additional methods of therapy.
3. Low-differentiated is the most dangerous type of cancer, which is characterized by an aggressive course and rapid growth. This type of oncology is practically untreatable, so the prognosis is unfavorable.

Colon adenocarcinoma is a malignant disease that requires urgent treatment. The sooner it is detected, the faster effective treatment will be selected, and therefore the higher the chances of restoring normal functioning of the body.