Main
- Colorectal cancer develops from polyps and does not cause symptoms for a long time, so screening, not how you feel, is what matters.
- Blood in the stool, dark stools, a change in bowel habit and weight loss are reasons for a planned visit.
- Severe bleeding, bowel obstruction and sharp abdominal pain require calling an ambulance immediately.
- The diagnosis is confirmed by colonoscopy with biopsy; the extent of the tumour is assessed by tomography.
- The condition is managed by an oncologist; an initial examination for complaints from the rectum is carried out by a proctologist.
What is colorectal cancer
Colorectal cancer is a malignant tumour that develops in the colon or rectum. It arises from the cells of the inner lining of the bowel and can spread to other organs.
What happens in the body
Colorectal cancer begins when the cells of the inner lining of the bowel stop obeying the usual rules of growth. Normally these cells renew constantly and in an orderly way, but in a tumour process some of them begin to divide uncontrollably. Gradually a nodule forms from such cells, which over time grows into the wall of the bowel. The tumour can affect neighbouring tissues and spread to other organs, most often through the lymphatic vessels or the bloodstream. In the early stages such overgrowth often gives no sign of itself and is not felt by the person. Noticeable manifestations appear when the tumour already affects the function of the bowel or the general condition of the body. Therefore, with any persistent changes in bowel function, it is reasonable not to postpone a visit to the doctor to clarify the cause.
What causes it to develop
- Polyps in the colon or rectum: these are growths on the inner lining of the bowel that over time can transform into a tumour.
- Inflammatory bowel diseases: prolonged inflammation of the bowel wall creates conditions in which cells change more often and less predictably.
- Hereditary predisposition: if close relatives have had such a tumour, the risk for the person is noticeably higher than average.
- Sedentary lifestyle: with a lack of movement, bowel function slows down, which over time affects the condition of its wall.
- Excess weight and poor diet: an abundance of fatty and processed food with a small amount of vegetables and fibre increases the load on the bowel.
- Smoking and alcohol abuse: these habits affect the whole body, and giving them up reduces the load on the bowel.
Who faces this more often
Older people face this condition more often, in whom the risk grows gradually, along with the accumulation of changes in the cells of the bowel. Family history plays a noticeable role: if close relatives have had a tumour of the colon or rectum, attention to one's own health should be higher. Lifestyle features also have an influence — lack of movement, excess weight, a diet with a small amount of vegetables and fibre. Prolonged inflammatory bowel diseases, in which the bowel wall is under constant strain, should be considered separately. A combination of several such circumstances raises the probability more than each of them individually. At the same time, in some people not a single obvious cause can be identified, and the tumour still arises. Therefore, knowing one's risk factors is useful primarily in order to discuss a suitable follow-up schedule with the doctor.
What symptoms can there be?
Colorectal cancer in its early stages often runs without noticeable signs, and symptoms appear when the tumour grows and disrupts the workings of the bowel. That is why it is important to know which changes in how you feel are worth paying attention to and when urgent help is needed.
How it is noticed at the very beginning
Colorectal cancer often gives no sign of itself until the tumour starts to interfere with the workings of the bowel. A person may notice weakness and tiredness, which are easily put down to fatigue after work or lack of sleep. Sometimes blood appears in the stool or the stool becomes dark, but this too is often explained by food that has been eaten. The usual rhythm of defecation may change: trips to the toilet become more or less frequent than usual. After a bowel movement there remains a feeling that the bowel has not emptied completely. Gradually pain or discomfort in the abdomen may arise, and weight falls without any visible reason. If such changes last longer than usual, it is not worth waiting for them to pass on their own — it is sensible to discuss them with a doctor.
Signs that occur most often
- Blood in the stool or dark stool: an admixture of blood or a black colour of the stool requires attention, because it may indicate bleeding in the bowel.
- Change in the usual rhythm of defecation: if trips to the toilet have become more or less frequent than usual and this persists, it is worth seeing a specialist.
- Feeling of incomplete emptying of the bowel: after defecation there remains a sensation that the bowel has not emptied fully, and this repeats.
- Pain or discomfort in the abdomen: dragging or cramping sensations in the abdomen without a clear reason deserve attention.
- Weight loss without a reason: weight falls although diet and activity have not changed — this is a reason to look into the condition.
- Weakness and tiredness: constant fatigue and weakness may be the consequence of a problem that needs to be clarified with a doctor.
When to seek help urgently
Examinations and tests
Examination for suspected colorectal cancer begins with a conversation with a doctor and a physical examination, while the diagnosis is confirmed or ruled out using instrumental and laboratory tests. Below is a description of what exactly is prescribed and what information each of them provides.
How the examination begins
The first step is for the doctor to gather complaints, clarify family history and conduct an examination, because this information sets the direction for further investigation. He asks about how you feel, about cases of the disease in relatives and about how long ago the changes appeared. The examination helps to notice signs that a person may not associate with the bowel. Family history is important because in some patients the risk is higher due to a familial predisposition. After the conversation and examination, it becomes clear which specific tests are needed in a particular case. To confirm the diagnosis, instrumental and laboratory tests are prescribed, rather than relying only on the account. The information gathered at the appointment helps the doctor choose the right scope of examination. Come to the appointment with existing discharge summaries and results of previous tests, this saves time and clarifies the picture.
What is prescribed and what it shows
What is worth preparing for the appointment
- Discharge summaries: all available medical documents, because they show the doctor the history of observations and previously performed tests.
- Results of previous tests: images, reports and protocols, as they help compare the picture and avoid prescribing unnecessary tests.
- Information about family history: cases of the disease in relatives, since this affects the assessment of risk and the choice of examination.
- List of complaints: write down what bothers you and when, so as not to forget anything at the appointment and to describe your condition accurately.
- Questions for the doctor: formulate in advance what is unclear, this way you will get answers on the substance and understand the next steps.
Which doctor should I see?
The pathway for suspected colorectal cancer begins with an oncologist, and for certain complaints — with a proctologist. Below is an outline of who manages the condition, what care consists of, and what depends on the regularity of follow-up.
Which specialist manages this condition
Colorectal cancer is managed by an oncologist, while the initial examination for complaints from the rectum is often carried out by a proctologist. The oncologist clarifies the stage, the location of the tumour and the person's general condition, because the care plan depends on these circumstances. The proctologist deals with diseases of the rectum and is often the first to see changes that require oncological assessment. If a specialist doctor is not available nearby, one starts with a proctologist at the place of residence or with a referral from a general practitioner. The general practitioner does not replace the oncologist, but helps to build the further pathway. A referral to an oncologist is issued after examination and conclusion, and this is standard practice. It is useful for the patient to collect discharge summaries and the results of previous examinations in advance, so that the doctor can see the whole picture.
What treatment consists of
- Surgery: removal of the tumour is performed when indicated, and this is the main way to influence the disease in its early stages.
- Selection of therapy: the doctor chooses an approach taking into account the stage, the location of the tumour and the general condition, rather than a single sign.
- Radiotherapy: radiation is used as part of the plan in certain situations, and the decision is made by the oncologist based on the assessment.
- Follow-up after treatment: regular examinations help to notice changes in time and adjust further steps.
- Rehabilitation and support: recovery after interventions and help with everyday difficulties go in parallel with the main treatment.
What depends on the patient themselves
The regularity of follow-up is the part of the result that rests on the person themselves, and not only on the doctor. Attending at the appointed times and following recommendations allow the oncologist to see the dynamics and change the plan in time. Missed examinations make it difficult to assess the condition, because the doctor relies on comparison with previous data. Collected discharge summaries, examination results and records of past interventions noticeably simplify the appointment and save time. An open conversation about how one feels and about difficulties helps to select support, including rehabilitation. Refraining from making decisions on one's own without discussion reduces the risk of harming oneself and confusing the picture. Relatives should know about the follow-up plan in order to help with attendance and organisation. Keep a simple calendar of visits and store documents in one place — this noticeably simplifies follow-up.
What helps prevent an exacerbation?
Preventing an exacerbation of colorectal cancer is helped not only by treatment, but also by the person's own everyday decisions. Below are habits, monitoring indicators and the regularity of visits to the doctor.
What to change in habits
Regular physical activity supports bowel function and helps maintain a normal weight, and this reduces the overall burden on the body. A balanced diet with vegetables and fibre improves bowel motility and the composition of the microflora, which is noticeable in regular stools without straining. Giving up smoking and limiting alcohol reduce the additional toxic load that weakens recovery processes. Maintaining a normal weight is important because excess kilograms are associated with chronic inflammation and hormonal shifts. Timely treatment of polyps and inflammatory bowel diseases removes the changes against which the risk of exacerbation is higher. If a person has a hereditary predisposition, habits should be discussed with a doctor separately, because there are no universal recommendations for everyone. The practical conclusion is simple: it is better to change habits gradually and together with the supervising doctor, rather than all at once and alone.
What should be kept under control
- Body weight: it is measured regularly, because weight gain is associated with inflammation and hormonal shifts that affect the course of the condition.
- Diet: vegetables and fibre should be present every day, since bowel motility and the composition of the microflora depend on this.
- Physical activity: movement in the usual routine supports bowel function and helps maintain weight without sharp fluctuations.
- Smoking and alcohol: they should be given up or kept to a minimum, as they place an additional burden on a weakened body.
- Polyps and inflammatory diseases: they are treated in a timely manner, because it is these changes that increase the risk of exacerbation in the future.
- Monitoring plan: with a hereditary predisposition it is drawn up individually, and following it is more important than general advice.
How often to see a doctor
Regular monitoring is needed even when you feel well, because changes in the body do not always make themselves known straight away. Screening examinations by age make it possible to notice a problem earlier than complaints appear and to adjust monitoring in time. If a person has undergone treatment, the frequency of visits is determined individually, taking into account heredity and concomitant diseases. With a hereditary predisposition, the monitoring plan is drawn up separately, and its timing differs from the general recommendations by age. Missing a scheduled visit does not feel like a loss, but it is precisely this that postpones the moment when the doctor can intervene. How you feel is an unreliable guide: a person may feel well, while an examination will show that correction is needed. The practical conclusion: keep the dates of visits and examinations in one place and reschedule them only together with the doctor.
What is worth remembering
A conversation about colorectal cancer comes down to a few conclusions that are worth keeping in mind. Below is what is really important to remember when it comes to colorectal cancer.
Key conclusions
Colorectal cancer develops slowly and does not make itself known for a long time, so how you feel is no substitute for screening. A person may feel perfectly well while changes in the bowel wall are already taking place. That is why the decision to get checked is made not on the basis of sensations, but on the basis of age and risk factors. Putting off a conversation with a doctor is the most common and the most costly mistake, because time works against the person. If close relatives in the family have had colorectal cancer, this must be told to the doctor directly at the appointment. This changes both when observation should begin and how often it is repeated. It is worth relying on regularity: a single conversation with a doctor does not solve the problem, whereas calm observation at an agreed interval does. Colorectal cancer is a topic where reasonable vigilance helps more than anxiety.
