Colorectal (large bowel) Cancer

Entire books have been written on the subject of colorectal cancer. Hundreds, even thousands of scientific articles are published about it every year. There is no way that, on this website, I can do anything other than scratch the surface of what is currently one of the planet’s major health issues. Over time, I hope to build more and more relevant information into this site – in the meantime, the links provided elsewhere on this website will lead you to a wealth of information.

What follows is, by necessity, just a very brief overview.

The term “colorectal cancer” refers to the specific cancer arising from the inner surface lining of the bowel called “adenocarcinoma”. There are other types of cancer that affect the large bowel (the colon and rectum) such as carcinoid tumour, leiomyosarcoma and lymphoma but these are all rare by comparison to adenocarcinoma. For all intents and purposes, then, colorectal cancer means adenocarcinoma of the colon and rectum.

In Australia, colorectal cancer is the commonest major organ malignancy. Since it affects men and women almost equally, it is actually more common than lung cancer (mainly men), breast cancer (almost exclusively women) and prostate cancer (exclusively men). It is most prevalent in people in their mid-sixties and older but it is also well recognised in a much younger population as well.

In a small percentage of cases, there is a strong hereditary influence evident; in many more cases, there is a subtle but still real increased risk amongst close family members. As a result, the children, brothers, sisters and even parents of someone with colorectal cancer are best to consider themselves at increased risk of developing this disease themselves and should take appropriate steps to “screen” themselves by means of regular colonoscopy. Your own Doctor will be best placed to advise you and your family members about this.

Treatment of colorectal cancer is often curative - over half of those newly diagnosed with this disease will be completely cured by standard treatment. The cornerstone of effective treatment remains surgery – the complete removal of the tumour and surrounding tissues containing the related lymph node drainage. For proper anti-cancer surgery to be performed, your Surgeon will need to be experienced in this sort of surgery. Nowadays, this almost always means a specially trained Colorectal Surgeon although there are still many parts of the world, especially in isolated areas, where General Surgeons who also perform a wide range of other operations are undoubtedly experienced in the surgery of colorectal cancer as well.

Perhaps the biggest change in the treatment of colorectal cancer over the last decade has been the increasing emphasis upon multi-modality treatment. That is, the use of combinations of surgery, chemotherapy and radiotherapy to provide the very best rates of disease control and cure. The close cooperation that now exists in many parts of the world between the various Specialists – Surgeons, Medical Oncologists, Radiation Oncologists – treating colorectal cancer has definitely improved the consistency and the effectiveness of treatment. If you have colorectal cancer, it would undoubtedly be in your best interests to be looked after by a Surgeon who already participates in this sort of multi-disciplinary approach to treating colorectal cancer.

Another important change has been the increased use of surgery for the treatment of spread of colorectal cancer to liver and lungs. Although the spread of cancer beyond the bowel and lymph nodes generally makes cure hard to achieve, more aggressive use of surgery to remove these so-called secondary deposits has resulted in unexpected cures or, failing complete cure, useful prolongation of life, often for years at a time. Again, your own Doctors will be best placed to determine which treatments are most appropriate for your specific case.

If you have a question about colorectal cancer, you might like to address it to me using the "Contact Michael" section on this website. I might not be able to answer every question put to me but your question and my answer, if posted on my website, might prove equally useful for someone else who finds themself in a similar situation.

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