Colorectal cancer (CRC) is a common and lethal disease. In the United States, approximately 153,000 new cases of large bowel cancer are diagnosed annually. CRC can be diagnosed after the onset of symptoms or through screening asymptomatic individuals.
Warning Signs: Patients with colorectal cancer (CRC) may present in three ways: a) The presence of suspicious symptoms and/or signs (rectal bleed, abdominal pain, and weight loss). b) Asymptomatic individuals discovered by routine screening or as a result of findings from a radiographic study done for another purpose. c) Emergency admission with intestinal obstruction, peritonitis, or rarely, an acute gastrointestinal bleed.
Most CRCs are diagnosed after the onset of symptoms (most commonly rectal bleeding, abdominal pain, otherwise unexplained iron deficiency anemia, and/or a change in bowel habits).
A change in bowel habits is a more common presenting symptom for left-sided as compared with right-sided cancers. Hematochezia is more likely with rectal than colon cancers, and occult colonic bleeding is more common with cecal and ascending colon cancers.
A positive fecal occult blood test has a much higher predictive value than any single or combination of symptoms, warranting a high priority for colonoscopy follow-up.
One in five patients with CRC presents with metastatic disease, with the most common sites being regional lymph nodes, liver, lungs, and peritoneum.
Treatment: Stage 1-2 can be treated with Surgery, Stage 3 with Surgery followed by Adjuvant Chemotherapy, and Stage 4 with Chemotherapy only.
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