A change in your bowel habits, including diarrhea or constipation or a change in the consistency of your stool for more than a couple of weeks
Rectal bleeding or blood in your stool
Persistent abdominal discomfort, such as cramps, gas or pain
A feeling that your 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.
When to see a doctor
If you notice any symptoms of colon cancer, such as blood in your stool or a persistent change in bowel habits, make an appointment with your doctor.
Talk to your doctor about when you should begin screening for colon cancer. Guidelines generally recommend colon cancer screenings begin at age 50. Your doctor may recommend more frequent or earlier screening if you have other risk factors, such as a family history of the disease.
Causes:
It's not clear what causes colon cancer in most cases. Doctors know that colon cancer occurs when healthy cells in the colon become altered. Healthy cells grow and divide in an orderly way to keep your body functioning normally. But sometimes this growth gets out of control — cells continue dividing even when new cells aren't needed. In the colon and rectum, this exaggerated growth may cause precancerous cells to form in the lining of your intestine. Over a long period of time — spanning up to several years — some of these areas of abnormal cells may become cancerous.
Precancerous growths in the colon
Colon cancer most often begins as clumps of precancerous cells (polyps) on the inside lining of the colon. Polyps can appear mushroom-shaped. Precancerous growths can also be flat or recessed into the wall of the colon (nonpolypoid lesions). Nonpolypoid lesions are more difficult to detect, but are less common. Removing polyps and nonpolypoid lesions before they become cancerous can prevent colon cancer.
Inherited gene mutations that increase the risk of colon cancer
Inherited gene mutations that increase the risk of colon cancer can be passed through families, but these inherited genes are linked to only a small percentage of colon cancers. Inherited gene mutations don't make cancer inevitable, but they can increase an individual's risk of cancer significantly.
Factors that may increase your risk of colon cancer include:
Older age. About 90 percent 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.
A personal history of colorectal cancer or polyps. If you've already had colon cancer or adenomatous polyps, you have a greater risk of colon cancer in the future.
Inflammatory intestinal conditions. Long-standing inflammatory diseases of the colon, such as ulcerative colitis and Crohn's disease, can increase your risk of colon cancer.
Inherited syndromes that increase colon cancer risk. Genetic syndromes passed through generations of your family can increase your risk of colon cancer. These syndromes include familial adenomatous polyposis and hereditary nonpolyposis colorectal cancer, which is also known as Lynch syndrome.
Family history of colon cancer and colon polyps. You're more likely to develop colon cancer if you have a parent, sibling or child with the disease. If more than one family member has colon cancer or rectal cancer, your risk is even greater. In some cases, this connection may not be hereditary or genetic. Instead, cancers within the same family may result from shared exposure to an environmental carcinogen or from diet or lifestyle factors.
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. Research in this area has had mixed results. Some studies have found an increased risk of colon cancer in people who eat diets high in red meat and processed meats.
A sedentary lifestyle. If you're inactive, you're more likely to develop colon cancer. Getting regular physical activity may reduce your risk of colon cancer.
Diabetes. People with diabetes and insulin resistance may have an increased risk of colon cancer.
Obesity. People who are obese have an increased risk of colon cancer and an increased risk of dying of colon cancer when compared with people considered normal weight.
Smoking. People who smoke cigarettes may have an increased risk of colon cancer.
Alcohol. Heavy use of alcohol may increase your risk of colon cancer.
Radiation therapy for cancer. Radiation therapy directed at the abdomen to treat previous cancers may increase the risk of colon cancer.
If your doctor suspects you may have colon cancer, you'll likely be referred to specialists who treat colon cancer. You may meet with a number of specialists, including:
Doctors who treat digestive diseases (gastroenterologists)
Doctors who treat cancer (oncologists)
Doctors who remove colon cancer using surgery (surgeons)
Doctors who use radiation to treat cancer (radiation oncologists)
Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be well prepared for your appointment. Here's some information to help you get ready for your appointment, and what to expect from your doctor.
What you can do
Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there's anything you need to do in advance, such as restrict your diet.
Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
Write down key personal information, including any major stresses or recent life changes.
Make a list of all medications, as well as any vitamins or supplements, that you're taking.
Take a family member or friend along, if possible. Sometimes it can be difficult to absorb all the information provided during an appointment. Someone who accompanies you may remember something that you missed or forgot.
Write down questions to ask your doctor.
Your time with your doctor is limited, so preparing a list of questions will help you make the most of your time together. List your questions from most important to least important in case time runs out. For colon cancer, some basic questions to ask your doctor include:
Where is my colon cancer located in my colon?
What is the stage of my colon cancer?
Can you explain my pathology report to me?
Can I have a copy of my pathology report?
Has my colon cancer spread to other parts of my body?
Will I need more tests?
What are the treatment options for my colon cancer?
Will any of the treatments cure my colon cancer?
What is the chance that my colon cancer will be cured?
How much does each treatment increase my chances that my colon cancer will be cured?
What are the potential side effects of each treatment?
How will each treatment affect my daily life?
Is there one treatment you feel is best for me?
What would you recommend to a family member or friend in my same situation?
How much time can I take to make my decision about treatment?
Should I seek a second opinion?
Should I see a specialist? What will that cost, and will my insurance cover seeing a specialist?
Are there any brochures or other printed material that I can take with me? What Web sites do you recommend?
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.
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