Colon Cancer

Adresse

Switzerland

Christian Toso
Professor
Christian Toso
Head of Division

Colon cancer is mainly of the adenocarcinoma type and develops from a polyps that has become cancerous.

The main risk factors for colon cancer include ageing, positive familial history of colon cancer, genetic factors (Lynch syndrome/HNPCC, familial adenomatous polyposis), chronic inflammatory bowel diseases, tobacco, alcohol, as well as the consumption of red meat and sedentary lifestyle.

Symptoms of colon cancer

Manifestations of colon cancer include abdominal pain, blood in the stool, change of the intestinal transit (alternating diarrhea and constipation), urgency to defecate, intestinal obstruction , intestinal perforation or, more insidiously, anemia . Colon cancer can also be detected in asymptomatic patients undergoing screening programs (FR).

Screening for colon cancer should be performed from the age of 50 years

Current recommendations stipulate that the majority of the population should be screened for colon cancer from the age of 50 by colonoscopy . Screening can also be done by looking for occult blood in the stool or by colo-scanner if access to colonoscopy is difficult. If there is no lesion or polyp requiring closer follow-up, colonoscopy should then be repeated every 10 years (and the test for occult blood in the stool every year in the absence of a colonoscopy).

People at high risk of colon cancer, i.e. those with one or more first-degree relatives with a positive history for colon cancer, should start screening at the age 40 years, and repeat it every 5 years.

Diagnosis of colon cancer

In case of established colon cancer, examinations to be performed include a complete colonoscopy (if not yet performed) and a CT scan of the abdomen, pelvis and chest. Sometimes, a PET scan may be necessary. Blood tests are also taken. The patient's situation is then discussed during a multidisciplinary meeting named tumor board .

Depending on the stage of the cancer, surgery by colectomy, designating the removal of the affected colon segment and its areas of lymphatic drainage, followed or not by chemotherapy, is proposed.

Minimally invasive surgery can be performed in up to 90% of colon cancer cases

Surgery is performed by laparoscopy in 90% of patients suffering from colon cancer. In some situations, however, it must be done by laparotomy and may involve the creation of an ostomy .

INFO + Colorectal surgery: answers to your questions (FR)

Adenocarcinoma
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Common cancerous tumor that develops from cells in a glandular lining or from the gland itself
Polyps
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Benign tumors that consists in protrusions of the gallbladder wall
INFO +  Polyps on the colon and the rectum
Intestinal obstruction
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The abnormal cessation of the transit of gas and stool
INFO +  Bowel obstruction
Colonoscopy
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Visual exploration of the gastro-intestinal tract, carried out using a probe fitted with a camera inserted into the rectum, used to highlight lesions of the inner lining of the colon
Tumor board
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A meeting between specialists from several disciplines related to cancer, to determine the best possible treatment for each patient. 
INFO +  The Digestive Cancers Program
Laparoscopy
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A surgical technique using small incisions and insertion of a camera
Laparotomy
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Open surgery of the abdomen
Ostomy
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The surgical connection of a segment of the digestive tract to the skin outside its natural location.
INFO +  Ostomy
Last update : 04/01/2022