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General Surgery

Large Intestine (Colorectal) Cancer

The general name for cancers that develop in the large intestine (colon) or the rectum, which is the final section of the large intestine. These are adenocarcinomas that originate from the cell layer lining the inner surface of the colon and rectum, arising as a result of the uncontrolled proliferation of these cells.

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ℹWhat is Large Intestine (Colorectal) Cancer?

Colorectal cancers are adenocarcinomas developing from the cell layer lining the inner surface of the colon and rectum. The most significant characteristic of these cancers is that they usually emerge when cells forming small, benign growths called polyps transform into cancer. For this reason, it is preventable or treatable when diagnosed early.

The disease can appear in any part of the colon or in the rectum. Colon cancer and rectal cancer are in a similar group; however, the treatment plan may vary depending on the location of the tumor.

Common Symptoms

Change in Bowel Habits
Diarrhea, constipation, or narrowing of stool caliber lasting more than two weeks.
Rectal Bleeding
Bright red or dark-colored (tarry) blood in the stool.
Abdominal Pain
Persistent abdominal cramps, gas pain, or a feeling of bloating in the abdomen.
Weight Loss
Rapid, unintentional weight loss without loss of appetite.
Anemia
Iron deficiency anemia developing due to long-term occult bleeding in the intestine, leading to fatigue and paleness.

Diagnosis Methods

Colonoscopy
The "Gold Standard" method used in diagnosis. The entire colon and rectum can be visualized via colonoscopy, and biopsies can be taken from suspicious lesions.
Biopsy and Pathology
A sample is taken from the suspicious tissue for a definitive diagnosis and examined pathologically.
Serum Markers and Blood Analysis
Evaluation of iron deficiency anemia, liver, and kidney functions. CEA (Carcinoembryonic Antigen) is checked as a marker.
Computed Tomography
Thoracic, abdominal, and pelvic CT are used for cancer staging and to investigate metastasis.
Pelvic MRI
Specifically in rectal cancer, it evaluates how deep the tumor has penetrated the rectal wall and assesses the lymph nodes.
FDG-PET CT
Can be used when metastasis is unclear or in cases of suspected recurrence/metastasis.

Causes

Age
Risk increases significantly after the age of 50.
Nutrition
A diet low in fiber and high in processed red meats (such as fermented sausage/sucuk, salami).
Genetics
A family history of colorectal cancer or polyps.
Medical History
Inflammatory bowel diseases such as Crohn's or ulcerative colitis.

Treatments

Surgical Treatment
The primary and most effective treatment method for colorectal cancers. The cancerous intestinal segment is removed along with the surrounding lymph nodes. It can also be performed using laparoscopic or robotic surgical techniques.
Chemotherapy
Applied as adjuvant (post-surgery) or neoadjuvant (pre-surgery). It is especially used in Stage III cases and in the treatment of rectal cancer.
Targeted Therapy
Smart drugs determined by genetic mutations in the tumor (such as KRAS, NRAS, BRAF) that target only the cancer cells.
Immunotherapy
Highly effective in cancers with specific genetic abnormalities such as MSI-H (Microsatellite Instability-High).
Radiotherapy
While rarely used in colon cancer, it is one of the fundamental treatments alongside surgery in the management of rectal cancer.
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