What causes colon cancer?

Written by Yan Chun
Oncology
Updated on January 17, 2025
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Colorectal cancer is a malignant tumor of the digestive system, and its occurrence is related to the following factors:

First, dietary factors. A high-fat content and a low fiber content in the diet both lead to an increased incidence of colorectal cancer. Furthermore, long-term consumption of pickled foods can also increase the incidence of colorectal cancer, presumably because these foods contain higher levels of nitrosamine carcinogens.

Second, some benign chronic diseases of the colon, such as adenomatous polyps and certain chronic colitis, can also lead to an increased incidence of colorectal cancer.

Third, environmental factors. Epidemiological studies have found that the occurrence of colorectal cancer is related to geographical distribution. In some environments with a high incidence of colorectal cancer, the content of some trace elements in the soil is too low, leading to a high incidence of colorectal cancer.

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Is stage II-III colon cancer considered late stage?

Patients with stage II and III colon cancer are not yet considered to be in the classic advanced stages. Current oncology believes that colon cancer is categorized as stage IV and considered advanced when distant metastases occur. Common sites of metastasis for colon cancer include the liver, lungs, and bones. Stage II colon cancer patients do not have metastases to the pericolic lymph nodes, which is relatively early; stage III colon cancer patients have metastases to the pericolic lymph nodes, which is later than stage II, but as long as there are no distant metastases, it does not reach the advanced stage IV.

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Can late-stage colon cancer be completely removed by surgery?

In clinical practice, for patients with mid-to-late-stage colon cancer, even after curative surgical resection, it is often difficult to completely remove the tumor. This is because by the mid-to-late stages, the colon cancer has typically started to invade surrounding tissues. Despite curative surgery, patients may still have subclinical lesions, which are typically hard to detect either under a microscope or with the naked eye. The presence of these subclinical lesions leads to a higher likelihood of recurrence and metastasis after curative surgery in mid-to-late-stage colon cancer patients. Therefore, to reduce the rates of recurrence and metastasis, it is common clinical practice to administer adjuvant chemotherapy and radiotherapy after the curative surgical resection for patients with mid-to-late-stage colon cancer, aiming to decrease the risk of cancer recurrence and metastasis.

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Early-stage colon cancer is difficult to clearly detect on a CT scan. In the moderate to late stages, colon cancer has more typical manifestations on CT, mainly characterized by thickening of the colon wall, irregular narrowing of the intestinal lumen, and stiffness of the intestinal wall. After enhancement, significant enhancement can be observed. The pericolonic fat space may appear blurred, and in the late stages, small lymph nodes can be seen, and even distant metastasis, most commonly to the liver, can be detected. It is necessary to differentiate colon cancer from colonic inflammation. Inflammatory lesions are usually more widespread and have typical clinical features such as fever and abdominal pain. It is also necessary to differentiate from lymphoma, as lymphomas also cause narrowing of the intestinal lumen but the narrowing is not eccentric and the intestinal wall remains soft, generally not leading to obstruction, whereas in late-stage colon cancer, colonic obstruction can be observed.

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The most common symptoms of transverse colon cancer mainly include abdominal pain, bloody stools, and changes in stool characteristics, such as thinner stools, which can sometimes lead to severe symptoms of intestinal obstruction. After these symptoms appear in transverse colon cancer, it is advisable to undergo a colonoscopy as soon as possible. Pathology obtained through the colonoscopy can confirm the diagnosis. Once transverse colon cancer is confirmed, it is also necessary to check for metastases to other parts of the body. For non-metastasized cases, early surgical treatment should be carried out, including a radical surgery for transverse colon cancer with lymph node dissection. Postoperative comprehensive anti-tumor treatment is generally required, involving six to eight courses of adjuvant chemotherapy. Postoperative chemotherapy aims to prevent local recurrence and distant metastasis.

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What are the symptoms of bone metastases from colon cancer?

Colon cancer generally refers to a malignant tumor that grows on the colon and typically appears in middle-aged populations. If colon cancer is not treated promptly, it can easily lead to bone metastasis. The bone metastasis of colon cancer is similar to other tumor metastases. The symptoms such as chest pain or tenderness upon pressing could be caused by bone metastasis from lung cancer. In the early stages of colon cancer, there are generally no symptoms of bone metastasis. However, once the tumor metastasizes to weight-bearing bones, thoracic vertebrae, cervical vertebrae, or lumbar vertebrae, it can result in paralysis. Patients must seek timely medical examination and treatment at a hospital to prevent the cancer cells from metastasizing.