Colorectal cancer most often occurs in the final portion of the colon (the large intestine). When colorectal cancer is in the beginning stages, it usually manifests as anemia, and at the end stage, with clogging. In most cases, this condition begins as a benign polyp on the wall of the intestine which increases in size and becomes a malignant tumor. Detected in its early stages, this type of cancer is completely curable.

Risk factors

However, the reason for colon cancer is unknown. Researchers suspect that a diet rich in animal fat/red meat and low in fiber play an important role in the development of this form of cancer. Cigarette smoking is also associated with colon cancer. Individuals with a family history of colon cancer, especially if more than one relative has had the disease, are at increased risk, and this suggests caution on their part. The same applies to those whose relatives have experienced colon polyps, which are an important additional risk factor. Men and women are equally prone to cancers of the colon, especially after the age of 40.


The first indication of a problem in the large intestine is a change in the normal movement of the bowels and their contents. This can be constipation, diarrhea, thinning stool, or a sensation that the bowel does not empty completely and efficiently. Other symptoms may be abdominal pain, a burning sensation down below, nausea, unusual and sometimes painful gas during bowel movements, blood in the stool, or bleeding from the anus.


If you have symptoms of colon cancer, you should visit a doctor for primary care. He certainly will conduct a manual examination of the rectum. During this examination a stool sample may be collected that will be tested for blood that is invisible to the naked eye. If cancer is suspected, then further testing can be performed such as a colonoscopy, computerized tomography, and others. If cancer is detected, surgery is considered mandatory.

Treatment Options

Cancer that has not spread beyond the border of the lining of the colon can be surgically removed using a colonoscopy apparatus. Unfortunately, this is rarely the case. Advanced tumors require major surgery in which the tumor is removed together with a portion of the intestine and lymph nodes. Some advanced cancers cannot be treated with surgery alone. Chemotherapy, radiation therapy, and biological therapy can be used in combination with surgery in order to assist the patient in managing the disease.

Minimally Invasive Surgery

Surgical options for treating this cancer are traditional open surgery or minimally invasive laparoscopic surgery. While both operations are effective in eliminating the cancer, the laparoscopic technique has the advantages of a shorter hospital stay, a faster recovery, less pain, and less scarring since the incisions are smaller. In open surgery, the incision is large – 20 to 25 cm long -- and is made in the abdominal muscles to achieve the best access to the colon and surrounding structures. The affected parts of the colon are removed, its two ends are sewn together, and the abdominal wound is closed with sutures or staples.

In laparoscopic surgery, several small incisions are made in the abdomen along with a larger incision at the point from which the intestine is to be removed, usually about 5 cm in length. The laparoscope is inserted through a small incision to provide an enlarged view of the colon and its surrounding tissues. This view is projected onto a monitor while the specialized tools are introduced into other openings to perform the surgery. This technique is as effective as open surgery with the advantages of easier and faster patient recovery.

Although laparoscopic surgery is the preferred method of treating this disease, some patients are prevented from taking advantage of this opportunity due to extreme obesity, previous abdominal surgery, or the surgeon’s lack of ability. In Bulgaria, a significant reason why some patients do not elect to undergo laparoscopic surgery is lack of financial capacity. These are the money that the patient and his relatives have to pay for the items that the Health Insurance Fund deems as "costly consumables" used in the operation.

All the aspects of a potential operation should be discussed between the patient and his close relatives. Since it is neither a small nor insignificant procedure, all relatives of the patient who would like to be informed should be kept informed throughout the process. Very often a diagnosis of colon cancer and the subsequent surgery can be life-changing for the whole family.

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