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Cáncer Colorrectal y su tratamiento

What is colorectal cancer?

Colorectal cancer is a disease that originates in the colon or rectum. Accurate preoperative staging allows for the correct classification of patients for the various existing therapies, as well as the selection of the best surgical treatment.

It is one of the most common types of cancer worldwide. Early detection significantly improves the prognosis, and among the most commonly used treatments are radiation therapies, especially external radiotherapy.

The use of radiotherapy helps reduce tumors, relieve symptoms, and improve the effectiveness of other treatments such as surgery or chemotherapy. 

Keep reading to learn more about our available treatment options.

RISK FACTOR'S

Aging is the most important risk factor for most cancers. Other risk factors for colorectal cancer include:

FAMILY BACKGROUND: Colorectal cancer in a first-degree relative.

PERSONAL HISTORY: From colorectal adenomas, colorectal cancer or ovarian cancer.

Hereditary Conditions: Such as familial adenomatous polyposis (FAP) and Lynch syndrome (hereditary nonpolyposis colon cancer [HNPCC])

EXCESSIVE ALCOHOL CONSUMPTION

TOBACCO

AFRICAN AMERICAN RACE OR ETHNICITY

OBESITY

Clinical Features

Colorectal cancer can develop without causing discomfort in its early stages, but as it progresses, symptoms may appear such as persistent changes in bowel habits (diarrhea, constipation, or a feeling of incomplete evacuation), rectal bleeding, dark or bloody stools, frequent abdominal pain, unexplained fatigue, and unexplained weight loss.

Recognizing these signs early is key to an early diagnosis and more effective treatment.

SYMPTOMS: Rectal bleeding, change in bowel habits, abdominal pain, intestinal obstruction, change in appetite, weight loss, weakness.

With the exception of symptoms of obstruction, these symptoms do not always correlate with the stage of the disease or signify a particular diagnosis.

 

DIAGNOSIS: The diagnosis of colorectal cancer is made through various medical tests that detect tumors or abnormalities in the colon and rectum.

The most common tests include colonoscopy, which allows direct visualization of the inside of the intestine and the collection of biopsies, as well as exams such as the fecal occult blood test, sigmoidoscopy, and imaging studies like computed tomography (CT) scans or magnetic resonance imaging (MRI). Timely diagnosis is essential to start appropriate treatment promptly.

STAGING

In patients with colorectal cancer, staging is essential not only to estimate the prognosis but also to define the different therapeutic options.

Let’s remember that the surgeon must decide whether the patient should undergo preoperative chemo-radiotherapy, choose the surgical technique (anterior resection with or without preservation of the sphincter apparatus, transanal local resection), and thoroughly discuss the potential sequelae.

For all these decisions, it is essential to perform an optimal preoperative study and staging. This staging will change in patients undergoing preoperative chemo-radiotherapy, as its effectiveness will result in a significant reduction of the tumor mass (both in the wall and lymph nodes) in more than 70% of patients, and even a complete tumor response in approximately 10 to 20% of them.

Below are the details of some of these treatments:

SURGICAL TREATMENT: Surgery is the fundamental basis for the successful treatment of colorectal carcinoma. Its objective is the removal of the primary tumor and any loco-regional extension that may have occurred, without causing tumor spread and with the best quality of life for the patient.

CHEMOTHERAPY TREATMENT: When choosing the chemotherapy regimen to be administered, the activity and tolerance of the chemotherapy regimen and a series of factors that depend on the patient (will, general condition, comorbidity, etc.) are taken into account. It increases survival and can be given palliatively in very advanced cancers.

RADIOTHERAPY TREATMENT: The use of radiotherapy as part of the treatment for malignant neoplasms is becoming increasingly widespread.

In locally advanced primary colorectal cancer, several studies have demonstrated its efficacy, showing a decrease in local recurrence and an increase in disease-free survival, both when administered preoperatively and postoperatively.

Emerging developments such as intensity-modulated radiotherapy (IMRT), image-guided radiotherapy (IGRT), and stereotactic body radiotherapy (SBRT) are being evaluated. These techniques offer the possibility of delivering higher doses of radiotherapy without affecting normal or healthy tissue.

Currently, the Centro Médico de Radioterapia Siglo XXI has the technology and expertise to treat this type of disease, ensuring the protection of surrounding organs and tissues, thereby providing a higher quality of life for the patient.

 

When is radiation therapy used to treat colorectal cancer?

Before and/or after surgery to help prevent the cancer from coming back. In this case, it is often given together with chemotherapy. Many doctors now favor giving radiation therapy before surgery because it can make it easier to remove the cancerous tumor.

With or without chemotherapy to help control rectal cancers in people who are not healthy enough to have surgery or to relieve symptoms in people with advanced cancer that is causing intestinal blockage, bleeding, or pain.

To re-treat tumors that have returned in the pelvic region after undergoing radiotherapy.

To help treat cancer that has spread to other areas (Metastases), such as bones, liver, brain.