Although the colon (large intestine) and rectum (last part of the large intestine) cancer can be seen in all age groups, the risk of developing it increases with increasing age. It usually starts as small, non-cancerous (benign) clumps of cells called polyps that develop on the lining of the colon. Over time, some of these polyps can develop into the colon cancer.

The polyps can be very small and therefore cannot give symptoms. Therefore, regular screening tests (such as occult blood test in the stool, endoscopy, and colonoscopy) are recommended to help prevent the colon cancer by identifying and removing the polyps before they develop into the cancer.

Symptoms:

The signs and symptoms of the colon cancer include the followings:

• A persistent change in the bowel habits, such as diarrhea or constipation, or a change in the stool consistency,
• A rectal bleeding (blood from the rectum) or blood in the stool,
• An abdominal discomfort such as cramps and gas pains,
• A feeling that your bowels are not completely empty (frequent feeling of going to the toilet),
• A weakness or tiredness, and
• An unexplained weight loss.

Many people with the colon cancer experience no symptoms in the early stages of the disease.

The symptoms can differ depending on the size of the cancer and its location in your large intestine.

When to Apply to a Doctor?

If you notice the symptoms that worry you, be sure to make an appointment with your doctor. Talk to your doctor about when to start colon cancer screening (endoscopy, colonoscopy). The worldwide guidelines recommend that the colon cancer screenings begin around age 50. If you have the risk factors such as family history, excessive alcohol consumption, the screening can be required at an earlier age.

Risk Factors

The factors that can increase your risk of colon cancer include the followings:

Old age: The colon cancer can be diagnosed at any age, but most people with the colon cancer are over the age of 50. The colon cancer rates have been increasing in the people under the age of 50 in the recent years.

Personal polyp history: If you have noncancerous colon polyps, you are at risk of developing colon cancer in the later years.

Inflammatory intestine diseases: The chronic inflammatory diseases of the colon, such as ulcerative colitis or Crohn's disease can increase your risk of the colon cancer.

Inherited syndromes: Some gene mutations passed down through your family can significantly increase your risk of the colon cancer.

Colon cancer history in the family: You are more likely to develop colon cancer if you have a relative with the colon cancer. The risk is even higher if more than one family member has colon cancer or rectal cancer.

Low-fiber and high-fat diet: The colon cancer and rectal cancer can be associated with a typical Western diet that is low in fiber and high in fat and calories. Some studies have shown an increased risk of the colon cancer in the people who consume diets rich in red meat and processed meat.

Sedentary lifestyle: The colon cancer developing probability is higher in the people who have sedentary lifestyle. The regular physical activity can reduce your risk of the colon cancer.

Diabetes: The risk of the colon cancer increases in people with the diabetes or insulin resistance.

Obesity: When compared with the people of normal weight, the risk of the colon cancer and dying from the colon cancer have increased in the obese people.

Smoking: The risk of the colon cancer in the smoking people can increase.

Alcohol: The excessive alcohol use increases your risk of the colon cancer.

Treatment

The main treatment for the colon and rectal cancer is surgery. However, there are different treatment options such as radiotherapy (radiation therapy) and/or chemotherapy (drug therapy) depending on the location, size and spread of the tumor. The appropriate treatment method is decided after the diagnosis and staging.

Surgical Treatment Options

The surgery can be performed with the open or closed (laparoscopic) methods in the cancer and non-cancerous diseases of the colon and rectum (such as diverticular disease, constipation, ulcerative colitis, polyps).

The main purpose in the surgical treatment (for open or closed surgery) is to perform surgery in accordance with the basic surgical and oncological principles. It will be more accurate to decide on the treatment (open or closed surgery) method according to the patient's personal characteristics and the condition of the tumor.

Laparoscopic (Closed Methods) Colorectal Surgery

The laparoscopic colorectal surgery can be performed in the majority of the patients. In the laparoscopic method, the patient's abdomen is not opened by cutting. The appropriate tools for the operation are entered through 4-5 holes determined according to the location of the tumor, and the part of the intestine with the disease is removed together with the associated lymph nodes by watching it on a monitor.

The laparoscopic methods have been found to be at least as safe and effective as the open surgery when performed by the surgeons with the advanced laparoscopic surgery training and experience in the laparoscopic colorectal surgery.

When compared to the open surgery, it is seen

1- Less pain,

2- Less hospital stay,

3- Better cosmetic results,

4- Less surgical site infection and abdominal hernia formation.

5- The time to return to the daily activities and work is faster.

Robotic Colorectal Surgery

The robotic surgery is superior to all other surgical options, especially in the pelvic area (rectal surgery). The imaging system of the robotic surgery contributes to the safe implementation of the operation by providing detailed vision in the pelvic area where the rectum is located. Moreover, by means of the rotation capability of the robotic arms, the operations performed in this area are easier than the laparoscopic surgery and contribute to increasing the success rate of the surgery.

For these reasons, the robotic colorectal surgery is the surgical method that we consider as the first choice today.