Case Study with NCP: Colorectal Cancer

Colorectal cancer is a disease in which normal cells in the lining of the colon or rectum begin to change, start to grow uncontrollably, and no longer die. These changes usually take years to develop; however, in some cases of hereditary disease, changes can occur within months to years. Both genetic and environmental factors can cause the changes. Initially, the cell growth appears as a benign (noncancerous) polyp that can, over time, become a cancerous tumor. If not treated or removed, a polyp can become a potentially life-threatening cancer. Recognizing and removing precancerous polyps before they become cancer can prevent colorectal cancer.

Predisposing Factors:

• Age above 40 years old
• Diet
• Low in Fiber
• High in fat, protein and refined carbohydrates
• Obesity
• History of chronic constipation
• History of IBD, familial polyposis or colon polyps
• Family history of colon cancer

Most Common Site:

Rectosigmoid area (70%)
Signs and Symptoms:

• Ascending (Right) Colon Cancer
• Occult blood in stool
• Anemia
• Anorexia and weight loss
• Abdominal pain above umbilicus
• Palpable mass
• Distal Colon/Rectal Cancer
• Rectal bleeding
• Changed in bowel habits
• Constipation or Diarrhea
• Pencil or ribbon - shaped stool
• Tenesmus
• Sensation of incomplete bowel emptying

Dukes’s Classification of Colorectal Cancer
Stage A: Confined bowel mucosa, 80-90% 5-year survival rate
Stage B: Invading muscle wall
Stage C: Lymph node involvement
Stage D: Metastases or locally unresectable tumor, less than 5% 5-year survival rate
Guidelines for early detection of Colorectal Cancer

• Digital rectal examination yearly after age 40
• Occult blod test yearly after age 50
• Proctosigmoidoscopy every 5 years after age 50, following 2 negative results of yearly examination

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