Your cancer

Living with the disease

Colon Cancers

What is it ?

Colon cancer, also referred to as colorectal cancer, is the third most common type of cancer amongst both women and men, and the second deadliest. There were 1.93 million new colon cancer cases reported causing 935,000 deaths worldwide in 2020.

Colon cancers

Colorectal cancer is an adenocarcinoma (malignant tumor) that develops when the cells that line the colon or the rectum become abnormal and grow out of control. Treatment varies depending on the exact location of the tumor and its molecular status.

Patient Testimonial

André, retired, shares his story about his colon cancer. 

Discover his testimony and his impressions in this fight against cancer. 

A complex disease with multiple potential interventions

Unlike many other cancers, colon cancer generally responds well to treatment and can often be cured at a metastatic stage. It is vital that the medical team determines the appropriate multi-modal treatment at the onset. This may include drug therapies, surgery, radiotherapy, and/or interventional radiology.

Treatments can be adapted per molecular profile

Colon cancer is a disease that lends itself to molecular profiling. Various molecular and clinical factors influence the prognosis and prescribed treatment. The overall treatment plan will depend on the tumors’ location, histological type and specific molecular characteristics (e.g. status of microsatellites, mutation of the RAS, BRAF, PI3K genes, HER2 expression, etc.) as well the location of any metastases and other factors.

The symptoms

The most common symptoms of colon cancer are changes to digestive and bowel habits and/or an unexplained deterioration of the patient’s general health. 

Symptoms can include :

Abdominal pain

Gastrointestinal obstruction

discomfort, cramps, build-up of gas/wind

Bowel issues

such as diarrhea and constipation

The presence of blood in the stool

Unusual and persistent fatigue

Unexplained weight loss

Loss of appetite

A blood test revealing anemia

Screening

Colorectal cancer screening can be performed by colonoscopy, which is recommended for patients with a past history of colonic polyposis and/or with a familial history of colorectal cancer.

Diagnostic Process

Colon cancer is primarily diagnosed via a colonoscopy, which is usually performed under general anesthesia. The procedure, combined with sample testing, can confirm the presence of a tumor, its location and the level of disease’s progression. For a more detailed diagnosis, the characteristics of the cancer will be further confirmed through various other examinations and techniques, including:

Computerized Tomography scan (CT or CAT scan) of the chest, abdomen and pelvis.

Magnetic Resonance Imaging (MRI) scan
and/or Positron Emission Tomography (PET) scan may be required.

Following the biopsy, a histological diagnosis
(analysis of the sample tissues to define the type
and histological subtype of the cancer)
and the presence of markers.

Molecular analysis to look for potential predictive mutations.

Risk factors

Colon cancer has a multi-factorial origin :
heredity, lifestyle, and exposure to carcinogens are amongst the key considerations.
When considering risk factors, we typically place the patient into one of three groups:

Medium risk:
those aged 50
and older who have tested positive
for blood in the stool

High risk:
those with a past history of polyps, colon cancer, a parent who has had colorectal cancer before age 65, and/or chronic inflammatory bowel disease.
Very high risk:
those who are
genetically predisposed
to colon cancer.

High and very high-risk groups should be monitored by a gastroenterologist.

Your physician and/or oncologist will be particularly attentive to the following molecular abnormalities:

  • The instability of microsatellites, which help identify patients who are likely to benefit from immunotherapy treatment
  • Mutations in the RAS gene that would be unlikely to benefit from (contra-indicated) targeted anti-EGFR-type therapies ces maladies)
  • Mutations in the BRAF gene to propose treatment with targeted anti-BRAF therapies

Sometimes an MRI of the rectum or PET / CT scan may be requested.

Treatments

The specific course of treatment of colorectal cancer is primarily determined by the tumors’ stage and molecular characteristics, specifically:

Localized colon tumors are typically removed surgically.

In some cases, the surgery will be accompanied by postoperative chemotherapy..

Therapeutic alternatives are more complex for metastatic cancers, or tumors that are active and spreading. In such cases, the treatment plan may consist of surgery on the primary tumor and metastases combined with a chemotherapy regimen. More frequently, treatment will rely heavily on medical treatments such as intravenous chemotherapy, oral chemotherapy, or other more targeted therapies whose administration depends on the tumor’s genetic characteristics. Finally, there is a small subgroup of patients who can benefit from anti-PD-1 immunotherapy, oftentimes with remarkable results.

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