Colorectal cancer

The multidisciplinary treatment of colon cancer has many benefits for the patient, in that we can offer them the best and fastest treatment possible for their situation.”

DR. JAVIER RODRÍGUEZ RODRÍGUEZ
SPECIALIST. DIGESTIVE TRACT TUMOURS AREA

The colon or large intestine is the final part of the bowel. It is shaped like a tube and its interior is covered with a mucous membrane made up of cells. When one of them becomes malignant and multiplies uncontrollably, colon cancer emerges.

The formation of colon cancer is a staged process that begins with the appearance of a polyp that becomes malignant. 

This malignant tumor can grow locally (invading the layers of the wall of the digestive tract and can reach the organs contained in the abdomen), by lymphatic spread to the nodes or by hematogenous spread (through the blood they go preferably to the liver, lung, bone and brain).

If the tumor is detected at an early stage, it is curable in more than 90% of cases. For this reason, early detection is vital, since it is a common cancer. About 80% of the cases are sporadic and 20% have genetic influence.

We have extensive experience and excellent results in the treatment of colorectal cancer.

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What are the symptoms of colon cancer?

The symptoms of colorectal cancer vary depending on the location.

If you experience any symptoms, we recommend visiting a gastroenterologist for diagnosis and to start any necessary treatment.

There are other nonmalignant diseases of the large intestine that may cause similar symptoms.

  • Blood in the stool: one of the most common symptoms of colorectal cancer. Reddish or black in color. If bleeding persists, anemia may develop.
  • Sensation of incomplete emptying of the bowel (tenesmus): usually occurs in cases of tumors located toward the end of the colon, or in the rectum.
  • Change in digestive habits: diarrhea or constipation occurs intermittently in people who previously had normal bowel habits.
  • Narrow stools: usually because the tumor is causing a narrowing of the bowel, not allowing normal passage of stool.
  • Abdominal pain: nonspecific pain that improves after passing gas or stool.
  • Extreme fatigue or weight loss with no apparent cause: these are general and unspecific symptoms that usually occur due to certain diseases such as cancer.

Do you have any of these symptoms?

You may have colon cancer

What are the causes?

The development of colorectal cancer depends on an interaction between genetic and environmental factors.

Environmental factors
These are the predominant factors in most cases of colon cancer. If these factors can be identified, many cases of colorectal cancer could be prevented. The most important causal factors seem to be related to diet.

Hereditary factors
Twenty percent of colorectal cancer patients have a close relative (parent, sibling or child) who has been diagnosed with the disease. To check for genetic factors, a genogram is prepared on the basis of the family’s history of cancer (not just colorectal but also other related cancers, such as those affecting the stomach, ovaries, endometrium, brain, kidney or bile duct). Familial adenomatous polyposis and nonpolyposis colorectal cancer can be hereditary.

The Hospital has a High-Risk Gastrointestinal Tumor Prevention and Response Unit that draws on extensive experience and cutting-edge technologies to identify this genetic risk.

Risk factors and prevention

Each person’s individual colorectal cancer risk depends on several factors. Some have become well established.

Risk is assessed as normal if you are over 50 and do not have any of the following risk factors:

  • Personal family history of colorectal cancer or adenomatous polyps.
  • Family history (parents, siblings and/or children) with colorectal cancer or adenomatous polyps.
  • Family history of multiple cancers, particularly of the breast, ovaries and endometrium (womb).
  • Diagnosis of inflammatory bowel disease (ulcerative colitis, Crohn’s disease).

How is colon cancer diagnosed?

<p>&nbsp;Colonoscopia</p>

Colorectal cancer is the third most common type of cancer. However, it is curable in 90% of cases if diagnosed early.

There are different tests for early diagnosis. The Hospital has state-of-the-art diagnostic technologies for detection, including noninvasive means such as capsule endoscopy for frailer patients.

To diagnose colorectal cancer, the colon must be directly visualized to assess whether lesions are present. If so, a sample is taken for analysis.

How is colon cancer treated?

Surgical treatment: conventional or laparoscopic removal of the tumor

The surgery seeks to remove:

  • The tumor, with sufficiently wide margins
  • The main arterial and venous vessels that nourish the intestinal segment where the tumor is located
  • Regional lymph nodes

Resection can be performed in conventional surgery or via laparoscopic surgery, with a smaller incision and a faster postoperative recovery.

Types of surgery:

  • Right hemicolectomy (tumor in the cecum or ascending colon)
  • Left hemicolectomy (tumor in the descending colon or sigmoid colon)
  • Segmental colectomy (tumors in the transverse colon or splenic flexure)

After removing the tumor, the Pathology Department will analyze it. Depending on the tumor’s characteristics, treatment with chemotherapy and/or radiation therapy may be necessary as a complementary treatment to surgery.

Metastatic cancer

When colorectal cancer has spread, one area where metastases are often found is the liver.

The aim of treatment is to surgically remove the liver metastases and the primary tumor, which improves patient survival rates.

If the metastases are inoperable, other treatments may be used to control the disease:

  • Chemotherapy combined with new biological therapies, depending on the cancer’s molecular expression.
  • Intra-arterial chemotherapy to reach metastatic foci more selectively. This achieves higher drug concentration without increasing toxicity and boosts response.
  • Radioembolization for liver metastases with yttrium microspheres. Enables consolidation of liver lesions after chemotherapy where they cannot be surgically removed.

The aim is to administer a combination of drugs to achieve an optimal balance between tolerating the treatment and controlling the disease, based on each patient’s individual characteristics.

Tratamiento quirúrgico: extirpación del tumor por vía convencional o laparoscópica

La cirugía tiene como objetivo extirpar:

  • El tumor, con márgenes suficientemente amplios
  • Los principales vasos arteriales y venosos que nutren el segmento intestinal en el que se encuentra el tumor
  • Los ganglios linfáticos regionales

La resección se puede realizar por vía convencional o por cirugía laparoscópica, con una incisión menor y un postoperatorio más rápido.

Tipos de cirugía:

  • Hemicolectomía derecha (tumor en el ciego o en el colon ascendente)
  • Hemicolectomía izquierda (tumor en el colon descendente o sigma)
  • Colectomías segmentarias (tumores en el colon trasverso o ángulo esplénico)

Una vez extirpado el tumor, se analiza en el Departamento de Anatomía Patológica. Dependiendo de las características del tumor puede ser necesario administrar tratamiento con quimioterapia y/o radioterapia como complemento de la cirugía.

Tumor con metástasis

Cuando el cáncer de colon se ha diseminado, una de las zonas en donde más frecuentemente origina metástasis es en el hígado.

El objetivo del tratamiento es la resección quirúrgica de las metástasis hepáticas y del tumor primario, ya que esto aumenta la supervivencia del paciente.

Si las metástasis no se pueden llegar a operar, pueden realizar tratamientos de otro tipo para controlar la enfermedad:

  • Quimioterapia combinada con nuevas terapias biológicas, según la expresión molecular del tumor.
  • Quimioterapia intra-arterial para alcanzar de modo más selectivo los focos de enfermedad metastásica. Logra más concentración del fármaco sin incremento de la toxicidad y favorece una mayor respuesta.
  • Radioembolización de metástasis hepáticas con esferas de Ytrio. Permite consolidar las lesiones hepáticas tras quimioterapia que no son susceptibles de extirpación quirúrgica.
    > Lea más sobre la radioembolización

El objetivo es administrar una combinación de fármacos que logre el mejor balance entre tolerancia y control de la enfermedad, según las características de cada paciente.

Where do we treat it?

IN NAVARRA AND MADRID

OUR MEDICAL TEAM

Specialists in the area of Digestive Tube Tumors

The Digestive Tube Tumors Area is composed of a multidisciplinary team of experts in the diagnosis and treatment of diseases of the digestive tract.

It includes specialists in the digestive system, radiology, pathological anatomy, surgery and medical and radiotherapeutic oncology and nursing support.

What diseases do we treat?

Imagen de la fachada de consultas de la sede en Pamplona de la Clínica Universidad de Navarra

Why at the Clinica?

  • Integral evaluation of the patient.
  • Cutting edge technology.
  • Expert professionals who are a national reference.

Safer than ever to continue taking care of you

We update safety protocols weekly with the latest scientific evidence and the knowledge of the best international centers with which we collaborate.