Colorectal cancer usually doesn’t make a sound at first. Digestive signs can nevertheless alert and deserve a medical consultation. Others occur when the disease advances or even metastasizes.
Colorectal cancer – which can affect the colon and rectum – is the third deadliest cancer in women, the second in humans. Diagnosed at an early stage, it can be cured in 9 out of 10 cases. This early diagnosis is facilitated by the national colorectal cancer screening program offered to people aged 50 to 74 but also by the identification of certain symptoms. On the occasion of blue marsa month dedicated to colorectal cancer screening, we interviewed Dr. Hervé Gautier, oncologist and president of Comité 91 of the League against Cancer, to take stock of these suggestive symptoms, in women and men.
What are the symptoms of colorectal cancer?
“The symptoms of colorectal cancer are initially rather imprecise. They become clearer as the disease progresses” answers Dr. Gautier right away. Those that should attract attention are:
- transit disorders : Sudden or worsening constipation, prolonged diarrhea or alternating diarrhea and constipation
- abdominal pain like colic
- the presence of blood in the stool (red or black)
“Then there are two more general symptoms like fatigue and weight loss which may occur a little later, continues the doctor. There is also gradually anemia (iron deficiency) which settles in connection with bleeding in the stool. When the disease is more important, it can go as far asbowel obstruction but the cancer is already very advanced in this case.”
“When the cancer is on the right, the symptoms are less specific”
Are the symptoms of colorectal cancer different between women and men?
Symptoms of colorectal cancer are the same in women and men “but there may be moderate nuances depending on location cancer” says the doctor. Colorectal cancer affects the colon and rectum. THE colon has several segments : the colon LEFTthe colon rightTHE transverse colon. “Cancer can affect either of these parts. Generally, it is distributed a little more to the right in women and to the left in men. When the cancer is on the right, the symptoms are less specific. When he’s left and especially when it touches the rectumif it causes bleeding, it will be seen soonersame thing if there are transit disordersthey will see each other sooner.”
Can colorectal cancer remain asymptomatic?
Yes. “For a cancer of this type to appear, it takes 5 to 10 years. For a long time, therefore, there are no symptoms” warns Dr. Gautier. Most colorectal cancers are linked to the malignant transformation of a polyp present in the colon or “a polyp can become cancerous with a fairly long delay” adds the oncologist.
“Metastases are observed in 40 to 60% of cases of colorectal cancer” reports the French National Society of Gastroenterology (SNFGE) “and are discoveries generallyt during surveillance examinations away from the initial treatment cancer” continues Dr. Gautier. There is therefore no no easily identifiable symptoms at the start of their training. “Metastases rarely occur immediately, the disease must initially be locally extensive, continues our interlocutor. It is especially for diseases with lymph node invasion that metastases appearrather than at the time of diagnosis for patients who will be screened.” Colorectal cancer metastases are first lymph nodes and then spread through the blood to the lungs and liver. “This is why chest x-rays are recommended every year to patients treated for colorectal cancer and why the liver is also monitored by abdominal ultrasound with durations and variations depending on the protocols.”
Are there factors facilitating colorectal cancer?
“Yes” replies our interlocutor who mentions the presence “special history” to increase vigilance and encourage screening. “There are the personal history of polypsTHE family history if, for example, there is colorectal cancer before the age of 60 in a first-degree relative or cancer in two first-degree relatives, you have to be vigilant and monitor the person more intensively. We also know that in women, there is more colon cancer than rectal cancer while it is the reverse in humans. Finally, there are particular illnesses some of which are hereditary at high risk of cancer which are inflammatory diseases of the colon such as Crohn’s disease or the rectocolitis or genetic disease, familial polyposis“ explains Dr. Gautier. THE lack of physical activity and of fiber consumption also play a role.
Thank you to Dr. Hervé Gautier, oncologist and President of Committee 91 of the League against cancer.