Colon cancer, also referred to as colorectal cancer, is characterized by a high incidence in the USA, especially among men above 50 years old. It is estimated that one in nineteen Americans will develop this disorder if preventive procedures are not improved (Gould & Dyer, 2014). In the majority of cases, the development of adenomatous polyps is associated with the emergence of malignant neoplasms. Polyps usually develop on the colon stem and protrude into the lumen, which tends to cause malignant changes and dysplasia.
Malignant neoplasms are found in the left, right, and the distal sigmoid colon, as well as rectum. Mik, Berut, Dziki, Trzcinski, and Dziki (2017) note that the differences between the abnormalities in the right and left colon have received considerable attention recently. In the right colon, carcinomas are mainly manifested through annular constrictive growths (Gould & Dyer, 2014). Adenocarcinomas in the right colon are more difficult to detect with the help of proctosigmoidoscopy, so CT scans or barium enema are utilized.
However, malignant tissues can take a form of ulcerating lesions, as well. Colon cancer is characterized by the spread of carcinomas in the lymph nodes, the wall, and mesentery that metastasize to other organs. The liver is generally affected in the first place, and the amount of malignant tissue and metastases depends on the stage of the disorder development. Another trait of the disorder is associated with the detection of the disease. Adenocarcinomas release carcinoembryonic antigen into the blood, but this kind of screening is rather unreliable as other types of cancer lead to the release of the same elements.
The clinical management of the disorder depends on the stage of its development and certain peculiarities. For instance, for non-metastasized colon cancer, surgery is seen as the primary treatment regimen (Kuipers et al., 2015). Patient outcomes depend on the quality of surgery since the disorder can be treated effectively if all the affected areas are removed. Other types of treatment have proved to be ineffective or insufficiently effective, so chemotherapy is used in a limited number of cases. For example, chemotherapy and radiotherapy are utilized to treat advanced-stage or intermediate-stage conditions. At that, these measures’ effectiveness varies, and is rather limited with older patients.
Metastatic colon cancer is often treated with the help of chemotherapy (based on the use of irinotecan and oxaliplatin). First-line chemotherapy of the disorder involves a combination of leucovorin, 5-fluorouracil, and irinotecan or oxaliplatin (Kuipers et al., 2015). This therapy affects the growth of malignant tissue, and the combination of agents has proved to be more efficient than the utilization of a single regimen. Target therapies include the employment of monoclonal antibodies addressing EGFR and VEGF-A, fusion proteins targeting growth factors, and multikinase inhibitors. Chemotherapy is mainly utilized to control the growth of carcinomas and reduce metastases.
In conclusion, it is necessary to note that colon cancer is a common disorder generally affecting men above 50years old. The diagnosis and treatment have undergone considerable changes recently and have become more effective. Still, colorectal cancer can be difficult to detect in the right colon. Primary types of treatment include surgery and chemotherapy for certain stages of the disorder development. For advanced and intermediate stages, chemotherapy is critical as it reduces metastases and controls the growth of malignant tissue. However, chemotherapy is often ineffective, especially when elderly patients are involved.
References
Gould, B. E, & Dyer, R. (2014). Pathophysiology for the health professions – e- book (4th ed.). St. Louis, MO: Elsevier Health Sciences.
Kuipers, E. J., Grady, W. M., Lieberman, D., Seufferlein, T., Sung, J. J., Boelens, P. G., … Watanabe, T. (2015). Colorectal cancer. Nature Reviews Disease Primers, 1(1). Web.
Mik, M., Berut, M., Dziki, L., Trzcinski, R., & Dziki, A. (2017). Right- and left-sided colon cancer – clinical and pathological differences of the disease entity in one organ. Archives of Medical Science, 1, 157-162. Web.