Colon cancer, also known as colorectal cancer, is a disease affecting the digestive system. It’s crucial to be aware of potential symptoms, including unintentional weight loss. While colon cancer typically affects older adults, it can occur at any age, and incidence rates are rising in younger adults. Starting regular screening at age 45 and being alert to key symptoms are vital steps in protecting your health. A prompt diagnosis leads to more treatment options and a better chance at a full recovery.
Recognizing Colon Cancer Symptoms
Sometimes, signs of colon cancer are easy to spot, but you have to know what you’re looking for. If you notice any symptoms of colon cancer, talk with your provider. It may be nothing to worry about. But a prompt diagnosis gives you more treatment options if you have cancer.
Changes in Bathroom Habits
The digestive system helps your body use vitamins and minerals and pushes waste out. Colon cancer symptoms can appear in the bathroom and affect your bowel habits. It may be colon cancer if you experience:
- Blood in your stool that is bright or dark red. If you see any sign of blood in your stool, you should consult your doctor. Rectal bleeding usually comes from bleeding in the lower colon or rectum and is a common symptom of colorectal cancer. Bright red blood on the toilet paper after a bowel movement or red or pink water in the toilet bowl can be signs of rectal bleeding.
- Bowel movements that produce thin or small stools. Drastic changes in the consistency of stool can be an early sign that something isn’t quite right.
- Constipation or diarrhea. Colon cancer can hinder the large intestine’s ability to perform its usual tasks, like ridding the body of waste and absorbing water and nutrients.
- Feeling like you never quite empty your bowel out completely.
- Need to have bowel movements more or less often than usual.
General Symptoms
Colon cancer symptoms can also cause nonspecific feelings of sickness. Nausea is common, as is vomiting and feeling fatigued all the time. Additionally, you may feel bloated. Gas pains, lower back pain, or cramps may dampen your day. You may get blood work done and find out you have anemia. These symptoms are easy to dismiss. However, you better pay attention to these symptoms. Because every one of them is telling you something. They may be saying that something more serious is going on, and it may be colon cancer.
If you experience any of these symptoms regularly, talk with your provider. Depending on your situation, your provider may recommend a colonoscopy or other screening tests that check for colon or rectal cancer.
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The Significance of Unexplained Weight Loss
For most people, losing weight is never easy. So, if you start losing weight without trying, something’s probably wrong. This is another symptom of colon cancer. One study found that accidental weight loss is very common with colon cancer. For those diagnosed early on, 38.1% lost weight without trying. Patients whose cancer spread beyond the colon had a 50/50 chance of unexpected weight loss. Of course, losing a pound here or there isn’t a problem. But if you accidentally drop 10 or more pounds in a short amount of time, take action and bring this up to your provider to make sure it’s nothing serious.
Unintentional weight loss is the loss of 10 pounds or more in six months or less without knowing the reason. Colorectal cancer can lead to unexplained weight loss in a variety of ways. Cancer cells use up a lot of the body’s energy supply, and the immune system also uses energy as it works hard to fight the disease. Additionally, if a tumor in the colon gets large enough, it could block the colon.
Colon Cancer in Young Adults
The older you get, the more likely you’ll get colon cancer. But the risk of developing colon cancer doesn’t only affect older adults. In fact, the National Cancer Institute says colon cancer is becoming much more common in young adults. While not common in the 20s, young people can experience colon cancer symptoms. The following risk factors may increase your likelihood of colon cancer before you hit 50:
- Being overweight or obese. Being overweight or obese was associated with a decreased risk for CRC. In fact, weight loss over the preceding 5 years prior to cancer diagnosis was correlated to diagnosis of CRC, with 17.5% of early-onset CRC cases losing more than 5 kg compared with 8.7% of controls.
- Eating lots of processed meats and fats and skipping fruits and vegetables.
- Frequent exposure to water or air pollution.
- Having a family member who had colorectal cancer. Having a blood relative who has colon cancer increases the risk of getting colon cancer.
- Living with irritable bowel syndrome and other conditions that inflame the gut. Conditions that cause pain and swelling of the intestines, called inflammatory bowel diseases, can increase the risk of colon cancer.
- Spending a lot of time watching television.
Study on Unintentional Body Weight Loss in Non-Metastatic Colon Cancer
A study investigated whether unintentional body weight loss (BWL) provides additional clinical information in terms of tumor progression and prognosis in non-metastatic colon cancer. The study retrospectively enrolled 2,406 consecutive colon cancer patients without metastasis. Unintentional BWL was defined as loss of >5% of body weight within the last 6-12 months, or defined subjectively upon fulfillment of at least two of the following: Evidence of change in clothing size and corroboration of the reported weight loss by family or friend.
Key Findings of the Study
- A significant association was found between BWL and tumor location [right vs. left: Odds ratio (OR)=1.62; P<0.001], tumor size (≥5 vs. <5 cm: OR=2.17; P<0.001), and tumor stage based on the tumor-nodes-metastasis system (T3-T4 vs. T1-T2: OR=2.02; P<0.001).
- Post-operative morbidity and mortality were not significantly influenced by BWL.
- Multivariate analysis revealed that BWL was significantly associated with overall survival [with vs. without BWL: Hazard ratio (HR)=1.178; P=0.036] and relapse-free survival (with vs. without BWL: HR=1.332; P=0.003).
Additional Details from the Study
The clinical presentations of colon cancer, which are attributed to tumor growth, include abdominal pain, change in bowel habits, bleeding, mucus passage, unintentional body weight loss (BWL), presence of an abdominal mass and more severe presentations, including obstruction and peritonitis. In colon cancer patients, unintentional BWL in the absence of other signs or symptoms is associated with poor prognosis.
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Patients completed a pre-operative questionnaire on their symptoms as part of their admission. They were classified according to their age into 3 groups: <50 years (young), 50-75 years (middle-age) and >75 years (old). BWL data were recorded for patients who were able to provide it. Tumor stages were determined on the basis of the American Joint Committee on Cancer TNM staging system (6th edition). Tumor location was categorized as in the right colon (from the cecum to transverse colon) or left colon (from the splenic flexure to the sigmoid colon).
Non-polypoid tumors (P<0.001), right colon tumors (P<0.001), large tumors (tumor size >5 cm; P<0.001), poorly differentiated tumors (P<0.001), stage II tumors (P<0.001) and advanced T-stage tumors (P<0.001) were more likely to be associated with BWL. The significant factors were tumor location, [right vs. left: odds ratio (OR)=1.62; 95% confidence interval (CI), 1.36-1.94; P<0.001], tumor size (≥5 vs. <5 cm: OR=2.17; 95% CI, 1.81-2.59; P<0.001) and T-stage of TNM system (T3-T4 vs. T1-T2: OR=2.02; 95% CI, 1.51-2.70; P<0.001).
Compared to patients without BWL, those with BWL were more likely to have hypoalbuminemia and obvious anemia. No significant differences in post-operative morbidity and mortality were noted between patients with and without BWL. Compared to patients without BWL, those with BWL had significantly poorer OS and RFS rates. Significant predictors regarding the OS rate were TNM stage, age, sex, BWL, CEA level, albumin level and post-operative morbidity. Significant predictors of RFS were TNM stage, BWL, CEA level, tumor morphology and histological type.
BWL is more likely to occur in colon cancer patients with non-polypoid than in those with polypoid tumors, in patients with right colon tumors than in those with left colon tumors, in patients with larger tumors than in those with smaller tumors, in patients with locally advanced tumors (T3-T4 vs. T1-T2 stage), and in patients with poorly differentiated than in those with well to moderately differentiated tumors. BWL in colon cancer patients was indicated to be associated with advanced disease stage and poor prognosis.
Obesity, Weight Loss, and Colon Cancer Risk
Epidemiologic data have shown that obesity independently increases colorectal cancer (CRC) risk, but the mechanisms are poorly understood. A study on diet-induced weight loss in obese individuals revealed that weight loss reduces colorectal inflammation and modulates inflammatory and cancer-related gene pathways.
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Details of the Weight Loss Study
Ten healthy, obese, premenopausal women were recruited for the study. Subjects started a very-low-calorie diet (VLCD) weight-loss program and were monitored weekly by the study physicians. The VLCD was continued until subjects had lost ≥8% of baseline weight, at which time the initial measurements were repeated.
Results of the Weight Loss Study
Subjects lost a mean of 10.1 ± 1% of their initial weight. Weight loss significantly reduced fasting blood glucose, total cholesterol, triglycerides, LDL, tumor necrosis factor-α (TNF-α), and interleukin (IL)-8 concentrations. After weight loss, rectosigmoid biopsies showed a 25-57% reduction in TNF-α, IL-1β, IL-8, and monocyte chemotactic protein 1 concentrations. T cell and macrophage counts decreased by 28% and 42%, respectively. Gene arrays showed dramatic down-regulation of proinflammatory cytokine and chemokine pathways, prostaglandin metabolism, and the transcription factors STAT3 and nuclear transcription factor κB.
Conclusions from the Weight Loss Study
Diet-induced weight loss in obese individuals reduces colorectal inflammation and greatly modulates inflammatory and cancer-related gene pathways. Obesity is associated with chronic low-grade inflammation in the adipose tissue, liver, and coronary endothelium and is accompanied by increased oxidative stress, which increases the expression of the proto-oncogenes FOS and JUN that leads to increased transcription of proinflammatory and cell-cycle regulatory genes that promote carcinogenesis.
Findings on Early-Onset Colorectal Cancer
Researchers conducted a study to identify potential risk factors for early-onset CRC using a national sample of veterans aged 18 to 49 years who underwent colonoscopy between 1999 and 2014. After adjusting for several factors, researchers found that increasing age and male sex were linked with increased risk for early-onset CRC.
In a post-hoc analysis, researchers identified that weight loss could be associated with early-onset CRC. Patients with CRC had a negative average 10-year change in weight while controls had a positive average change. Significant weight loss should trigger a thorough evaluation even in younger patients.
Prevention and Screening
Screening for colon cancer is recommended, with people at average risk considering starting around age 45. People with an increased risk should think about starting screening sooner. There are several different tests used for colon cancer screening.
Lifestyle Changes
Making changes in everyday life can reduce the risk of colon cancer.
- Eat a variety of fruits, vegetables, and whole grains. Fruits, vegetables, and whole grains have vitamins, minerals, fiber, and antioxidants, which may help prevent cancer.
- Drink alcohol in moderation, if at all.
- Stop smoking.
- Exercise most days of the week. Try to get at least 30 minutes of exercise on most days.
- Maintain a healthy weight. If you are at a healthy weight, work to maintain your weight by combining a healthy diet with daily exercise. If you need to lose weight, ask your health care team about healthy ways to achieve your goal.