Colorectal Cancer

PATHOPHYSIOLOGY

Colorectal cancer is caused by mutations that occur either
sporadically, through exposure to carcinogens (e.g. tobacco smoke) MANIFESTATIONS
or inherited (National Cancer Institute, 2018). Two group of genes
| What Should I Be Aware of? |
most commonly effected are proto-oncogenes (e.g. KRAS) and tumor
• A persistent change in
suppressor genes (e.g. APC & p53) (Conlin, 2005). Proto-oncogenes
growth and proliferations. When mutated,
bowel description such as
regulate cell they become diarrhea, or constipation

oncogenes that remain in activated states, resulting in uncontrolled or change in stool

cellular proliferation (American Cancer Society, 2014). In contrast, consistency (narrow)
tumor suppressor genes slow down cell division, allowing for DNA • Rectal bleeding or bloody
repair, and are responsible in signaling programed cell death stool

(apoptosis) (American Cancer Society, 2014. Rapid production of • Abdominal or rectal pain
or discomfort
cells can result in benign neoplasms called polyps. These can become
• Constant feeling of fullness
cancerous and develop into adenocarcinomas which begin in the • Unexpected weight loss,
epithelium of organs and metastasize to distant tissues/organs weakness or fatigue

(Stanford Health Care, n.d.; American Cancer Society 2017). • Abdominal or rectal lumps

• Nausea and vomiting
("Symptoms of colorectal cancer -
(Massachusetts General Hospital, 2019) Canadian Cancer Society", 2019)
RISK FACTORS

|Non-Modifiable|
• Age and Sex: increases after the age of 40 and
presents a greater risk in males MANAGEMENT
• Personal History of Neoplastic Polyps |Common Drugs|
• Personal history of inflammatory bowel Bevacizumab
disease Ramucirumab
• Family History of Colon Cancer or Polyps Ziv-aflibercept
• Inherited Genetic Risk: most common include
Cetuximab
FAP and Lynch Syndrome
Panitumumab
Aspirin
• Racial and Ethnic background: African (Targeting Colorectal Cancer, n.d.)
American highest in North America and Jews
have highest risk worldwide |Alternative Treatments|
|Modifiable| Surgery, Chemotherapy, Radiation, Immunotherapy
• Physical Inactivity (A sedentary lifestyle)
and obesity (central deposition of adipose)
|Nutrition|
Modifying one’s diet can also help with the management
• Nutritional Practices: a diet low in fiber and of Colorectal Cancer in particular consuming plant foods
high in meats, fat, and carbohydrates such as berries, plums, pomegranates, cruciferous
• Alcohol consumption in combination with vegetables, tomatoes, garlic, turmeric, ginger, soy, whole
smoking grains, and mushrooms (Tao, Li, Li, & Li, 2018). These
• Diabetes or insulin resistance food items contain fibers and phytochemical that can
• Geographic Factors: place of migration and restrain the development and progression of colon cancer
urbanized residence by protecting against colon carcinogens, inhibiting tumors
(Haggar & Boushey, 2009)
growth and metastasis as well as induce apoptosis (Tao,
Li, Li, & Li, 2018).

“Colorectal cancer is responsible for approximately 13% of new cancer cases

and
12% of cancer deaths.”
("Colorectal Cancer - Canada.ca", 2019)