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Colon Carcinoma: Causes, Symptoms & Treatment

Colon carcinoma is a malignant tumor of the large intestine. It is one of the most common cancers worldwide and has a good prognosis when detected early.

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Things worth knowing about "Colon carcinoma"

Colon carcinoma is a malignant tumor of the large intestine. It is one of the most common cancers worldwide and has a good prognosis when detected early.

What is colon carcinoma?

Colon carcinoma is a malignant (cancerous) tumor that develops in the colon, which is the large intestine. It belongs to the group of colorectal carcinomas and is one of the most common cancers in both men and women. The risk of developing colon carcinoma increases significantly after the age of 50.

Causes and risk factors

The exact cause of colon carcinoma is not always clear, but several well-established risk factors are known:

Age: Risk increases significantly after the age of 50.
Diet: A diet low in fiber and high in red or processed meat increases the risk.
Physical inactivity and obesity: Lack of exercise and excess body weight are contributing factors.
Alcohol and smoking: Both substances are associated with an increased cancer risk.
Genetic factors: Hereditary conditions such as familial adenomatous polyposis (FAP) or Lynch syndrome (HNPCC) significantly raise the risk.
Chronic inflammatory bowel disease: Conditions such as Crohn's disease and ulcerative colitis are associated with a higher risk.
Colorectal polyps: Adenomatous polyps can develop into carcinomas over time.

Symptoms

In early stages, colon carcinoma often causes no or only non-specific symptoms. As the disease progresses, the following signs may appear:

Changes in bowel habits (constipation, diarrhea, or alternation between the two)
Blood in the stool (visible or hidden)
Abdominal pain, cramps, or bloating
Unexplained weight loss
Persistent fatigue and weakness (possibly due to anemia caused by chronic blood loss)
Sensation of incomplete bowel emptying

Because these symptoms can also be caused by other conditions, medical evaluation is always necessary.

Diagnosis

The most important diagnostic tools for colon carcinoma include:

Colonoscopy: The gold standard; allows direct visualization of the bowel lining and tissue sampling (biopsy).
Fecal occult blood test (FOBT/FIT): A screening test that detects hidden blood in the stool.
Imaging: Computed tomography (CT) or magnetic resonance imaging (MRI) to assess the extent and spread of the tumor.
Blood tests: Tumor markers such as CEA (carcinoembryonic antigen) may be used to monitor disease progression.
Histological examination: The definitive diagnosis is confirmed through laboratory analysis of tissue samples.

Staging

Colon carcinoma is classified according to the UICC staging system into four stages (I to IV), ranging from a tumor confined to the bowel wall (Stage I) to distant metastases in other organs (Stage IV). The stage is the key factor in determining treatment strategy and prognosis.

Treatment

Surgery

Surgical removal of the tumor is the primary treatment option. Depending on the location and extent of the carcinoma, a portion of the colon is removed (hemicolectomy or sigmoid resection). The goal is complete removal of the tumor with adequate safety margins.

Chemotherapy

Adjuvant chemotherapy (administered after surgery) is commonly used in Stage III disease to eliminate remaining cancer cells and reduce the risk of recurrence. In Stage IV, chemotherapy is primarily used to prolong survival and relieve symptoms.

Targeted therapy

Certain medications such as VEGF inhibitors (e.g., bevacizumab) or EGFR inhibitors (e.g., cetuximab) may be used in advanced stages when the tumor carries specific molecular markers.

Immunotherapy

For tumors with specific genetic alterations (MSI-H or dMMR), immunotherapy using checkpoint inhibitors can be an effective treatment option.

Prevention and early detection

Colorectal cancer screening is essential for early detection. Regular colonoscopy is recommended for all adults starting at age 45 to 50, depending on national guidelines. Colon carcinomas detected at an early stage have an excellent chance of cure.

References

Bray F et al. – Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide. CA: A Cancer Journal for Clinicians, 2024.
National Comprehensive Cancer Network (NCCN): NCCN Clinical Practice Guidelines in Oncology – Colon Cancer, Version 2.2024.
Dekker E et al. – Colorectal cancer. The Lancet, 394(10207):1467–1480, 2019.

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