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Grows over years from polyps — which is exactly why screening can prevent it, not just find it early.
Also known as: colon cancer · rectal cancer · colorectal cancer
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
Almost always develops from initially benign polyps that can turn malignant over years. Early forms cause no symptoms — later come blood in the stool, changed bowel habits over weeks, abdominal pain, unintended weight loss or unexplained anaemia. Diagnosis by colonoscopy with biopsy. Treatment mainly surgical, supplemented by stage. Caught early, the outlook is good.
The treatment plan is not made by one person alone but in a round of surgery, oncology, radiology, pathology and radiotherapy. You may ask what was discussed there and which alternatives came up.
Before a big decision it is planned for in many clinics, and the records belong to you. It costs one to two weeks — acceptable in almost every course, and one asks about that if it is urgent.
It is today part of the treatment and not its opposite: it lessens the exhaustion, keeps muscle and bone and improves how the treatment is tolerated. Begin with guidance, less on bad days, but not nothing at all.
Unintended weight loss worsens how any treatment is tolerated. Restrictive diets do more harm than good here — with loss of appetite, dietary advice helps early, not only once kilos are already gone.
By the clock rather than as needed works better and needs less overall. Fear of dependence is the wrong adviser in this situation — untreated pain costs sleep, appetite and strength.
Psycho-oncological support, social advice for insurance and work, and the question of who takes on what at home. This is no emergency measure but belongs at the start — and the relatives belong in it.
With a case in the family, screening for siblings and children starts earlier than usual — usually ten years before the age at diagnosis. That is the most effective benefit a diagnosis can have for the family.
A polyp takes ten to fifteen years to become a cancer — that long window is why colonoscopy achieves so much: what is removed never arises. Found early, five-year survival is above ninety percent; found late, well below.
Surgery removes the tumour; the chemotherapy afterwards targets single cells that may already have broken away — it lowers the return by about ten to fifteen in a hundred, and runs for three to six months. With spread, today’s combinations hold the disease in check on average for years without removing it. What achieves most happens beforehand: a polyp taken off during a scope is a cancer that never arises.
Bright red blood comes far more often from haemorrhoids or a tear. Dark blood mixed with the stool, and blood without pain, belongs examined though — not assigned in advance.
Over more than four weeks: stools getting thinner, alternating diarrhoea and constipation, the feeling of never being quite finished. The change counts more than the state itself.
Iron deficiency in a man or in a woman past the menopause is a question to the bowel until it is answered. That is one of the most common routes by which a finding is picked up early.
Recurring cramps, a distended belly, nausea — and kilos that vanish without effort. If vomiting and a standstill of stool and wind come with it, it is an emergency.
The loss of muscle mass helps decide how well a treatment is tolerated. Enough protein spread across the day, together with movement, is the part one holds oneself.
Low values are common with a longer illness, and correcting them counts for bone and muscle. For high-dose courses against the illness itself there are no studies; they can interfere with treatment.
Belong in the workup of an anaemia that is otherwise too quickly put down to the illness or the treatment. Both are easy to measure and easy to supplement.
Nausea, diarrhoea and fever dry one out quickly, and several treatments strain the kidney. Drinking enough is no side issue here.
In observational studies a higher level is linked with fewer cases. The large intervention trials found no reduction in frequency — both belong said side by side.
Clearly worthwhile and well supported when deficient — vegan, older adults, certain drugs. No energy boost without a deficiency.
Reduced insulin action and persistently high insulin levels go with a raised risk — insulin and IGF-1 are growth signals for the gut lining too. That is one of the connections between excess weight and cancer that can be named.
In the large hormone trials fewer bowel cancers occurred on the combined treatment — one of the few points where the result came out favourable. It is still no reason for hormone therapy.
With acromegaly the risk of bowel polyps is raised, because the growth signal is permanently high. This is why colonoscopy there belongs earlier and more regularly.
Large observational studies find fewer cases with high fibre intake and more with a lot of processed meat. The figures refer to over 50 g of processed meat a day across years, not to a single meal.
Weight loss worsens tolerance of therapy. 1.2–1.5 g protein per kg body weight a day is the usual target, split across several meals.
The claim usually rests on the PET scan: weakly radioactive glucose is injected, and the tumour lights up. That shows tumour cells take up sugar faster than the tissue next to them — not that eaten sugar feeds them. You come to a PET scan fasting, and the tumour lights up anyway; the body keeps blood sugar within narrow limits by itself. It cannot be starved out this way. There is an established link nonetheless, but it runs through body fat: in 2016 the International Agency for Research on Cancer (IARC) reviewed the available studies and found sufficient evidence, for thirteen cancers, that absence of excess weight lowers the risk. That concerns prevention — it is not an answer to where an existing illness came from.
In large cohorts regular movement is linked with fewer cases and, after diagnosis, with a better course. Studied at about 150 minutes a week at moderate effort.
High fibre intake is linked with fewer cases in observational studies. The link is observational — there is no fibre course as a treatment.