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Best treatments for colonic neoplasm

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Written by Andrew Le, MD.
Last updated June 21, 2024

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What is Colonic Neoplasm?

Colonic neoplasms are abnormal growths that develop in the inner lining of the colon or rectum. Most neoplasms start as small clumps of cells called polyps that grow out of the intestinal wall. While many polyps are benign (non-cancerous), certain types have the potential to turn into malignant (cancerous) tumors over time.

  • Adenomas are the most common type of precancerous polyp. These neoplasms come from the glandular cells that line the colon and rectum. Adenomas are classified by their size and how much of the polyp looks like normal tissue under a microscope. Larger adenomas and those with more abnormal-looking cells are more likely to develop into cancer.
  • Serrated polyps are neoplasms that look saw-toothed under the microscope and include sessile serrated lesions and traditional serrated adenomas. Serrated polyps are often flat and difficult to see during a colonoscopy, which is why thorough screening is so important.

Several factors can increase your risk of developing colonic neoplasms. Age is the biggest risk factor, with rates increasing significantly after age 50. Other risk factors include a family history of colorectal cancer, inflammatory bowel diseases like Crohn's or ulcerative colitis, obesity, smoking, heavy alcohol use, and a diet high in red and processed meats. However, anyone can develop colonic neoplasms, which is why regular screening is recommended for all adults over 45.

Symptoms and Diagnosis of Colonic Neoplasm

In the early stages, colonic neoplasms often cause no noticeable symptoms. As a tumor grows larger, it may cause changes in bowel habits, such as diarrhea, constipation, or narrowing of the stool. Other symptoms may include rectal bleeding, abdominal pain or cramping, weakness, fatigue, and unintended weight loss.

Because early-stage colonic neoplasms often don’t have symptoms, regular screening is the best way to detect these growths before they turn into cancer. Screening can also prevent colorectal cancer by finding and removing precancerous polyps.

Some of the screening tests available are:

  • Stool-based tests: Tests like the fecal occult blood test (FOBT) and fecal immunochemical test (FIT) check for blood in the stool, which can be a sign of a neoplasm. These tests are non-invasive and can be done at home, but they may miss some polyps and require frequent testing.
  • Colonoscopy: Colonoscopies allow the doctor to view the inside of the entire colon and rectum using a camera on the end of a flexible tube. During a colonoscopy, any suspicious growths can be removed and sent for biopsy. This is one of the best ways to screen for neoplasms.
  • Flexible sigmoidoscopy: This test is performed similarly to a colonoscopy, but it only examines the rectum and sigmoid colon, the lower part of the colon.
  • CT colonography (virtual colonoscopy): This uses X-rays and computer technology to create detailed images of the colon.

Your healthcare provider can help determine which screening method is right for you based on your age, risk factors, and personal preferences.

If a suspicious growth is found during screening, the next step is a diagnostic colonoscopy to remove the abnormal tissue and determine if it is cancerous. During the procedure, the doctor may take a biopsy, which involves removing a small piece of the growth for examination under a microscope.

Common Treatment Options for Colonic Neoplasm

Treatment for colonic neoplasms depends on the type, size, and stage of the growth, as well as your overall health. The main treatment options include:

  • Polypectomy: During a colonoscopy, the doctor may be able to completely remove a small polyp using a wire loop or forceps. This technique is often sufficient for benign polyps and early-stage cancers that haven't grown beyond the inner lining of the colon.
  • Surgery: For larger polyps or more advanced cancers, surgery may be necessary to remove the abnormal growth and a margin of healthy tissue around it. Surgical options can be minimally invasive or open surgery, depending on the location, type, and size of the neoplasm.
  • Chemotherapy: Anticancer drugs may be used before or after surgery to shrink a tumor or destroy any remaining cancer cells. Chemotherapy can be given orally, through an IV, or directly into the abdomen. Side effects may include fatigue, nausea, and increased risk of infection.
  • Radiation therapy: High-energy beams may be used to kill cancer cells in a specific area of the body. Radiation therapy is often combined with chemotherapy for rectal cancer treatment.
  • Targeted therapy: These newer drugs target specific molecules involved in tumor growth and survival. Targeted therapies may have fewer side effects than traditional chemotherapy, but they only work for cancers with certain genetic mutations.

The prognosis for cancerous colonic neoplasms depends on the stage of the cancer at diagnosis and the response to treatment. Localized cancers that haven't spread beyond the colon or rectum have a 5-year survival rate of about 90%, while more advanced cancers have lower survival rates.1

Survival statistics are averages and can't predict a specific person’s outcome. Factors like age, overall health, and genetics can all affect prognosis. Regular follow-up care and healthy lifestyle changes can help improve quality of life and long-term outcomes for colorectal cancer survivors.

Lifestyle Changes for Managing Colonic Neoplasm

In addition to medical treatments, lifestyle changes can help manage colonic neoplasms and reduce the risk of recurrence. Some strategies include:

  • Eating a healthy diet: A diet high in fruits, vegetables, and whole grains has been linked to a lower risk of colorectal cancer.2,3 Try to eat at least 5 servings of fruits and vegetables per day, and choose whole grain breads, cereals, and pastas over refined options. Limiting red and processed meats, which have been associated with an increased cancer risk, is also recommended.
  • Getting regular exercise: Physical activity has been shown to lower the risk of colorectal cancer and improve treatment results for survivors.4,5 Aim for at least 150 minutes of moderate-intensity exercise or 75 minutes of vigorous activity each week. Walking, swimming, cycling, and dancing are all good options.
  • Maintaining a healthy weight: Being overweight or obese increases the risk of colorectal cancer.6,7 Losing excess weight through diet and exercise can help reduce your risk. Your healthcare provider can help you set a healthy weight goal and create a plan to reach it.
  • Avoiding tobacco and limiting alcohol: Smoking and heavy alcohol use have both been linked to an increased risk of colorectal cancer.8,9 If you smoke, quitting is one of the best things you can do for your health. If you drink alcohol, limit your intake to no more than 1 drink per day for women or 2 drinks per day for men.
  • Getting regular screenings: Even after treatment for a colonic neoplasm, regular follow-up screenings are essential to find any new abnormal growths early. Your healthcare provider will recommend a screening schedule based on your risk factors and medical history.

Making these lifestyle changes can be difficult, but small steps add up over time. Consider asking for support from family and friends, or joining a support group for people with colorectal cancer. Your healthcare team can also provide resources and advice to help you make healthy choices.

Emerging Therapies and Future Outlook for Colonic Neoplasm

While surgery, chemotherapy, and radiation remain the mainstays of treatment for colonic neoplasms, researchers are always developing new treatment therapies to improve results and quality of life for patients. Some promising areas of research include:

  • Immunotherapy: These treatments use the power of the body's own immune system to fight cancer. Immunotherapy drugs called checkpoint inhibitors have shown promise in treating some advanced colorectal cancers by blocking proteins that prevent immune cells from attacking tumors.10
  • Targeted therapies: As researchers learn more about the genetic changes that cause colorectal cancer growth, they are developing drugs that target these specific alterations. For example, drugs that inhibit the EGFR protein have been effective in treating some metastatic colorectal cancers.12
  • Nanoparticle drug delivery: Tiny particles called nanoparticles can be engineered to carry chemotherapy drugs directly to tumor cells, potentially reducing side effects and improving efficacy. Some nanoparticle-based treatments are already being tested in clinical trials for colorectal cancer.
  • Improved endoscopic techniques: Advances in endoscopy are making it possible to detect and remove precancerous polyps and early-stage cancers with less invasive procedures. For example, endoscopic submucosal dissection (ESD) allows doctors to remove larger polyps in one piece, reducing the risk of recurrence.11
  • Personalized therapy: By analyzing the genetic profile of a tumor, healthcare providers may be able to tailor treatment to target that cancer's specific weaknesses. This approach, known as precision medicine, is still in the early stages but is promising for improving outcomes and reducing side effects.

Despite these developments, early detection and prevention remain the best strategies for treating and preventing colonic neoplasms. Regular screenings can catch precancerous polyps before they turn into cancer, and a healthy lifestyle can lower your risk of developing these growths in the first place.

Conclusion

Colonic neoplasms are a serious but often preventable health concern. By understanding the risk factors, symptoms, and treatment options for these growths, you can take an active role in protecting your colorectal health.

The most important step is to get regular screenings starting at age 45 (or earlier if you have risk factors like a family history of the disease). These tests can detect precancerous polyps and early-stage cancers when they are most treatable.

If you are diagnosed with a colonic neoplasm, there are many effective treatment options available. Your healthcare provider will work with you to develop a personalized treatment plan.

In addition to medical treatments, lifestyle changes can help reduce your risk of recurrence.

With early detection, prompt treatment, and a commitment to healthy living, many people with colonic neoplasms can heal and enjoy a good quality of life. If you have any concerns about your colorectal health, talk to your healthcare provider.

Citations:

<1>Colon cancer develops from polyps (growths) in your colon's inner lining. Healthcare providers have screening tests and treatments that detect and remove precancerous polyps. If untreated, colon cancer may spread to other areas of your body. Thanks to these tests, early treatment and new kinds of treatment, fewer people are dying from colon cancer.</1>

<2>Aacrjournals.org. (2009). The Interaction of a High-Fat Diet and Regular Moderate Intensity Exercise on Intestinal Polyp Development in ApcMin/+ Mice | Cancer Prevention Research | American Association for Cancer Research. Retrieved from https://aacrjournals.org/cancerpreventionresearch/article/2/7/641/48619/The-Interaction-of-a-High-Fat-Diet-and-Regular</2>

<3>Medical News Today. (2022). Colon cancer: Symptoms, stages, causes, and treatment. Retrieved from https://www.medicalnewstoday.com/articles/150496</3>

<4>Wikipedia. (2023). Colorectal cancer. Retrieved from https://en.wikipedia.org/wiki/Colorectal_cancer</4>

<5>StatPearls. (2023). Colon Cancer - StatPearls - NCBI Bookshelf. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK470380/</5>

<6>Harvard Health Publishing. (2019). Try a FODMAPs diet to manage irritable bowel syndrome - Harvard Health. Retrieved from https://www.health.harvard.edu/diseases-and-conditions/a-new-diet-to-manage-irritable-bowel-syndrome</6>

<7>MedlinePlus. (n.d.). Colorectal Cancer | Colon Cancer | Rectal Cancer | MedlinePlus. Retrieved from https://medlineplus.gov/colorectalcancer.html</7>

<8>American Cancer Society. (n.d.). What Is Colorectal Cancer? | How Does Colorectal Cancer Start? | American Cancer Society. Retrieved from https://www.cancer.org/cancer/types/colon-rectal-cancer/about/what-is-colorectal-cancer.html</8>

<9>Ncbi.nlm.nih.gov. (2010). Lifestyle Modifications and Colorectal Cancer - PMC. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3950624/</9>

<10>MedlinePlus. (n.d.). Colorectal Cancer | Colon Cancer | Rectal Cancer. https://medlineplus.gov/colorectalcancer.html</10>

<11>Burke, C., & Bianchi, L. K. (n.d.). Colorectal Neoplasia. Cleveland Clinic Center for Continuing Education. https://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/gastroenterology/colorectal-neoplasia/</11>

<12>Jain, A., Singla, S., Jagannath, P., & Mukhopadhyay, S. (2019). Colorectal Carcinoma and Emerging Targeted Therapies. Indian Journal of Medical and Paediatric Oncology, 40(Suppl 1), S12-S18. https://doi.org/10.4103/ijmpo.ijmpo_193_18</12>

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The stories shared below are not written by Buoy employees. Buoy does not endorse any of the information in these stories. Whenever you have questions or concerns about a medical condition, you should always contact your doctor or a healthcare provider.
Dr. Le obtained his MD from Harvard Medical School and his BA from Harvard College. Before Buoy, his research focused on glioblastoma, a deadly form of brain cancer. Outside of work, Dr. Le enjoys cooking and struggling to run up-and-down the floor in an adult basketball league.

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