We all get a little scared when we hear the words “ colon cancer, ” don’t we? But what many people don’t know is that this cancer often doesn’t develop all at once. Instead, before it becomes cancer, certain changes occur in our colon. The best thing is that if we can identify these “ precancerous conditions” early, we have the opportunity to prevent cancer from developing. So today, let’s talk about these warnings that are given to us before this dangerous disease comes.
What are the conditions that precede this cancer?
Simply put, these are abnormal cell growths that form in the walls of our colon. These are not currently cancerous, but they can turn into cancer if left untreated over time. There are several main conditions among them. Let's look at each one.
1. Adenomatous Polyps: The Most Common Risk
You've probably heard the word " polyps ." These are small growths that form on the inside wall of the colon. They're like a wart on the skin, like a wart. There are several types of polyps, but the type called adenomatous is the one that has the highest risk of becoming cancerous.
The important thing is that these polyps may not show any outward symptoms. That's why medical tests are so important.
How are these detected and treated?
The best way to check for polyps is with a colonoscopy . In this test, a doctor inserts a small camera-equipped tube (scope) through your anus to examine your entire colon. This test can clearly see things like polyps.
The treatment is as follows:
- Polyp removal: The good news is that if polyps are found during a colonoscopy, they can be cut out and removed right away. This does not require major surgery.
- Sending to the laboratory: The removed polyp is sent to a laboratory to confirm whether it is adenomatous or another harmless type.
- Re-screening : If one polyp is found, your doctor will likely recommend a full colonoscopy to check for more. After that, it is usually recommended to have a follow-up test in 1 to 3 years , after the colon is completely “clean.” If your test results continue to be positive, your doctor will decide when to have your next test.
2. Familial Adenomatous Polyposis (FAP)
This is a slightly different, and more serious, condition. FAP is a hereditary, or genetic, condition. A person with this condition develops hundreds, if not thousands, of polyps in their colon.
Imagine, this is so serious that if someone with FAP is left untreated, the chance of developing colon cancer by the age of 40 is close to 100%.
Therefore, if FAP is diagnosed, it will definitely require surgical treatment. The surgical procedures and treatments for this are listed in the table below.
| Patient's condition | Treatment method and surgery |
|---|---|
| If there are no polyps in the rectum | Total colectomy: Most of the colon is surgically removed, and a portion of the small intestine (ileum) is reconnected to the rectum. After surgery, the rectum is examined every 6 months (proctoscopy). |
| If you have rectal polyps or don't want to take the risk of cancer | Ileal pouch-anal anastomosis: Both the large intestine and the rectum are removed. Then, a small pouch is created from the small intestine and connected to the end of the rectum. This allows the patient to continue to have normal bowel movements. |
3. Inflammatory Bowel Disease (IBD)
IBD is a chronic inflammation of the intestines. Examples of this are diseases like ulcerative colitis . When the intestines are inflamed for a long time, there is a risk that the cells in those parts will change and become cancerous .
How do you manage someone with IBD?
- Regular screening: People with IBD should have regular colonoscopies to check for signs of cancer. This can help catch any changes early.
- Prophylactic Colectomy: Some patients decide to surgically remove the colon before cancer develops, rather than waiting for it to develop. Here, too, the previously mentioned ``ileal pouch-anal anastomosis`` surgery can be performed to maintain a good quality of life.
All of this makes it clear that colon cancer is not something that develops overnight. Our body gives us various signals before it occurs. The most important thing is that we are aware of those signals, see a doctor at the right time, and get the necessary tests and treatment.
Take-Home Message
- Most colon cancers begin as treatable, non-cancerous conditions (precancerous conditions).
- Tests like colonoscopy can detect these conditions early and remove them before they become cancerous. If your doctor recommends it, don't skip these tests.
- If anyone in your family has had conditions like colon cancer, polyps, or FAP, it's important to let your doctor know. This will help them assess your risk.
- Colon cancer can be almost completely prevented with early detection and proper treatment. So don't be afraid, be aware.
Colon Cancer, Precancerous Conditions, Adenomatous Polyps, Colonoscopy, FAP, Familial Adenomatous Polyposis , IBD, Inflammatory Bowel Disease, Surgery











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