As the actor who plays “Dawson” died of colorectal cancer at the age of 48, the question arises of the telltale symptoms. Update with Dr. Hervé Gautier, oncologist.
Colorectal cancer can affect the colon and rectum and often progresses quietly (hence the interest in screening offered free of charge by Health Insurance between ages 50 and 74). It is the third most deadly cancer in women, the second in men. Diagnosed at an early stage, colorectal cancer can be cured in 9 out of 10 cases. On the occasion of Blue Mars, the month dedicated to colorectal cancer screening, we interviewed Dr Hervé Gautier, oncologist and president of Committee 91 of the League Against Cancer, to take stock of the symptoms (three in particular) which can suggest colorectal cancer, in women and men.
What are the symptoms of colorectal cancer?
“The symptoms of colorectal cancer are initially quite vague. They become clearer as the disease progresses” replies Dr. Gautier straight away. Those that should attract attention are:
- transit disorders: sudden or worsening constipation, prolonged diarrhea or alternating diarrhea and constipation
- abdominal pain like colic
- the presence of blood in the stools (red or black)
“Then there are two more general symptoms such as fatigue and weight loss which can occur a little later, continues the doctor. There is also gradually anemia (iron deficiency) which sets in linked to bleeding in the stools. When the disease is more serious, it can go as far as intestinal obstruction but the cancer is already very advanced in this case.
Are the symptoms of colorectal cancer different between women and men?
The symptoms of colorectal cancer are the same in women and men “but there may be moderate nuances depending on the location of the cancer” specifies the doctor. Colorectal cancer affects the colon and rectum. The colon has several segments: the left colon, the right colon, the transverse colon. “Cancer can affect one or other of these parts. Generally, it is distributed a little more to the right in women and to the left in men. When the cancer is on the right, the symptoms are less precise. When it is on the left and especially when it affects the rectum, if it causes bleeding, it will be seen more quickly, the same thing if there are transit disorders, they will be seen more quickly.”
Can colorectal cancer remain asymptomatic?
Yes. “For a cancer of this type to appear, it takes 5 to 10 years. For a long time, there are therefore no symptoms” warns Dr. Gautier. Most colorectal cancers are linked to the malignant transformation of a polyp present in the colon or “a polyp can become cancerous over a fairly long period of time” adds the oncologist.
“Metastases are observed in 40 to 60% of cases of colorectal cancer” reports the French National Society of Gastroenterology (SNFGE) “and are generally discovered during remote monitoring examinations of initial cancer treatment” continues Dr. Gautier. There are therefore no easily identifiable symptoms at the start of their training. “Metastases rarely occur immediately; the disease must initially be locally widespread, continues our interlocutor. It is mainly for diseases with lymph node involvement that metastases appear, rather than at the time of diagnosis for patients who are going to be screened.” Colorectal cancer metastases are first lymph node then spread through the blood to the lung and liver. “This is why chest x-rays are recommended every year for patients treated for colorectal cancer and why we also monitor the liver by abdominal ultrasound with durations and variations depending on the protocols.”
Are there factors that facilitate colorectal cancer?
“Yes” responds our interlocutor who evokes the presence “particular antecedents” should increase vigilance and encourage screening. “There is the personal history of polyps, the family history if there is for example colorectal cancer before the age of 60 in a first-degree relative or cancer in two first-degree relatives, we must be vigilant and monitor the person more intensively. We also know that in women, there is more colon cancer than rectal cancer while it is the opposite in men. Finally, there are particular diseases including some hereditary ones with a high risk of cancer which are inflammatory diseases of the colon such as Crohn’s disease or ulcerative colitis or a genetic disease, familial polyposis” explains Dr. Gautier. Lack of physical activity and fiber consumption also play a role.
Thanks to Dr. Hervé Gautier, oncologist and President of Committee 91 of the League Against Cancer.
