Etiology- What causes this disease?
This cancerous disease begins in the final part of the digestive tract in the large intestine of a person called the colon. There are many possible reasons that can cause colon cancer including years of obesity, type II diabetes, inflammatory bowel disease (IBD), etc. If a person has ever had Crohn’s disease (a chronic abnormal immune response that affects the digestive system) or ulcerative colitis along with years of obesity, these diseases would increase the chances of him developing colon cancer. Besides, a person with type II diabetes is at a high risk of developing colorectal cancer because type II diabetes has direct effects on the likely course of prognosis.
Moreover, colon cancer can also be the result of a person inheriting bad genes as the two most common inherited syndromes namely hereditary non-polyposis colorectal cancer (HNPCC) and familial adenomatous polyposis (FAP) that can potentially increase the chances of developing colon cancer. It occurs when healthy cells’ genetic component is formed and while mutating, these cells develop errors in DNA which divide abnormally in the colon and resultantly form a tumor in the last part of the digestive tract (Banasik, 2021).
Pathogenesis
What happens at the cellular, tissue, and organ levels?
The key changes at cell and tissue levels due to colorectal cancer involve loss of cell polarity, extracellular interactions in epithelial cells, and collective cell migration because cells in this type of cancer lose their normal polarized structural organization. Lymphocytes near the dissociated tumor cells become migratory and increase the tumor cells invasion which resultantly decreases cell adhesion (Banasik, 2021). The loss of cellular polarity due to different mutations ultimately results in the loss of barrier functions in the intestinal tissues. The major organ that is affected by colon cancer is the intestine because the colon is associated with it.
How does that alter the function of the associated system?
Patients with colon cancer encounter many problems in the functioning of associated systems. It disrupts iron homeostasis as the intestine triggers the pressure towards the expression of iron uptake in the body. The body of the patient starts exporting significant proteins such as hephaestin (HEPH) and ferroportin (FPN).
How does it impact the function of the body as a whole?
Colon cancer can lead to weight loss, shortness of breath, loss of appetite, blood in stool or bleeding from the gastrointestinal tract, bowel obstruction, anemia, and abdominal pain. These signs and symptoms spread to other organs in case of tumor severity and kill the patient if left untreated for a long time.
Clinical Manifestations
What signs will you observe or measure?
A person having a cancerous tumor in his/her large intestine may have signs of abdominal discomfort such as pain, gas, cramps, etc., unexplained weight loss, and a persistent feeling that the bowel is not empty.
What symptoms will the client experience or feel?
The common symptoms that a person may experience would be fatigue or weakness, rectal bleeding, constipation, diarrhea, and a persistent change in the consistency of bowel habits (Banasik, 2021). However, symptoms vary with the stages of cancer, size of the tumor, and location of the tumor in the large intestine.
What abnormal labs and diagnostic tests confirm or support the diagnosis of the disease?
When symptoms appear, a doctor conducts several screening tests that are to identify polyps in the large intestine. Stool DNA namely the Guaiac-based Fecal Occult Blood test (gFOBT) and blood test namely Fecal Immunochemical Test (FIT) can be used to detect blood in the stool (Banasik, 2021).
Treatment Implications
Briefly explain the types of treatments used.
The treatment options for colon cancer include surgery for the removal of a cancerous tumor from the colon which is subdivided into two types of surgical methods; local excision– cutting of cancer without cutting through the abdominal wall at the early stage of cancer, and anastomosis– cutting cancer and a small number of healthy tissues around the tumor when the tumor is larger. Furthermore, radiofrequency ablation is used to kill cancer cells in the colon with tiny electrodes by inserting an incision in the abdomen (Banasik, 2021).
Targeted therapy and Immunotherapy are the two other treatment methods through which cancer is cut out from the colon. The former therapy method uses drugs to attack specific cancerous tumors or cells in the large intestine whereas the latter method uses the patient’s immune system to restore the body’s natural defense system against colon cancer.
What are the goals of treatment in relation to the pathophysiology?
The goals of colon cancer treatment through clinical trials may be the best treatment option for some of the patients whose cancer has not gotten worse or better. Abnormal and diagnostic tests including different treatment methods ensure the safe and effective diagnosis as well as treatment so that the stage of the colon cancer can be found and treated accordingly.
Are we seeking a cure, remission, or palliative care?
The treatment methods and diagnostic tests have the goal to seek relief for the suffering and pain of the patients having symptoms of last-stage colon cancer through treatment of spiritual, psychosocial, and physical signs of the disease experienced by patients who are likely to die soon. Chemotherapy or radiotherapy in this regard is categorized as palliative care to cure colorectal cancer at the serious stage of this illness.
References
Banasik, J. L. (2021). Pathophysiology. (7th ed.). Elsevier Health Sciences. US.
