• What is colon cancer syndrome?


    Colon cancer is a disease in which mutated cancerous cells grow either in the colon, rectum or appendix. It can start in any of the previous organs or it can start in other organs and then, the changed cells move to the colon. According to the World Health Organization, it is the third most common form of cancer and the third leading cause of cancer-related death in the Western world

    These signs and symptoms depend on the location of the tumor and if it has spread to other organs (metastasis). They are divided in three categories: local, constitutional (whole body), metastatic.

    Local signs and symptoms:


    • Constipation
    • Diarrhea
    • Incomplete defecation feeling
    • Changes in stool shape
    • Lower gastrointestinal bleeding
    • Black stool Bowel obstruction
    • Abdominal pain
    • Vomiting
    • Peritonitis
    • Blood in the urine
    • Vaginal discharge
    • Constitutional signs and symptoms:
    • Occult bleeding
    • Iron deficiency anemia
    • Fatigue
    • Palpitations
    • Pale skin
    • Weight loss
    • Fever
    • Thrombosis

    Metastatic signs and symptoms:


    • Spread to the liver: jaundice and abdominal pain
    • Spread to the bile duct: jaundice, biliary obstruction, pale stools

    Why is a colon cancer screening exam important?


    Although colon cancer takes many years to develop, an early detection improves the chance to fight against it and to be cured. Screening exams are recommended for people who have colon cancer syndrome, meaning that they are genetically predisposed to develop a colon cancer. The most common exams are:

    • Digital Rectal Exam (DRE): the doctor feels for abnormal areas
    • Fecal Occult Blood Test (FOBT): it checks if there is blood in the stool
    • Endoscopy - Sigmoidoscopy: checks for polyps into the rectum and lower colon
    • Endoscopy - Colonoscopy: Looks for polyps and other abnormalities. The advantage of this exam is that, if polyps are found they can be immediately removed, and some tissue for a biopsy can be taken.

    If one or more members of your family have passed away or have had any type of cancer, there is a possibility that other family members develop the colon cancer syndrome as well as other types of cancer syndromes, visit your doctor for screening exams and identify if you have any colon cancer stage.

    In order to know the colon cancer stage of a person, it is necessary to have the results of the pathologic exams. Doctors guide themselves with the following chart from the AJCC Cancer Staging Manual ( Springer-Verlag, Sixth Edition.ed)


    AJCC stage

    TNM stage

    TNM stage criteria for colorectal cancer

    Stage 0

    Tis N0 M0

    Tis: Tumor confined to mucosa; cancer-in-situ

    Stage I

    T1 N0 M0

    T1: Tumor invades submucosa

    Stage I

    T2 N0 M0

    T2: Tumor invades muscularis propria

    Stage II-A

    T3 N0 M0

    T3: Tumor invades subserosa or beyond (without other organs involved)

    Stage II-B

    T4 N0 M0

    T4: Tumor invades adjacent organs or perforates the visceral peritoneum

    Stage III-A

    T1-2 N1 M0

    N1: Metastasis to 1 to 3 regional lymph nodes. T1 or T2.

    Stage III-B

    T3-4 N1 M0

    N1: Metastasis to 1 to 3 regional lymph nodes. T3 or T4.

    Stage III-C

    any T, N2 M0

    N2: Metastasis to 4 or more regional lymph nodes. Any T.

    Stage IV

    any T, any N, M1

    M1: Distant metastases present. Any T, any N.