Now I’m sure you realise how important it is to maintain such wonderful machinery!
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Are you aware of the incredible digestive « machine » that is constantly in action inside your body? One of its key components is the colon, a muscular tube that happens to be as wide as your smartphone (8 cm).
Dive in to learn more about this wonderful organ.
You will discover what it does for you, how you can take care of it, and what sometimes goes wrong… Ready? Follow me!
Start
Diving
Diving
Chapter
1
Discover
a wonderful Organ
a wonderful Organ
Your colon measures approx. 1.5 meter and is naturally equipped with fascinating “technology” that deserves your full attention.
Not only does your colon play an essential role in transforming the food and liquids you consume into nutrients and energy, but it is also a champion in waste management.
The colon is lined with a complex system of millions of nerves. It is equipped with its own reflexes and senses and it is considered as a second brain.
Studies suggest that the colon microbiota actually influences brain function, mood and also behaviour.
Dive deeper into this chapterDiscover
Chapter 1
Discover
a wonderful Organ
So, what happens
to the food you eat?
to the food you eat?
And how does it travel through your body?
#1 Step
In your mouth, food is first chewed into smaller pieces, and your saliva begins to break it down into a form your body can absorb and use.
#2 Step
In your oesophagus, muscular contractions move what you have swallowed towards your stomach for digestion.
#3 Step
In your stomach, enzymes break it down into a liquid mixture.
#4 Step
In your small bowel (or small intestine), the breakdown process continues using enzymes released by the pancreas and bile from the liver. This is where all the important nutrients (carbohydrates, proteins, fats, vitamins, minerals, …) are absorbed by your body.
#5 Step
What is left over from the previous process then passes through your colon (or large bowel / intestine), where the digestive process is finalised.
#6 Step
Your rectum stores the now solid waste received from the colon until it is moved out of your body through your anus.
Now...
let’s take a closer look
at your colon
at your colon
The colon is made up of different parts, which are named after the way food travels through them:
#1 Part
The ascending colon (on the right side of your belly), which starts with a pouch called the cecum, where undigested food arrives from the small bowel.
#2 Part
The transverse colon.
#3 Part
The descending colon (on the left side of your belly).
#4 Part
The sigmoid colon (« S » shape).
The colon slowly removes water and remaining nutrients from the liquid matter it receives from the small bowel, and handily packages the final waste for easy disposal.
How does it do that?
Separate layers of muscles allow the colon to tighten and relax to squeeze what is left from your food along towards the rectum.
Billions of friendly bacteria living in your colon feed on the waste and break down the remaining carbohydrates to synthesise key vitamins (B and K).
The mucosa lining the colon walls contains blood vessels, lymph vessels, nerves and mucous glands. It absorbs water, electrolytes and vitamins. When what is left from your food arrives in the descending colon, it is mostly solid. The mucus secreted by the mucosa helps it move easily through the rest of the colon and rectum.
Did you know that you have a second brain in your belly?
The colon is lined with a complex system of millions of nerves (the enteric nervous system) that can work independently of our brain to coordinate its own reflexes and senses.
That’s why scientists talk about a « second brain » in the colon.
And there is growing evidence that this second brain actually influences your « first » brain!
Indeed, there is some research that suggests that through our microbiota, our colon influences brain function, mood and also behaviour. This discovery has become a major topic of interest in research.
Chapter
2
Take care
Of your colon
Of your colon
How can you do that?
MORE
Fibres from fruits,
vegetables,
whole grains
vegetables,
whole grains
Dairy
products
products
Fish
Regular
physical
activity
physical
activity
Relaxation
and meditation
to reduce stress
and meditation
to reduce stress
LIMIT
Red meat and
processed
meats
processed
meats
AVOID
Alcohol
Smoking
Dive deeper into this chapterTake care
Chapter 2
Take care
Of your colon
Adopting a healthy lifestyle can reduce your risk of developing colorectal cancer.
Here are some simple steps you can take:
EAT MORE
Fibres (from fruit, vegetables, whole grains)- Dairy products
- Fish
- Regular physical activity
- Relaxation and meditation to reduce stress
LIMIT
- Red meat (beef, veal, pork, lamb, mutton, horse, goat)
- Processed meat (transformed through salting, curing, fermentation, smoking, or other processes to enhance flavour or improve preservation)
- Fats
AVOID
- Smoking
- Heavy alcohol consumption
- Obesity
Being physically active and having a healthy diet may help prevent other cancers and health problems!
More information
Read
Chapter
3
CHECK THAT EVERYTHING IS
IN ORDER
IN ORDER
If healthy lifestyle choices can help protect your colon, regular screening is also recommended to help prevent colorectal cancer or detect it at an early stage where treatments may be more successful.
RIGHT OR
WRONG
WRONG
WRONG
Colorectal cancer usually does not cause symptoms until the disease is advanced. While some symptoms may alert you, an effective and regular screening test is the most reliable method to reduce your risk of getting colorectal cancer.
While some symptoms may alert you, an effective and regular screening test is the most reliable method to reduce your risk of getting colorectal cancer.
BUT WE DO HAVE SOME
GOOD NEWS
GOOD NEWS
Detected early, 9 out of 10 colorectal cancers can be treated
So, how can you detect
colorectal cancer?
colorectal cancer?
Let’s go hunt bowel polyps!
Detecting them early can make a huge difference!
WHO SHOULD
GET Screened?
GET Screened?
If you answer « yes » to any one of the following questions, you should talk to your doctor about colorectal cancer screening
Are you over 50?
Do you have a family history of colorectal cancer?
Do you have any of the symptoms of colorectal cancer?
HOW DO YOU
GET Screened?
GET Screened?
2 methods of screening
A Faecal Occult Blood Test (FOBT)
Colonoscopy
Dive deeper into this chapterCheck that
Chapter 3
Check that
everything
is in order
Have you heard about bowel polyps?
Bowel polyps are growths that protrude from the mucosa inside the colon or rectum.
Polyps are usually benign, but some types called adenomas can change into a malignant cancer over a number of years. Advanced adenomas (in particular, those measuring more than 10 mm in diameter) are the most well-known precursor lesions of colorectal cancer.
Detecting them early can make a huge difference!
As these polyps can bleed, blood can be found in stools. The aim of screening programmes is to detect, through the presence of blood in stools, the potential presence of polyps which can then be removed as early as possible, before they develop into cancer.
Who should
get screened?
get screened?
If you answer « yes » to any one of the following questions, you should talk to your doctor about colorectal cancer screening.
Are you over 50?
Do you have a family history of colorectal cancer?
Do you currently have any of the symptoms of colorectal cancer?
Are you over 50?
The risk of developing colorectal cancer increases as you get older. Without symptoms or family history of colorectal cancer, screening is generally recommended for people who are over the age of 50.
Are you at a higher risk?
You should begin colorectal cancer screening earlier than 50 years old if you have any of the following risk factors:
- A personal history of inflammatory bowel disease (IBD), such as Crohn’s disease or ulcerative colitis
- A personal history of other types of cancer, including ovarian cancer or uterine cancer
- A family history of colorectal cancer, especially when family members are diagnosed with colorectal cancer before 60. If a first-degree relative has colorectal cancer, the risk for developing colorectal cancer doubles. This can be due to inherited genes or to shared environmental factors.
- A family history of any hereditary colorectal cancer syndrome, including familial adenomatous polyposis (FAP), Lynch Syndrome, Gardner syndrome, Juvenile polyposis syndrome, MYH-associated polyposis, or Peutz-Jeghers syndrome.
What are the symptoms to watch out for?
Symptoms and signs of colorectal cancer may include, but aren’t limited to:
- An unexplained change in bowel habits that lasts for more than a few days
- Stools that are narrower than usual
- Blood in stools
- Abdominal pain and/or discomfort (gas pains, bloating, fullness, cramps)
- Unexplained weight loss
- Extreme tiredness for no obvious reason
- Lower back pain
People with colorectal cancer may experience one, some, all or none of these symptoms.
Don’t panic
If you have these symptoms, it does not necessarily mean that you have colorectal cancer. They are the same as those of extremely common conditions, such as hemorrhoids and irritable bowel syndrome.
But do talk to your doctor!
How do you get screened?
There are two methods of screening for colorectal cancer:
- A Faecal Occult Blood Test (FOBT): It’s a painless, safe and simple test that can detect tiny amounts of blood (invisible to the naked eye) in stool samples, which can be a sign of polyps or cancer. You collect your own sample in the privacy of your own home, and send it to a laboratory for analysis.
- Colonoscopy: A flexible lighted tube with a camera is inserted through the anus to inspect the inside of the colon and rectum, looking for polyps or cancer. If polyps are found, most can be removed painlessly during the examination.
Many countries offer a systematic screening programme to detect polyps and colorectal cancer at an early stage.
In Europe, screening is recommended every two years for men and women between 50 and 74 years old. The screening programme usually consists of a Faecal Occult Blood Test (FOBT), followed by a colonoscopy for individuals who have a positive FOBT.
Screening programmes vary from country to country. Talk to your doctor to find out how screening for colorectal cancer is managed in yours.
If there is an organised screening programme for colorectal cancer in your country, you will receive an invitation to participate after you reach the recommended age.
However, even if you are not at the recommended age for screening, if you have risk factors (see above) or notice anything unusual about your health, consult your doctor without delay.
What if your FOBT result is positive?
Having a positive FOBT means that blood was found in your stool. However, it does not mean that you have a colon polyp or colorectal cancer. The presence of blood may be due to other causes, such as bleeding in the stomach or upper gastrointestinal tract.
In most cases, you will be referred for further investigations which may include a clinical examination and/or a colonoscopy.
Don’t hesitate!
There is ample scientific evidence that screening for colorectal cancer with stool-based tests and colonoscopy reduces the risk of death from colorectal cancer.
Ask your doctor about screening!
More information
Read
Item 1 of 1
Chapter
4
It sometimes Happens:
Colorectal Cancer
Colorectal Cancer
or Bowel Cancer
So, what can go wrong inside your colon ?
Well…
Those polyps
sometimes
become
cancerous
How frequent is
colorectal
Cancer?
colorectal
Cancer?
What are
the Symptoms?
the Symptoms?
Many people with colorectal cancer don’t have any symptoms until the disease is advanced.
Symptoms and signs of colorectal cancer may include, but aren’t limited to:
What are
the Causes?
the Causes?
In most cases, colorectal cancer is « sporadic », meaning that the cause is unknown.
5–10% cases are related to inherited genes that convey a risk for the disease.
How does it
Progress?
Progress?
5 stages
Progress from benign adenomas to cancer (adenocarcinomas) is slow. It can take more than 10 years, sometimes even 20 years.
The good news
9 out of 10 people diagnosed with colorectal cancer at an early stage had better outcomes than those diagnosed with more advanced disease.
That’s why early diagnosis is essential!
How is
Colorectal
cancer Treated
Colorectal
cancer Treated
Have you ever heard about biomarker testing?
We are all different, tumours are too... That’s why biomarker testing is becoming increasingly important to guide treatment strategies in metastatic colorectal cancer.
MMR Status
RAS Status
BRAF Status
HER2 Status
NTRK Status
Every tumor is unique.
Knowing its characteristics is like having the tumour's identity card. The analysis of these biomarkers is called molecular testing. Knowing your biomarker profile is important as it can affect :
- the course of the disease
- treatment strategy
- the course of the disease
- treatment strategy
Do you want to know more?
Hear the conversation between Katell Maguet and Prof. Filippo Pietrantonio to know more about colorectal cancer and the importance of taking care of this important organ.
Any questions?
Contact your healthcare professional or a patient association!
Dive deeper into this chapter
Further information
Chapter 4
It sometimes happens: Colorectal Cancer (or Bowel Cancer)
So, what can go wrong
inside your colon?
inside your colon?
Well
Those polyps sometimes become cancerous…
How frequent is colorectal cancer?
- 3rd most common cancer worldwide: more than 1.9 million new cases in 2022
- 2nd most deadliest cancer worldwide: more than 900 000 deaths in 2022
- Highest incidence rates are in Europe, Australia / New Zealand and North America
Incidence rates are steadily increasing in countries that are undergoing economic transition, which likely reflects changes in lifestyle factors.
In high-income countries, an overall decline in the incidence of colorectal cancer has been noted, which has been attributed to population-level changes toward healthier lifestyle choices and the uptake of screening. However, a worrying rise has been observed in adults younger than 50 years old at diagnosis.
WHAT IS EARLY-ONSET COLORECTAL CANCER?
Early-onset colorectal cancer (EO-CRC) is colorectal cancer diagnosed before the age of 50. It may also be called early age onset colorectal cancer and young-onset colorectal cancer.
- Since the 90s, the number of EO-CRC cases has been rising by about 1.5% each year, and sadly, so have the number of deaths related to it.
- By 2030, it's estimated that colorectal cancer could be the leading cause of cancer deaths in people aged 20-49.
- EO-CRC tends to be more aggressive and the outlook for young patients can be worse than for older ones.
- Younger people with EO-CRC are often not diagnosed by organized screening, leading to delayed diagnoses.
Learn the symptoms of colorectal cancer and talk to your doctor if something doesn't feel right.
Further informationWhat are the symptoms?
Many people with colorectal cancer don’t have any symptoms until the disease is advanced.
Symptoms and signs of colorectal cancer may include, but aren’t limited to:
- An unexplained change in bowel habits that lasts for more than a few days
- Stools that are narrower than usual
- Blood in stools
- Abdominal pain and/or discomfort (gas pains, bloating, fullness, cramps)
- Unexplained weight loss
- Extreme tiredness for no obvious reason
- Lower back pain
People with colorectal cancer may experience one, some, all or none of these symptoms.
Don’t panic
If you have these symptoms, it does not necessarily mean that you have colorectal cancer. They are the same as those of extremely common conditions, such as hemorrhoids and irritable bowel syndrome.
But do talk to your doctor!
What are the causes?
In most cases, colorectal cancer is « sporadic », meaning that the cause is unknown.
5–10% cases are related to inherited genes that increase the risk for the disease.
How does it progress?
Progress from benign adenomas to cancer (adenocarcinomas) is slow. It can take more than 10 years, sometimes even 20 years, offering a large window for early detection and optimised management. This is why regular screening over a long period is important.
From the mucosa, the cancer can spread through tissue, the lymph system and blood vessels. The stage used to define it describes the extent of its spread within the body:
#0 Stage
The cancer is only in the mucosa.
#I Stage
It has grown into the submucosa or muscle.
#II Stage
It has grown through the muscle wall or through the outer layer of the bowel and may be growing into tissues nearby.
#III Stage
The cancer has spread to lymph nodes nearby.
#IV Stage
The cancer may have spread to nearby lymph nodes. It has spread to other parts of the body such as the peritoneum, liver or lungs. Stage IV cancer is also called metastatic colorectal cancer.
Staging of colorectal cancer helps determine how advanced the disease is and how best to treat it.
How is colorectal cancer treated?
Treatment depends on the stage and type of the cancer, individual characteristics and the benefits/risks balance for the patient.
Treatments act on the cancer either locally (surgery, radiotherapy) or systemically, which means all over the body (chemotherapy, targeted therapy, immunotherapy) :
- Surgery is the most common treatment for colorectal cancer. In early stages of the disease, it may be sufficient to remove the tumour. When it is possible, it may also be performed to remove metastatic lesions in patients with advanced disease.
- Radiotherapy uses high-energy rays or particles to destroy cancer cells.
- Chemotherapy uses drugs. It is given through the mouth (as a tablet) or the vein (as an injection, drip or infusion). It aims to kill or limit the growth of tumour cells. A patient may receive one drug at a time or a combination of different drugs.
- Targeted therapy uses drugs that are designed to interfere with the growth of cancer cells. The aim is to block specifically the growth and spread of cancer cells and limit damage to healthy cells.
- Immunotherapy aims to boost the body’s natural defenses (immune system) to fight the cancer.
You may have heard about biomarker testing. How does this help?
We are all different, tumours are too… That’s why biomarker testing is becoming increasingly important to guide treatment strategies especially in metastatic colorectal cancer.
But what are we talking about?
A biomarker is a biological molecule found in blood, other body fluids or tissues, which gives an indication of a normal or abnormal process, or of a condition or disease. It can be a change in DNA, RNA, or protein.
Cancer cells may have changes in genes (mutations) that can affect how the cancer grows. and define response (or lack of response) to therapy. Knowing them in a patient is like knowing the fingerprints of their hand. It is a characterisation of their tumour that can provide doctors with a great deal of information and help them find the most suitable treatment.
In metastatic colorectal cancer, the most common alterations are found in genes called RAS, BRAF and mismatch repair (MMR) genes.
More information
Read
Item 1 of 2
Watch
Any questions?
Contact your healthcare professional or a patient association!
Healthcare professionals and patient associations are key contacts to get specific and accurate answers to your questions. Many patient associations provide information about prevention and screening, as well as advice and support to patients and families.
Don’t hesitate to contact them!
In Europe, Digestive Cancers Europe (DiCE) is the umbrella organisation of a large group of national associations representing patients with colorectal cancer.
Find a patient organisation in your country: Members - Digestive Cancers Europe
Chapter
5
science in progress
Many scientists are constantly seeking ways to detect and treat colorectal cancer more effectively and the landscape is rapidly evolving.
Recent improvements and key findings cover different areas, including better understanding the disease, improving early detection, characterizing tumours and personalizing treatments.
Dive deeper into this chapterScience
Chapter 5
Science
in progress
Many scientists are constantly seeking ways to detect and treat colorectal cancer more effectively. Here are a few examples of ongoing research in different areas:
- Improving prevention
- Improving detection
- Finding new drugs
- Assessing drugs that are already used against other cancers or testing new combinations of drugs to see if they work better together during clinical trials.
- Finding new targets for therapy
- Personalizing treatments
These examples only give an idea of the types of questions that researchers are currently investigating. There are many more!
To learn more, talk to your HCP or your local patient association!
Our dive is now coming to an end…
Are you ready to protect your wonderful colon?
Adopt/maintain a healthy lifestyle!
Think about colorectal cancer screening!
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is now coming to an end...
is now coming to an end...
Are you ready to protect your wonderful colon?
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