Disorders of the Gastrointestinal System, 2nd Edition
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localized for years. Early diagnosis before involvement of the lymph nodes has a 91% cure rate, while the five-year surviv - al rate for persons with adjacent organ or lymph node spread is about 72% (Amer- ican Society of Clinical Oncology, 2022). Colorectal cancer includes cancers that affect both the colon and the rectum. The term colon cancer refers to malignancies that occur below the small intestine and above the last six inches of the GI tract. Rectal cancer refers to malignancies that occur in the last six inches of the GI tract, excluding the anus (Macrae, 2022a). The exact etiology of colorectal cancer is unknown; however, research has shown a higher incidence of the disease in pa- tients who make certain lifestyle choices and/or fall into the following categories (Dragovich, 2022): ● Diets with red meat, low fiber, and low fruit and vegetable intake. ● History of IBD. ● History of polyps or family history of colorectal cancer. ● Genetic conditions such as Lynch syndrome and familial adenomatous polyposis (FAP). ● History of other cancers. Research indicates that the develop- ment of colorectal cancer is linked to sev- eral gene mutations. Most colon cancers stem from adenomatous polyps. Howev- er, other polyps may become malignant, and it is impossible to determine which polyps will become cancerous. Complete removal of all colon polyps dramatical- ly decreases the risk of a polyp causing a malignancy (Rodriguez-Bigas & Over - man, 2022).
| NURSING CONSIDERATION
Some patients may assume their symptoms are not serious and think they are caused by common problems such as hemorrhoids. In many cases, these patients do not seek medical attention. Screening according to recommendations should be encour- aged, especially if risk factors are present. Encourage patients to always seek medical interventions if they have symptoms (Dragovich, 2022). The increasing use of home testing for occult blood is helping to identify symptoms that will cause the patient to seek a medical evaluation; howev- er, patients at risk should be taught that these tests are not diagnostic and may not identify early symptoms. The signs and symptoms of colorectal cancer depend on the location and stage of the malignancy. Although the ear- ly-stage disease may not cause any signs or symptoms, the following are associat- ed with it as it advances (Macrae et al., 2022): ● Diarrhea. ● Constipation. ● Dark or bright red blood in the stool. ● Abdominal cramps, bloating, gas pains. ● Changes in appetite. ● Weight loss.
● Fatigue. ● Anemia.
● Tenesmus (feeling that the bowel is not emptying, even after bowel movements).
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