Skin failed to win his fight against the colon cancer. The health conditions of O Rei, admitted to the Albert Einstein hospital in Sao Paulo, drastically improved when the Brazilian champion was diagnosed with “renal and cardiac dysfunction”. Pelé had been operated on for colon cancer a year ago. In recent days, the Folha newspaper of São Paulo had written that the football legend was not responding to chemotherapy.
What is it
As stated on the Aric website, colorectal cancer is cancer that forms in the tissues of the colon (the longest part of the large intestine) or the rectum (the part of the large intestine closest to the anus). . Colon and rectum are part of the intestine, the organ that absorbs nutrients taken with food. It looks like a hollow tube whose length varies from person to person between 4 and 10 meters, but on average it is 7 meters long. The intestine is divided into two parts that have different functions: the small intestine and the large intestine. The small intestine ‒ or small intestine, in turn divided into duodenum, jejunum and ileum ‒ has the function of completing the digestion that began in the mouth and continued in the stomach, to which it is connected via the duodenum. Instead, the main function of the large intestine ‒ or large intestine ‒ is to absorb water to compact the stool. The large intestine includes the colon ‒ in turn divided into the right or ascending colon (with the cecum and appendix), the transverse colon, the left or descending colon and the sigmoid colon ‒ and the rectum, which finally ends in the anal canal.
Symptoms
In general, polyps do not cause symptoms, but sometimes they can give rise to small blood losses, detectable with a stool test for the search for the so-called “occult blood”. In some cases the blood losses are greater and visible even to the naked eye and real rectal bleeding can also occur. The symptoms are very variable and conditioned by various factors such as the site of the tumor, its extension and the presence or absence of obstructions or haemorrhages. This causes the manifestations of this type of cancer to often overlap with those of many other abdominal or intestinal diseases. For this reason, early, vague and sporadic symptoms such as tiredness and lack of appetite, and other more serious ones such as anemia and weight loss, are often overlooked by the patient, especially at a young age. Sometimes stubborn constipation, alternating with diarrhea, can be a first alarm bell that should not be underestimated.
The cause
Like all tumors, colorectal cancer is also a consequence of the uncontrolled growth of cells, in this case of the epithelial cells of the mucosa that internally lines the internal part of the intestine. Intestinal cancers arise mainly in the colon and rectum, while cancers of the small intestine and anal canal are very rare (2-3 percent of all digestive tract cancers). Colon tumors are almost three times more frequent than rectal tumors, and manifest themselves in different ways both at the clinical and molecular level. This affects the type of local (surgery and/or radiotherapy) and systemic (chemotherapy, biological and molecular therapy, immunotherapy) treatment, as well as the sequence in which these different types of treatments are offered to the patient.
Who is at risk
Nutritional factors: many studies have shown that a diet high in fat and animal protein and low in fiber is associated with an increase in intestinal tumors. Conversely, diets rich in fiber, characterized by a high consumption of fruit and vegetables, appear to have a protective role. Obesity and overweight are additional risk factors, generally linked to an unhealthy diet and lifestyle.
Genetic factors: it is possible to inherit the predisposition to get colorectal cancer if there are diseases such as hereditary adenomatous polyposis (including familial adenomatosis polyposis, or FAP, Gardner syndrome and Turcot syndrome) in the family of origin and hereditary non-polyposis colorectal cancer (also called HNPCC or Lynch syndrome). These are hereditary diseases transmitted by parents who are carriers of specific genetic alterations and may also not give rise to any symptoms. The probability of passing on the altered gene to offspring is 50 percent, regardless of gender. These cancers with inherited risk factors account for about 10 percent of all colorectal cancers. Furthermore, it is estimated that the probability of developing colorectal cancer increases by two to three times in first-degree relatives of a person with cancer or polyps of the large intestine, even if not affected by recognized hereditary syndromes.
Non-hereditary factors: age (the incidence is higher in the elderly), smoking, physical inactivity, inflammatory bowel disease (such as ulcerative colitis and Crohn’s disease) are also important in determining the risk of getting colorectal cancer ), a past history of colon polyps or previous colorectal cancer. Polyps and cancers that are not hereditary syndromes are called “sporadic”.
Mortality and spread
The most updated data show that from 2008 to 2016 every year the incidence decreased by 3-4 percent in the age group subjected to free population screening, i.e. in people between 50 and 69 years of age. However, and in contrast, more recent data instead highlight an annual increase of 0.4 percent of cancer cases in individuals under 50 years of age and therefore not covered by screening. This increase in cases particularly concerns very young subjects, up to the age of 30 at the time of diagnosis, for causes not yet known and currently being studied also by researchers in Italy. Moreover, contrary to expectations, colorectal cancers occurring in young people, in more than 50 percent of cases are not due to familiarity with this type of cancer or genetic diseases predisposing to the development of cancer, but appear to be sporadic . Mortality from colorectal cancer is in steep decline, with rates declining by about 10 percent over the past five years. These progresses are mainly attributable to screening programs, early diagnosis and the improvement of therapies, both surgical and medical, increasingly targeted.