Colorectal cancer is a common malignancy throughout the world in both men and women. It is third-leading cause of cancer related deaths in both genders, according to the American Cancer Society. It is most often diagnosed in the sixth decade of life. Several complications may arise from colorectal cancer. Most of these complications arise in advanced disease. The complications are bowel obstruction, perforation, bleeding and intractable pain.
Bowel Obstruction
Obstruction of the large intestines, which is the large bowel/colon, is the most common complication of colorectal cancer. Quite often this may be the first presentation of the disease. This usually manifests with abdominal swelling, abdominal pain, vomiting and constipation. Persons who develop bowel obstruction are severely ill and require surgical intervention to relieve the obstruction. Surgery may involve removal of the malignant portion of the colon or a fashioning of a colostomy, an opening placed in the bowel and then anchored to the skin to allow collection of the feces into an external collecting bag. The latter procedure is used as a temporary measure until a more definitive operation can be performed. Bowel obstruction tends to occur in advanced colorectal cancer.
Bowel Perforation
This complication occurs when the cancer erodes the bowel wall, allowing feces to escape into the abdominal cavity. This creates a severe infection within the abdominal cavity. Persons who develop this complication are severely ill. They are significantly dehydrated and complain of vomiting, diarrhea, fever, abdominal swelling and severe abdominal pain. If this complication occurs, surgery is the only option.
Intractable Pain
As the cancer progresses it invades the surrounding tissues and organs. It may invade nearby nerves causing significant, chronic pain. This type of pain is often very difficult to control, even with surgery. This is not a common complication but when it does occur, it can be quite debilitating
Bleeding
All colorectal cancers bleed. However, this bleeding is not always visible with the naked eye. Rarely does colorectal cancer bleed significantly to warrant emergency intervention. More often blood loss is subtle and over a long leads to an anemia.
References
- "Sabiston Textbook of Surgery"; Townsend Jr., C et al; 2008
- "Washington Manual of Surgery"; Doherty, G.M. et al; 2002
