The Empowered Patient’s Guide to Colon Cancer Pain

Colon Cancer is the fourth most commonly-occuring cancer globally. In the US, colon cancer is the third most common cancer and the second leading cause of cancer deaths. And while colon cancer rates are decreasing in people 55 and older, they are rising in younger adults. Colon cancer isn't always fatal but early detection is key to survival.

Colon cancer typically presents as a dull belly ache. It's important to be screened for colon cancer if you notice changes in bowel habits.

 

What Exactly Is Colon Cancer and How Does It Cause Pain?

Colon cancer begins as small, non-cancerous clumps called polyps, which often produce no symptoms. Some of these polyps may become cancerous and can grow into the wall of the colon. Colorectal cancer begins in the innermost layer (the mucosa) and can grow outward, effecting other layers of the colon. If undetected, the cancer can metastasize (spread) to other parts of the body.

The pain experienced with colon cancer is not always identified as a typical pain sensation, explains Imran Ali, MD, MS, MPH, and physician Fellow in Palliative Care/Geriatric Supportive Oncology training at NYC VA System/Icahn School of Medicine at Mount Sinai. “Colon cancer typically presents as a dull belly ache, if anything at all,” Dr. Ali says. In the more advanced stages of colon cancer, the pain may feel cramp-like or similar to bloat. Pain that is persistent and severe can be a sign of colon cancer and should never be overlooked. If you are experiencing new abdominal discomfort that is persistent, it is important to request colon cancer screening.

Changes in bowel habits can be warning signs of colon cancer. Diarrhea, constipation, and changes in the consistency of stool should not be ignored. Sometimes we dismiss our own pain as discomfort, but how we defecate (poop) can tell us a lot about our health. Blood in the stool, fatigue, and unintended weight loss can also be early signs of colon cancer.[3]

In the later stages of colon cancer, tumors can cause obstructions and bloating. You may also notice that your stools are thin and pencil like as a result of blockages. If you have consistent discomfort or disruptions in your bowel habits, consult your doctor.

The Details About Colon Cancer, Progression, and Prognosis

Like all cancers, colon cancer is divided into different stages. These stages are based on the progression of the disease and are often used to choose treatments and predict survival rates. It is important to note that survival rates are an average of existing data and each person’s experience with colon cancer will be different and will be dependent on factors such as:

  • Age
  • Lifestyle
  • Other health conditions
  • Type of treatment
  • Specific tumor markers
  • Whether the cancer has returned

When colon cancer is diagnosed in the early stages, survival rates are quite high. To break it down:[4]

  • Localized colon cancer includes stages 0-1. In these stages, the cancer has not grown beyond the lining of the colon. Localized colon cancer has an average 90% survival rate.
  • Regional colon cancer includes stages 2-3. In stage 2, the cancer has grown thru the colon wall but has not affected the lymph nodes. In stage 3, localized lymph nodes are affected by the cancer. Regionalized colon cancer has a survival rate of 71.1%
  • Distant colon cancer is stage 4. In stage 4, the cancer has spread to other sites, including lymph nodes or other organs. Distant colon cancer has a survival rate of 13.8%.

Colon cancer that is caught early can often be successfully treated. The greatest danger of this cancer is that it often goes undetected, making it progressively more difficult to treat. Because warning signs of colon cancer are often hard to catch, it’s crucial to get regular screenings—a colonoscopy.

Managing Colon Cancer and Potential Pain

When we talk about managing colon cancer, we need to consider more than the basic treatment options. Managing colon cancer should include:

  • Treatments for the cancer
  • Lifestyle interventions
  • Pain management strategies
  • Mental health and well being

Treatment for colon cancer will depend on the individual and on the stage of the cancer.[5]

  • In localized colon cancer, doctors are likely to recommend localized treatments such as, surgery, ablation, and radiation.
  • In regional colon cancer, doctors often recommend surgery, with the potential use of adjuvant chemotherapy, depending on the individual. In some more advanced cases of regional cancer, the tumor is too large to remove by surgery. In this case, radiation may first be used to shrink the tumor, before surgically removing the cancer.
  • In distance colon cancer, chemotherapy is nearly always recommended. In distance colon cancer, the cancer often spreads to the liver or lungs. If the spread is not too great, surgery may still be used. Ablation or embolization may also be used.

The treatments for colon cancer, can cause their own symptoms, a primary one being pain, explains Dr. Ali.

  • Chemotherapy can cause neuropathic pain. This pain is often described as a pins and needles sensation, similar to the feeling of your foot “falling asleep”.
  • Radiation therapy can produce symptoms of nausea, rectal irritation, ladder irritation (the frequent feeling of needing to go), fatigue, erection problems in men and vaginal irritation in women.
  • Ablation and embolization therapy can cause abdominal pain, infection of the liver, bleeding in the chest cavity or abdomen, fever, gallbladder inflammation, infection of the liver.
  • Surgery risks depend on the type of surgery. A polypectomy is performed to remove polyps (polypectomy) and be done with a colonoscope. This procedure is generally noninvasive. A colectomy is a surgery that removes all or part of the colon; this is used in more advanced stages. If only part of the colon is removed, it's called a hemicolectomy, partial colectomy, or segmental resection. Total colectomy isn't often needed to remove colon cancer. Surgery often results in post-operative pain and can be treated with various pharmaceuticals, as well as complimentary therapies. Sometimes, after surgery it takes time for the bowel to function again. Certain pain medications, such as opioids, can prolong this process.

Lifestyle Intervention, Alternative Therapies, and Recent Advances

In addition to the traditional approaches, there are many developments in how doctors treat colon cancer and the pain that accompanies it.

  • •      Targeted therapies are medications that target 1 or more of the biological processes that bowel cancer uses to spread inside the body. Effects of targeted therapies may include: skin rash, diarrhea, and sore eyes.
  • Immunotherapy may also be used to treat colon cancer, specifically those people with advanced stages of colon cancer. Dr. Ali explains that immunotherapy may work better for some people than for others, dependent on their specific genome and genome instability.
  • Diet is important. Consuming a large amount of red and processed meats may increase your risk for developing colon cancer. At the same time, consuming a dietary pattern high in fibre, vitamin D, calcium, fruits, and vegetables may have a protective affect.
  • The gut microbiome is powerful. Having a healthy balance of bacteria in your gut is an important protector against colon cancer. An imbalanced gut can promote inflammation and can influence the development of cancerous polyps in your colon. A diet rich in a diverse array of plants, fermented foods, fruits and vegetables can help to maintain a balanced gut microbiome. Pre- and probiotics may also be recommended.

Treating Colon Cancer Pain

The pain associated with colon cancer and its treatments can be lessened using a variety of therapies and lifestyle interventions. Pain caused by the tumors themselves can be lessened by therapies to remove of reduce the tumors. Pain caused by colon cancer treatments can be treated with:

  • Over the counter, prescription pain relievers such as, aspirin, acetaminophen, ibuprofen
  • Weak opioids (codeine)
  • Strong opioids (morphine, oxycodone)
  • Antidepressants
  • Anti seizure drugs
  • Steroids

Complimentary therapies to treat colon cancer pain include:

  • Acupuncture has shown to be effective for reducing many types of cancer pain.[6]
  • Medicinal marijuana has shown to be effective in reducing certain pain symptoms associated with cancer. Marijuana (especially a balanced ratio with 1:1 THC to CBD) may help reduce pain signaling, inflammation, and anxiety. Dronabinol, a pharmaceutical form of THC, and a man-made cannabinoid drug called nabilone are approved by the FDA to treat some conditions.[7]
  • CBD is an extracted marijuana cannabinoid that won’t get you high. CBD may help to relieve pain, lower inflammation, and decrease anxiety.
  • Reiki can help reduce feelings of pain in some people.[8]

What It All Means

The pain and symptoms of colon cancer aren’t always obvious. A dull bellyache that persists may be a warning sign. Consistent cramps may be a reason to visit a doctor. Early prevention is the most important factor when it comes to surviving colon cancer. Your best defense is regular screenings, even if you are under 55. Diet and lifestyle matter. A typical western diet, sedentary lifestyle and imbalanced gut all increase the risk of developing colon cancer. Staying active, eating a healthful and balanced diet, and increasing your vegetable intake are all protective measures.

Colon cancer is not a death sentence. Researchers are constantly improving treatment options, and complimentary therapies to improve both survival rates and quality of life.

Updated on: 04/21/21
Continue Reading:
Coping with Cancer Pain
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