With around 63,000 new cases every year, colorectal cancer is the second most common cancer diagnosis in Germany after breast cancer. Targeted preventive care is therefore particularly important and particularly effective in the case of colorectal cancer, because the precancerous lesions can be removed immediately during the examination. But in about one percent of all check-ups, colon cancer is found. On the occasion of the “Colon Cancer Month March” proclaimed by the Felix Burda Foundation, the LebensBlicke Foundation and the network against colon cancer eV, BUNTE.de explains what those affected and their relatives should know after a diagnosis. The good news: There are numerous ways to deal with the disease better and improve the chances of recovery.

Colon cancer – how dangerous is it actually?

According to the Felix Burda Foundation, almost 24,000 people die of colon cancer in Germany every year. However, mortality has been falling for several years and, above all, this number says nothing about the personal risk of an illness. Because the prognosis depends on many other influencing factors, how far advanced the disease is and how aggressively the tumor is growing. If colon cancer is discovered at an early stage, those affected have a good chance of a complete cure. The exact stage of the tumor is indicated by the so-called TNM classification. It describes the size of the tumor (T), the involvement of the lymph nodes (N) and the spread to organs (M).

These studies bring clarity

To more accurately determine the stage of colon cancer, oncologists conduct further examinations. In the case of a tumor in the colon, these include:

• major colonoscopy
• tactile examination
• abdominal ultrasound
• X-ray of the chest
• Measurement of so-called tumor markers (CEA) in the blood

In some cases, computed tomography of the chest and abdomen is useful.

In the case of a (rare) tumor in the rectum, oncologists also use the so-called rigid rectoscopy, an MRI or CT of the pelvis and an endosonography (ultrasound performed from the inside).

This is how colon cancer surgery works

If the operation is due, those affected should plan a few days in the hospital. The operation usually takes place the day after admission. It is carried out either with the so-called keyhole technique (minimally invasive) or begins with the surgical opening of the abdominal wall. Both methods use general anesthesia.

The keyhole technique has the advantage that patients feel more resilient more quickly and a smaller scar remains. Depending on the location and size of the tumor, the treating physicians decide which method makes sense.

Depending on the stage of the tumor, the surgery can have the following results:

• At best, the operation means a cure. This is usually the case when the colon cancer was in its early stages.
• If nearby lymph nodes are affected, those affected usually need subsequent chemotherapy.
• If the tumor is very advanced, surgery can improve quality of life by relieving constipation caused by the tumor.
• In some cases, patients receive an artificial bowel outlet (the so-called stoma) after the operation. Creating a stoma is easy on the intestines and helps in the healing process. It is usually removed after three to six months.

come back to life

The day after the operation, those affected usually start with physiotherapy and exercise. The first meal after the operation usually takes place in the hospital. If chemotherapy or other follow-up treatment is necessary and an artificial bowel outlet has been placed, the patients still have to deal with their disease for some time. That can be very stressful. The psycho-oncologist Carsten Witte knows this from his experience as head of the psychosocial consultation at the Center for Radiation Therapy in Freiburg: “Intestinal cancer patients are usually very grateful for the relief provided by the stoma, but they also often suffer particularly from spending several months with this bag, which having to live depends on the artificial anus.” But: Those affected can do a lot, even alongside treatment, to recover faster, experience fewer side effects and maintain a better quality of life during their illness.

These are the tips from Carsten Witte:

• Don’t be afraid to ask any questions you have to the treating doctors while you’re still in the hospital.
• Take a digital assistant to guide you through the difficult time and give you orientation and support. Your digital companion in the form of an app should be medically validated and help you with nutrition tips, physical and mental exercises and important information about your treatment. An example of this is Mika, a free app for all cancers.
• Join a support group. One example is the Deutsche ILCO eV, a nationwide association that passes on its diverse experiences of living with a stoma or colorectal cancer to those affected and their relatives. To be found online at www.ilco.de.