How does colon-recto cancer even start:

Most colorectal cancers start as a growth on the inner lining of the colon or rectum. These growths are called polyps.

Some types of polyps can change into cancer over time (usually many years), but not all polyps become cancer. The chance of a polyp turning into cancer depends on the type of polyp it is. There are different types of polyps.

• Adenomatous polyps (adenomas): These polyps sometimes change into cancer. Because of this, adenomas are called a pre-cancerous condition. The 3 types of adenomas are tubular, villous, and tubulovillous.
• Hyperplastic polyps and inflammatory polyps: These polyps are more common, but in general they are not pre-cancerous. Some people with large (more than 1cm) hyperplastic polyps might need colorectal cancer screening with colonoscopy more often.
• Sessile serrated polyps (SSP) and traditional serrated adenomas (TSA): These polyps are often treated like adenomas because they have a higher risk of colorectal cancer.

Other factors that can make a polyp more likely to contain cancer or increase someone’s risk of developing colorectal cancer include:

• If a polyp larger than 1 cm is found
• If more than 3 polyps are found
• If dysplasia is seen in the polyp after it’s removed. Dysplasia is another pre-cancerous condition. It means there’s an area in a polyp or in the lining of the colon or rectum where the cells look abnormal, but they haven’t become cancer.

The body is made up of trillions of living cells. Normal body cells grow, divide into new cells, and die in an orderly way. During the early years of a person’s life, while they are still growing, their normal cells divide faster. Once the person becomes an adult, most cells divide only to replace worn-out or dying cells or to repair injuries.

Cancer begins when cells in a part of the body start to grow out of control. There are many kinds of cancer, but they all start because of out-of-control growth of abnormal cells.

Cancer cell growth is different from normal cell growth. Instead of dying, cancer cells continue to grow and form new, abnormal cells. In most cases the cancer cells form a tumor. Cancer cells can also invade (grow into) other tissues, something that normal cells cannot do. Growing out of control and invading other tissues are what makes a cell a cancer cell.

Cells become cancer cells because of damage to DNA. DNA is in every cell and directs all its actions. In a normal cell, when DNA is damaged the cell either repairs the damage or the cell dies. In cancer cells, the damaged DNA is not repaired, but the cell doesn’t die like it should. Instead, this cell goes on making new cells that the body does not need. These new cells will all have the same damaged DNA as the first abnormal cell does.

People can inherit damaged DNA, but most often the DNA damage is caused by mistakes that happen while the normal cell is reproducing or by something in our environment. Sometimes the cause of the DNA damage is something obvious, like cigarette smoking. But often no clear cause is found.

Cancer cells often travel to other parts of the body, where they begin to grow and form new tumors that replace normal tissue. This process is called metastasis. It happens when the cancer cells get into the bloodstream or lymph vessels of our body.

No matter where a cancer may spread, it is always named for the place where it started. For example, breast cancer that has spread to the liver is still called breast cancer, not liver cancer

Different types of cancer can behave very differently. For example, lung cancer and breast cancer are very different diseases. They grow at different rates and respond to different treatments. This is why people with cancer need treatment that is aimed at their particular kind of cancer.

Not all tumors are cancerous. Tumors that aren’t cancer are called benign. Benign tumors can cause problems – they can grow very large and press on healthy organs and tissues. But they cannot grow into (invade) other tissues. Because they can’t invade, they also can’t spread to other parts of the body (metastasize). These tumors are rarely life threatening.

Their are risk factors in getting colon cancer as well as other cancer and noncancerous diseases BUT remember their are modifiable risk factors leading to disease which are factors we can’t control being 4 areas 1.)Race 2.)Age 3.) Sex 4.) Heredity in the family (particularly nuclear and grandparents meaning higher risk than a first cousin or second cousin and down the family tree).

Risk Factors to colon cancer can be:

Most colorectal cancers occur in people without a family history of colorectal cancer. Still, as many as 1 in 5 people who develop colorectal cancer have other family members who have been affected by this disease.  People with a history of colorectal cancer in one or more first-degree relatives (parents, siblings, or children) are at increased risk. The risk is about doubled in those with only one affected first-degree relative=Nuclear Family. It is even higher if that relative was diagnosed with cancer when they were younger than 45, or if more than one first-degree relative is affected.

The reasons for the increased risk are not clear in all cases. Cancers can “run in the family” because of inherited genes, shared environmental factors, or some combination of these.

Having family members who have had adenomatous polyps is also linked to a higher risk of colon cancer. (Adenomatous polyps are the kind of polyps that can become cancerous.)

1-Inherited syndromes

About 5% to 10% of people who develop colorectal cancer have inherited gene defects (mutations) that can cause family cancer syndromes and lead to them getting the disease. These syndromes often lead to cancer that occurs at a younger age than is usual.

The most common inherited syndromes linked with colorectal cancers are familial adenomatous polyposis (FAP) and hereditary non-polyposis colorectal cancer (HNPCC), but other rarer syndromes can also increase colorectal cancer risk.

Familial adenomatous polyposis (FAP): FAP is caused by changes (mutations) in the APC gene that a person inherits from his or her parents. About 1% of all colorectal cancers are due to FAP.

The most common type of FAP causes people to develop hundreds or thousands of polyps in their colon and rectum, usually in their teens or early adulthood.

Hereditary non-polyposis colon cancer (HNPCC): HNPCC, also known as Lynch syndrome, accounts for about 2% to 4% of all colorectal cancers.

The cancers in this syndrome also develop when people are relatively young, although not as young as in FAP. People with HNPCC may also have polyps, but they only have a few, not hundreds as in FAP. The lifetime risk of colorectal cancer in people with this condition may be as high as 80%.

Turcot syndrome: This is a rare inherited condition in which people are at increased risk of adenomatous polyps and colorectal cancer, as well as brain tumors. There are actually 2 types of Turcot syndrome:

• One can be caused by gene changes similar to those seen in FAP, in which cases the brain tumors are medulloblastomas.
• The other can also be caused by gene changes similar to those seen in HNPCC, in which cases the brain tumors are glioblastomas.
• MUTYH-associated polyposis:Racial and ethnic background  1. Jews of Eastern European descent (Ashkenazi Jews) have one of the highest colorectal cancer risks of any ethnic group in the world. Several gene mutations leading to an increased risk of colorectal cancer have been found in this group. People with type 2 (usually non-insulin dependent) diabetes have an increased risk of developing colorectal cancer. Both type 2 diabetes and colorectal cancer share some of the same risk factors (such as excess weight). But even after taking these factors into account, people with type 2 diabetes still have an increased risk. They also tend to have a less favorable prognosis (outlook) after diagnosis.  

2-Night shift workers are prone to cancers (colon/rectal and breast cancer).

3-Previous treatment for certain cancers –

Several studies have suggested that men who had radiation therapy to treat prostate cancer might have a higher risk of rectal cancer because the rectum receives some radiation during treatment. Men should consider the many possible side effects of prostate cancer treatment when making treatment decisions. Some doctors recommend that the risk of rectal cancer should be considered as one of those possible side effects but the patient is always responsible in doing research on their own before making the final decisions of treatment.  They choose the treatment they feel is the best choice; not the doctor.

• Some studies have found that men who survive testicular cancer seem to have a higher rate of colorectal cancer and some other cancers. This might be because of the treatments they have received.

4-Factors less clear but can effect risk for colon cancer:

        1-Type 2 diabetes

       2-Racial Group African Americans have the highest colorectal cancer incidence and mortality rates of all       racial groups in the United States. The reasons for this are not yet understood.

        3-Peutz-Jeghers syndrome: People with this rare inherited condition tend to have freckles around the mout (and sometimes on the hands and feet) and a special type of polyp in their digestive tracts (called hamartoma). They are at greatly increased risk for colorectal cancer, as well as several other cancers, which usually appear at a younger than normal age. This syndrome is caused by mutations in the gene STK1.  People with this syndrome develop colon polyps which will become cancerous if the colon is not removed.

Patients undergo lifelong surveillance of organs to monitor for cancer and prevent secondary problems from the polyps.

REVISED 3/05/2023

“A risk factor is anything that raises your chance of getting a disease such as cancer. Different cancers have different risk factors. Some risk factors, like smoking, can be changed. Others, like a person’s age or family history, can’t be changed.

But having a risk factor, or even many, does not mean that you will get the disease. And some people who get the disease may not have any known risk factors.

Researchers have found several risk factors that might increase a person’s chance of developing colorectal polyps or colorectal cancer.”

American Cancer Society (https://www.cancer.org/cancer/colon-rectal-cancer/causes-risks-prevention/risk-factors.html)

The colon is part of the body’s digestive system. The digestive system removes and processes nutrients (vitamins, minerals, carbohydrates, fats, proteins, and water) from foods and helps pass waste material out of the body. The digestive system is made up of the esophagus, stomach, and the small and large intestines. The colon (large bowel) is the first part of the large intestine and is about 5 feet long. Together, the rectum and anal canal make up the last part of the large intestine and are about 6-8 inches long. The anal canal ends at the anus (the opening of the large intestine to the outside of the body).

Colorectal cancer starts in the colon or the rectum. These cancers can also be called colon cancer or rectal cancer, depending on where they start. Colon cancer and rectal cancer are often grouped together because they have many features in common.  So this is why pt’s are diagnosed at times colorectal cancer by some M.D.’s.

Key Points

“Regular screening, beginning at age 45, is the key to preventing colorectal cancer (cancer of the colon or rectum). If you’re 45 to 75 years old, get screened for colorectal cancer regularly. If you’re younger than 45 and think you may be at high risk of getting colorectal cancer, or if you’re older than 75, talk to your doctor about screening.

Colorectal polyps and colorectal cancer don’t always cause symptoms, especially at first. That is why getting screened regularly for colorectal cancer is so important.”

Centers for Disease Control and Prevention-CDC (https://www.cdc.gov/cancer/dcpc/resources/features/colorectalawareness/index.htm)

“The large intestine is the last part of the gastrointestinal (GI) tract, the long, tube-like pathway that food travels through your digestive system. The large intestine is about six feet long — much shorter than the small intestine, which is 22 feet. It’s called the large intestine because it’s wider — about three inches, while the small intestine is only one inch in diameter. It follows from the small intestine and ends at the anal canal, where food waste leaves your body. The large intestine, also called the large bowel, is where food waste is formed into poop, stored, and finally excreted. It includes the colon, rectum and anus. Sometimes “colon” is also used to describe the entire large intestine.”

Cleveland Clinic (https://my.clevelandclinic.org/health/body/22134-colon-large-intestine)

the colon to rectum

The GI tract starts at the mouth, to the esophagus, to the stomach, to the small intestines, than to the large intestines, than the rectum to the anus where we remove stool from the GI tract.

Know the cecum is a pouch-like passage that connects the colon to the ileum (the last part of the small intestine). If cancer develops in the cecum, it is treated like colon cancer.

The entire colon is about 5 feet (150 cm) long, and is divided into five major segments. The rectum is the last anatomic segment before the anus, the last part of the GI tract is where the bowel movement comes out.

The ascending and descending colon are supported by peritoneal folds called mesentery.

The proximal colon is the ascending colon and the transverse colon together. The distal colon is the descending colon and the sigmoid colon together.

The right colon consists of the cecum, ascending colon, hepatic flexure and the right half of the transverse colon. The left colon consists of the left half of the transverse colon, splenic flexure, descending colon, and sigmoid.

The intestine is part of the digestive system.  It is made up of the small intestine and the large intestine. The colon and rectum are parts of the large intestine. The colon is a U-shaped tube made of muscle, found below the stomach. The rectum is a shorter tube connected to the colon. Together, the colon and rectum are about 2 metres (6.5 feet) long. They are surrounded by other organs including the spleen, liver, pancreas, bladder and reproductive organs.

The large intestine is made up of the cecum, colon, rectum and anus. The colon and rectum are held in the abdomen by folds of tissue called mesenteries.

The rectum is the lower part of the large intestine that connects to the sigmoid colon. It is about 15 cm (6 in) long. It receives waste from the colon and stores it until it passes out of the body through the anus.

The anus is the opening at the lower end of the rectum through which stool is passed from the body.

The key functions of the colon include the following:

• Water and nutrient absorption
• Vitamin absorption
• Feces compaction
• Potassium and chloride secretion
• Moving waste material toward the rectum

Mechanism

Motility

The intestinal wall is made up of multiple layers. The 4 layers of the large intestine from the lumen outward are the mucosa, submucosa, muscular layer, and serosa. The muscular layer is made up of 2 layers of smooth muscle, the inner, circular layer, and the outer, longitudinal layer. These layers contribute to the motility of the large intestine. There are 2 types of motility present in the colon, haustral contraction and mass movement. Haustra are saccules in the colon that give it its segmented appearance. Haustral contraction is activated by the presence of chyme and serves to move food slowly to the next haustra, along with mixing the chyme to help with water absorption. Mass movements are stronger and serve to move the chyme to the rectum quickly.

Absorption of Water and Electrolytes

Absorption of water occurs by osmosis. Water diffuses in response to an osmotic gradient established by the absorption of electrolytes. Sodium is actively absorbed in the colon by sodium channels. Potassium is either absorbed or secreted depending on the concentration in the lumen. The electrochemical gradient created by the active absorption of sodium allows for this. Chloride ions are exchanged for bicarbonate ions across an electrochemical gradient.

Production/Absorption of Vitamins

The colon also plays a role in providing required vitamins through an environment that is conducive for bacterial cultivation. The colon houses trillions of bacteria that protect our gut and produce vitamins. The bacteria in the colon produce substantial amounts of vitamins by fermentation. Vitamin K and B vitamins, including biotin, are produced by the colonic bacteria. These vitamins are then absorbed into the blood. When dietary intake of these vitamins is low in an individual, the colon plays a significant role in minimizing vitamin disparity.

Now that we have reviewed the colon and rectum anatomy and physiology we will tomorrow start on colon cancer awareness for March.

Know cancer in the anal canal or anus is treated differently from colorectal cancer.

“There are an estimated 1.7 to 3.8 million traumatic brain injuries each year in the United States, according to the CDC, of which 10 percent arise due to sports and recreational activities.  Sustaining an injury while playing sports can range from a mild physical trauma such as a scalp contusion or laceration to severe a traumatic brain injury (TBI) with concurrent bleeding in the brain or coma. It is important to recognize when a head trauma is severe or has resulted in a TBI because it is crucial to seek immediate medical attention.  A traumatic brain injury (TBI) is defined as a form of acquired brain injury from a blow or jolt to the head or a penetrating head injury that disrupts the normal function of the brain. A TBI can result when the head suddenly and violently hits an object, or when an object pierces the skull and enters brain tissue.”

American Association of Neurologiva Surgeons (https://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Sports-related-Head-Injury)

“Anger can be a common emotion among people experiencing major depression. You may feel angry at the world, angry about events from your past, or even angry at yourself. This anger can be intense and difficult to control, to the point that it worsens your depression and affects your personal and professional relationships”.

Very Well Mind (https://www.verywellmind.com/connection-between-depression-and-anger)

“3 principles in keeping love alive 1. Participate in the act of love · 2. Maintain your individuality and appreciate your partner’s individuality · 3. Ignore your critical inner voice.”.

PsychAlive (https://www.psychalive.org/3-principles-keep-love-alive/)

The concept of being alone isn’t linked to the feeling of loneliness. In fact, you can make living without love beneficial and positive for you by reading through this article. Soon, you’ll not only be satisfied, but also ecstatic about the way you are and the way your life. One of the major keys in making this happen is endurance and discipline in allowing yourself to get active and not isolate yourself; for if you do and for awhile it’s hard to get out of it. Here are some steps in helping you reach the goal of not feeling alone:

• Build other relationships. Having a partner shouldn’t be on the relationship pedestal. Without a significant other to get in the way, you now can put in the time and effort to value and develop the numerous other relationships in your life. Include your family and friends nearby, but also those far away. Send cards and write emails to keep in touch with all of your contacts. Don’t forget to include your community. Greet your neighbors and other familiar strangers on the street. As your network grows, you’ll find that what’s most important is the boundless love that you possess and can share with those around you.
• Keep busy. Getting involved in various activities is a threefold benefit to your life. You’ll be able to fill your schedule, build self-confidence and make tons of new friends. There are countless avenues you can explore from sports to volunteering to religion. Think of the activities you used to be involved in and would like to start up again, but also push yourself to try something new.
• Be optimistic. Focus on all that you do have instead of concentrating on what you don’t have. If you’re still in the dating game, think positive that the person you’ll deeply connect with is just around the corner. If you want to learn to be happy being alone, act the part and the feelings will come afterwards. Life is all about attitude, so turn the feeling of absence into one of thankfulness. There is already so much to be thankful for.
• Love yourself. This point is the most important of them all. You may be lacking love from another person, but you definitely should not be lacking love for yourself. You’re the one person that completely and truly understands your needs, so fulfill your own expectations and show appreciation for yourself. Indulge in what makes you insanely happy and joyful. Put yourself in a good mood by treating yourself to your favorite delights. Don’t forget to take care of yourself.

We talk a lot about singles, but we don’t talk about this: what it’s like to live without a partner while longing for one, over years, then decades.

Just 51 percent of the adult population is married, down from 72 percent in 1960. So we talk about swinging, “Sex and the City” singles and extended adolescences. We talk about the delay of marriage or the rise of cohabitation and single motherhood. Depending on our perspective, we cheer the broadening definitions of family or bemoan the breakdown of the nuclear unit.

But the cousin or neighbor or co-worker who always seems to be on his or her own? We don’t give them much thought.

It’s easier not to. Perhaps as much as religion, our society hinges on belief in romantic love. How many songs and novels revolve around the long search and eventual discovery of a beloved? The phrase “happily ever after” implies a singular outcome: two lives made ever better by virtue of their union.

Never mind that close to half of marriages end in divorce that many of those who stay married do so unhappily, and that, rationally, we all know life can be a struggle regardless of relationship status. Ninety percent of us will marry — often repeatedly — on the belief that marriage can add something fundamentally good to our lives.

Certainly, there’s a huge biological imperative to pair up — procreation and protection of the young used to demand it. But reproductive technologies have expanded our baby-making options, and security systems do a good job of deflecting predators. And we still want the ineffable. We want love.

Love is true, but yet, it is fickle. Long lasting love has to evolve and grow over the years, and at times it takes a few unique measures too. Find out how to keep love alivetake in a relationship.

Knowing how to keep love alive in a relationship can seem easy, but it’s actually more difficult that most lovers imagine.

You have to remember you’re not always going to be the same teenager who fell in love with your teenage lover. You will evolve and so will your partner.

Most couples assume they don’t need to have intimate conversations or exchange thoughts about each other’s views on life because they already know everything about their partner.

But what many don’t understand is that we grow and evolve as individuals constantly, and our likes, dislikes and opinions too change all the time.

In the introduction on how to keep love alive, we’ve seen that there are just two basic requirements for a relationship to be successful.

Affection and sexual desire.

As long as we can keep these two emotions on a high, love too can be kept alive and exciting.

Find out how to keep love alive and make the relationship more exciting and fun, even as the years roll by with these simple and at times, unconventional tips.

How to keep love alive

Most lovers start taking their partner for granted over the years, and this eventually leads to boredom in a relationship. Curiosity in a relationship is the driving force in keeping love alive in a long term relationship.

When you assume you know everything about a partner, love starts to stagnate and differences start to crop up, even if the words aren’t voiced out. After all, both of you grow as individuals with each passing day. [Read: How to know if you are in love]

Here are a few tips on how to keep love alive in a relationship and how to bring the excitement back again, especially when it comes to affection and sexual attraction.

Avoid taking each other for granted

One of the disadvantages of long term relationships is the fact that lovers start to take each other for granted. They assume they know their partner’s likes and dislikes and end up making a lot of assumptions, which can be critically wrong at times.

On the other hand, even favors and special gestures are taken for granted as the years go by. If a husband prepares a breakfast-in-bed for his wife every Sunday morning for a few months, it’s a special gesture at the beginning. But as the months go by and the husband decides to sleep in one Sunday morning, the wife ends up getting upset that she wasn’t served her breakfast. Likewise, there may be several other kinds of special gestures that lovers share with each other which can eventually be taken for granted.

By taking these gestures for granted, nothing really becomes a special gesture anymore. Instead it becomes an obligation. Always remember to acknowledge a gesture, however small it may be if you want to understand the secret behind knowing how to keep love alive in a relationship.

By taking each other for granted, be it an evening foot rub or a big birthday bash, you’re taking away the affection behind a gesture, and turning it into an obligation. If you want to keep the love alive in your relationship, acknowledge the gestures and never ever take your partner for granted.

Surprise each other

Remember the first year of your relationship? Both of you went out of your way to buy each other birthday gifts, and every now and then you popped in a surprise just to see your lover smile in surprise. Do you still do that?

In almost all cases, couples stop paying attention to happy surprises after a few years. We want to keep the love alive in a relationship, but almost all of us stop doing anything to keep the relationship exciting and unique. It doesn’t matter if it is concert tickets, a surprise vacation or even a posse of flowers. Go out of your way to make your partner feel special like you used to, and you’ll see that the relationship will only get more exciting and affectionate in no time. [Read: Dating facts]

Celebrate special occasions

Pay attention to relationship landmarks and special occasions in the relationship. Many Valentine’s Days, anniversaries and birthdays may come and go, but that doesn’t mean you should ignore them because you have so many special moments all year round.

Try to make every year exciting and special in its own way. And wherever possible, try to go out of your way to make your partner feel special. You may lose a few hours or a couple of days planning something special, but the fact that you still try to please your partner and make them feel special is a sure sign that you’re taking an initiative to keep the love alive in the relationship.

As long as you give enough importance to affection and sexual desire in a relationship, it’s a great assurance that the flame of love will burn bright in your relationship for years to come.

Sexual desire is by far, one of the most important requirements of a happy romantic relationship. If you want to know how to keep love alive, then your best bet is to focus on a more than satisfying sex life. Can you remember the first time you got intimate with your partner? It may be a while ago, but you can’t really forget the racing heartbeats, the passionate cold sweat and the weak knees, can you?

Now just because it’s been a few years since you’ve been together, there’s really no reason why sex can’t remain exciting and heart pounding. Most people want to know how to keep love alive, but yet they don’t really pay attention to sexual attraction between the partners. Humans are built for procreation, we’re one of the few species on earth that indulge in sex for pleasure. All of us want and need sex, irrespective of whether we get to have it with a partner or someone else. So if you really want to keep your love life on a high, you really have to understand the importance of sex in a relationship, and how vital a role it plays in holding two individuals together in a romantic relationship.

You may have been satisfied doing the missionary position or making love in a quiet bedroom for years until both of you start to get bored with each other bodies. But you can change all that in a few weeks. Start doing something new and exciting, be it indulging in a few fantasies or trying new things in bed or finding new places to make love with each other. It may feel awkward at first, but you’ll be able to have a more satisfying and fulfilling romantic life if you can satisfy your inbuilt sexual urges.

Figuring out how to fix a relationship, if that is the reason for lack of love with romance like when you first fell in love is a lot like stacking a deck of cards. There are so many different cards involved and it’s really difficult to know where exactly the balance went awry.

Just like a stack of cards, in almost all cases, it’s never a single reason that leads to a failure in love.

It’s a series of disappointments and resentments that lead to an unhappy relationship and eventually on both sides doing it.  So it takes 2 to hurt each other and 2 to work things out but let the disappointments and resentments go on and it could get to a point of no turning back.

But nevertheless, it really the relationship doesn’t have to end this way.  Remember most vows include at the alter the day of marriage you will be there in good times and bad.   Even the unhappiest of relationships can be fixed with a bit of understanding and love.  Do you 2 have that in you or was it never there day one or are you two individual strong people who really love each other that are just human making mistakes at times.  Including that you 2 strong people allow your love to overrule the mistake the other one makes with not holding it over the person later in life with the one who made the mistake resolve the problem with never letting it happen again.  Love can be a strong bond or a weak one.