Things to remember in life:

• “Wearing clothes that are too tight can lead to several health issues, including digestive problems, yeast infections, and nerve compression.
• Repeatedly wearing overly tight clothing can restrict blood flow and compress nerves, potentially leading to lasting health effects.
• While occasionally wearing tight-fitting clothes is unlikely to cause significant harm, it’s important to pay attention to your body and avoid clothing that causes discomfort, pain, or restricted breathing.”

Healthline

The answer is yes.

If you have a body you’re proud of, thanks to hours of lifting weights and watching your diet, you may on occasion show it off by wearing something form fitting, but make sure it’s not TOO constrictive. As a recent news story showed, wearing tight clothing, in this case, “skinny jeans” could land you in the hospital.

Are Your Skinny Jeans TOO Tight?

Recently, a woman donned a pair of skinny jeans to help her friend move to a new apartment. While milling around her friend’s old apartment, she squatted down time after time to pick items up with the skinny jeans hugging her legs. By the end of the day, she could no longer feel her legs because of leg swelling and nerve compression, and fell while walking through a park. When she couldn’t get up, she had to crawl to the side of the road and hail a passing taxi to transport her to the hospital.

Sadly, she went on to spend four days in the hospital getting treatment to repair the damage the form-fitting jeans did to her muscles, nerves, and blood vessels. The swelling in her legs was so pronounced that medical personnel had to cut her skinny jeans off. Lab studies showed she had abnormally high levels of creatine kinase, an enzyme that rises when muscles are damaged.

The diagnosis was rhabdomyolysis and compartment syndrome – a condition marked by the build-up of pressure within a muscle.  When muscles swell inside a space that’s too tight, it can quickly damage tissues by blocking the blood supply they need for survival. Muscles are surrounded by fascia, connective tissue that doesn’t stretch or expand easily. So when pressure builds up, it can’t be easily released. People sometimes develop compartment syndrome when they have an arm or leg in a tight cast and less commonly from wearing clothing that’s too tight. Some people are more prone to developing compartment syndrome because their fascia is overly rigid.

Can Wearing Tight Clothing Cause Nerve Damage?

Compartment syndrome from wearing tight clothing is rare, but what isn’t so rare is a condition called meralgia paresthetica, another health problem caused by, among other things, wearing tight pants. With meralgia paresthetica, the lateral femoral cutaneous nerve that supplies sensation to the outer aspect of the thigh is compressed by constrictive clothing, usually a pair of tight pants. Pregnancy, having diabetes, and being overweight are also risk factors for this condition. Fortunately, damage to the nerve usually isn’t permanent, although surgery may occasionally be needed.

If you wear a compression garment or shape wear that makes your tummy and hips look slimmer for a night out on the town, you’re at higher risk for meralgia paresthetica. Better to tone up those areas through exercise than wear something overly constrictive to push in your hips or tummy.

 Can Tight Clothing Cause Spinal Problems?

Ask a chiropractor and they’ll tell you not to wear clothing that limits movement of your hips and core. Why? Doing so tightens the muscles that support your spine and throws off your postural alignment. A study published in Applied Ergonomics showed wearing tight pants restricts movement of the lower hips and trunk. As a result, the lumbar spine has to work harder to compensate. It’s always risky to limit movement of one part of the kinetic chain since another part has to take up the slack.

It’s not just tight pants that are a problem but tube and pencil skirts that force you to take short steps and place greater stress on your joints. Combine a tube skirt with high heels and you make the problem even worse by throwing off your center of gravity. Your risk of injury is higher too when you slip into a tight tube or pencil skirt. Ever tried to squat down or bend over to pick something up in a narrow skirt? It’s not easy – or safe.

Don’t forget – you may not feel the impact wearing tight clothing has on you right away, unless you develop an acute injury. Think of the risk as being cumulative over time. Keep in mind that anything that alters your natural gait and stride can create back and spine problems over time.

 Digestive Issues and Yeast Infections

Wearing tight clothing around your waist or abdomen increases the pressure inside your abdomen cavity. This pressure pushes up on your diaphragm and can trigger or worsen acid reflux symptoms. So, if you have heartburn, indigestion or bloating after a meal, check to see if your pants are too tight, and if you have on tight clothing, watch how much you eat! Clothing with tight waistbands and belts that constrict your waist or tummy are common culprits as are compression garments like Spanx.

Finally, tight clothing that reduces air flow to your “private parts” place you at greater risk for vaginal yeast infections. When you walk around in tight pants, moisture builds up in your crotch area and serves as a breeding ground for Candida, the fungi that cause yeast infections.

The Bottom Line

Not only is constrictive clothing uncomfortable, it may be hazardous to your health. If you wear something tight, keep it on for the least amount of time possible. Just as you save your stilettos for a special occasion, treat tight clothing the same way. It’s not comfy nor is it healthy. Wearing pants that are tight around the calves is especially risky when it’s warm outside and you’re standing or sitting a lot. The warm weather and standing can cause leg swelling and with tight pants on, your calves can only expand so much, leading to a build-up of pressure.

The take-home message? Be fashionable but sensible about what you put on.

Some clothing-related maladies go by mundane-sounding names that hardly hint at their potential to sicken. For example, a middle-aged or older man whose belly hangs below the waist of his pants may suffer from “tight pants syndrome,” a term coined in a 1993 article by Dr. Octavio Bessa, an internist in Stamford, Conn.

Bessa described a collection of gastrointestinal symptoms including abdominal pain, heartburn and reflux a few hours after meals that he would see in 20 to 25 men every year. The common thread: All wore ill-fitting pants with waistbands several inches smaller than their bellies, Bessa reported in the Archives of Internal Medicine.

Three years later, two diagnostic imaging specialists from Wales described a “sporting variant” of tight-pants syndrome that they linked to tight Neoprene bike shorts worn to prevent muscular injury. Drs. Charles G.F. Robinson and Nigel Jowett recounted how the shorts blocked venous blood flow in the legs of a 25-year-old man after his workout on a stationary bike. The doctors determined he’d suffered deep venous thrombosis (DVT), clotting probably exacerbated by a hip fracture four years earlier.

Despite treatment with blood thinners, the patient later developed a dangerous pulmonary embolism, indicating a clot had traveled to his lungs.

Pants that are too snug can lead to certain health issues, research suggests. Meaning you can be fit not just overweight.

Women suffer their own tight-pants agonies, too. A gynecological variation can foster yeast infections, pelvic pain, itching and irritations easily mistaken for a sexually transmitted disease. The solution? Looser, cotton clothing.

The way a woman wears her slacks might leave her prone to the breakdown of fatty tissue at the outside of the thighs, called lipoatrophia semicircularis, dermatologists say. “Persistent mechanical pressure” exerted by “strangling folds” of too-tight trousers can impair circulation and set the stage for this condition, especially in women who sit for long periods, according to a study from Chile’s Universidad Andres Bello in the June 2007 Journal of Dermatology.

Wearing tight neckties and shirts with constricting collars can impede blood flow through neck veins and arteries and may affect vision. In a 2003 study of 40 men, half with glaucoma, three minutes with a tightened tie raised eye pressure among the majority of those with and without the disease. Elevated eye pressure is a key element of diagnosing and monitoring glaucoma, a leading cause of blindness.

The lead researcher, Dr. Robert Ritch, a glaucoma specialist at New York Eye and Ear Infirmary, maintained in the study in the British Journal of Ophthalmology that the transient rise in pressure readings “could affect the diagnosis and management of glaucoma.” But several prominent glaucoma specialists said the study failed to establish that transient high pressure from the tightened ties could cause glaucoma.

Believe it or not but too-tight neckties might impede proper circulation in severe cases, research suggests.

Tight neckties also can limit neck movement and raise muscle tension in the upper back and neck, researchers at Korea’s Yonsei University reported last year in “Work: A Journal of Prevention, Assessment and Rehabilitation.” They tested 30 computer workers when wearing and not wearing tight neckties and concluded that “it is especially important for male workers to select and tie neckties appropriately” to prevent musculoskeletal injuries.

Although clothing-related pain and dysfunction can affect almost everyone, Avitzur said women have a tendency to overlook discomfort, for the sake of appearance. An admitted fashion health victim, Avitzur said she had worn ill-fitting boots and “too-heavy earrings that tore through one of my lobes.”

She got the idea for a blog about skinny jeans while at the office of the plastic surgeon who repaired the damage from her poor earring choice.

References:

Applied Ergonomics xxx (2013) 1e9. “Effects of restrictive clothing on lumbar range of motion and trunk muscle activity in young adult worker manual material handling”

Medical Daily. “Fashion Victim In Tight Pants Experiences Nerve And Muscle Damage: Medical Conditions Caused By Skinny Jeans” June 22, 2015.

ABC News.go.com

“Cardiovascular disease can be deadly for anyone. But females face unique risks, largely due to differences in anatomy and hormones. They’re more likely to have other heart attack symptoms along with chest pain, and they have a higher chance of developing symptoms from heart failure. Heart-healthy lifestyle changes can help.

Cardiovascular disease (CVD) affects women in unique ways. Sex-specific differences like anatomy, red blood cell count and hormones seem to impact a person’s risk factors, symptoms and other aspects of their cardiovascular health.

Researchers have found many sex-specific differences in the cardiovascular system. These complex differences, often at a microscopic level, can affect how females experience heart disease compared to males. A few examples include:

• Anatomy. Females have smaller blood vessels and heart chambers. The walls of their ventricles (pumping chambers) are also thinner.
• Blood count. Females have fewer red blood cells. As a result, they can’t take in or carry as much oxygen at any given time.
• Cardiovascular adaptations. Changes in altitude or body position (like quickly standing up after lying down) are more likely to affect females. These changes can lead to sudden drops in blood pressure.
• Hormones. Estrogen and progesterone levels are typically higher in females, while testosterone is higher in males. These hormones can impact many aspects of your heart health and overall health.”

Cleveland Clinic (Heart Disease in Women: Risk Factors, Symptoms & Prevention)

Many many women and their doctors don’t know that heart disease is the number one killer of women. Furthermore, the heart disease that is seen in women is often not quite the same as heart disease in men.

Let’s remember that Heart disease is an umbrella term that includes heart failure, coronary artery disease (CAD), arrhythmias, angina, and other heart-related infections, irregularities, and birth defects.

These facts lead to two common (and sometimes tragic) misapprehensions held by many women and their doctors: That women don’t really get much heart disease, and when they do, it behaves pretty much like the heart disease that men get.

The truth is that not only is heart disease very common in women, but also, when women get heart disease it often acts quite differently than it does in men. Failing to understand these two fundamental truths leads to a lot of preventable deaths and disability in women with heart disease.

If you are a woman, you need to know the basics about heart disease – especially heart disease as it behaves in women.

When women have angina, they are more likely than men to experience “atypical” symptoms. Instead of chest pain, they are more likely to experience a hot or burning sensation, or even tenderness to touch, which may be located in the back, shoulders, arms or jaw – and often women have no chest discomfort at all. An alert doctor will think of angina whenever a patient describes any sort of fleeting, exertion-related discomfort located anywhere above the waist, and they really shouldn’t be thrown off by such “atypical” descriptions of symptoms. However, unless doctors are thinking specifically of the possibility of CAD, they are all too likely to write such symptoms off to mere musculoskeletal pain or gastrointestinal disturbances.

Women are more likely than men to have heart attack symptoms unrelated to chest pain, such as:

• • • Neck, jaw, shoulder, upper back or abdominal discomfort.
    • Shortness of breath.
    • Right arm pain.
    • Nausea or vomiting.
    • Sweating.
    • Lightheadedness or dizziness.
    • Unusual fatigue.

Heart attacks (or myocardial infarctions)  also tend to behave differently in women.

Frequently, instead of the crushing chest pain that is considered typical for a heart attack, women may experience nausea, vomiting, indigestion, shortness of breath or extreme fatigue – but no chest pain. Unfortunately, these symptoms are also easy to attribute to something other than the heart. Furthermore, women (especially women with diabetes) are more likely than men to have “silent” heart attacks – that is, heart attacks without any acute symptoms at all, and which are diagnosed only at a later time, when subsequent cardiac symptoms occur.

The Diagnosis of CAD in Women Can Be More Difficult.

Diagnostic tests that work quite well in men can be misleading in women. The most common problem is seen with stress testing – in women, the electrocardiogram (ECG) during exercise can often show changes suggesting CAD, whether CAD is present or not, making the study difficult to interpret. Many cardiologists routinely add an echocardiogram or a thallium study when doing a stress test in a woman, which greatly improves diagnostic accuracy.

In women with typical CAD, coronary angiography is every bit as useful as in men; it identifies the exact location of any plaques (i.e., blockages) within the coronary arteries, and guides therapeutic decisions. However, in women with atypical coronary artery disorders (to be discussed in the next section), coronary angiograms often appear misleadingly normal. Thus, in women angiography is often not the gold standard for diagnosis, as it is for most men.

CAD In Women Can Take Atypical Forms.

At least four atypical coronary artery disorders can occur in women, usually in younger (i.e., pre-menopausal) women. Each of these conditions can produce symptoms of angina with apparently “normal” coronary arteries (that is, coronary arteries that often appear normal on angiogram). The problem, obviously, is that if the physician trusts the results of the angiogram, he/she is likely to miss the real diagnosis.

DALLAS, February 19, 2013 — A new study show women’s heart disease awareness is increasing.  A study with the number of women aware that heart disease is the leading cause of death nearly is doubling in the last 15 years, but that this knowledge still lags in minorities and younger women, according to the American Heart Association (AHA).

Among the study’s major findings, researchers comparing women’s views about heart disease in 1997 and today found:

• In 2012, 56 percent of women identified heart disease as the leading cause of death compared with 30 percent in 1997.
• In 1997, women were more likely to cite cancer than heart disease as the leading killer (35 percent versus 30 percent); but in 2012, only 24 percent cited cancer.
• In 2012, 36 percent of black women and 34 percent of Hispanic women identified heart disease as the　top killer — awareness levels that white women had in 1997 (33 percent).
• Women 25-34 years old had the lowest awareness rate of any age group at 44 percent.

Among the women surveyed in 2012, researchers found:

• Racial and ethnic minorities reported higher levels of trust in their healthcare providers compared with whites, and were also more likely to act on the information provided—dispelling the myth that mistrust of providers contributes to disparities.
• Compared with older women, younger women were more likely to report not discussing heart disease risk with their doctors (6 percent among those 25-34 versus 33 percent for those 65 and older).

Risk Factors for Heart Disease in Women – Those we can’t change = Nonmodifiable Factors:

Age and Family History, Gender, Ethnicity.

The risk of having heart disease increases with age and this is due to stiffening of heart muscles which makes the heart less efficient in pumping blood around the body. You can determine your heart age by using this tool, developed by the British Heart Foundation: https://www.bhf.org.uk/heart-health/risk-factors/check-your-heart-age.

Another risk factor you cannot change is if you have a history of heart disease among family members. This can double your risk, so if your mother, father, sister or brother has suffered from heart disease before the age of 60 you are at a greater risk of developing heart disease.

Modifiable Risk Factors – Those we can change are:

1-Smoking is the single largest preventable cause of death in Australia, and approximately 40% of women who smoke die due to heart disease, stroke or blood vessel disease. Smokers are 2-4 times more at risk of developing heart disease compared to non-smokers. In 2011/2012, over 1.3 million women in Australia smoked, and 89% of them did this on a daily basis. While these numbers are for women aged 15 and over, the largest group were in the 25-34 age group.

Passive smoking (exposure to the cigarette smoke of others) also causes an increase in the risk of developing heart disease, which increases further in people having high blood pressure or high cholesterol. Women who smoke and also take the contraceptive pill have a 10 times higher risk of having a heart attack.

2-Alcohol. Do you know that drinking too much alcohol increases the risk of heart disease? Excessive drinking causes more weight gain (due to increased calories!), increase in blood pressure and blood lipids. Over a long period of time it can weaken the heart muscle and cause abnormal heart rhythms. Try and not drink alcohol every day, limit it to two standard drinks at a time and aim for at least two alcohol free days a week and make sure you don’t increase the amount you drink on the other days. Periodically take a break from any alcohol for a week or more and you will notice many benefits including a better nights sleep.

3.High Blood Pressure or Hypertension. Your blood pressure is a measurement of how ‘hard’ your heart is working to push blood around your body, through the blood vessels. It can be a ‘silent’ killer and if you do not know your blood pressure then it is worth having it checked by your GP. Changing your lifestyle will reduce your blood pressure. A recent study suggests that keeping your blood pressure under 140/90 can increase your life expectancy by 5 years at the age of 50 years. You can assess your high blood pressure through your MD monthly or less expensive buy a b/p machine and check your b/p everyday especially if your on antihypertensive meds to make sure your b/p isn’t under 100/60 to prevent hypotension.

4.Diabetes. Do you have diabetes and if so, is it under control?

Diabetes doubles your risk of having heart disease. People who have uncontrolled diabetes are at risk of having heart disease at an earlier age. For pre-menopausal women, having diabetes cancels the protective effects of hormone present in women and significantly increases the risk of heart disease. Taking steps to find out what your blood sugar is and keeping it well-controlled is essential.

5.Obesity- Do you know your body fat content? 　If you think that you are overweight then you put yourself at risk of having heart disease. Being overweight will increase your blood pressure and contribute to developing diabetes. In addition to that, women who carry weight around their middle (belly fat) as opposed to their hips are twice as likely to develop heart disease.

By taking the steps to reduce your weight, you can reduce your risk of heart disease. A great tool developed by National Heart Foundation of Australia calculates if you might be at risk: http://www.heartfoundation.org.au/healthy-eating/Pages/bmi-calculator.aspx

6- INACTIVE-Are you physically active every day? Recent research indicates that “sitting is the new smoking” and being physically inactive can double your risk of having heart disease. It is important to get some exercise every day, such as a 30 minute walk where you raise your heart rate. It also raises your serotonin levels (feel-good hormone) and can reduce depression

7- STRESS-We could almost ask – do you know anyone who is not stressed?! However, while everyday life is stressful, those people who are almost constantly stressed are at risk of adopting unhealthy behaviours in order to reduce their stress levels. Examples include increasing their alcohol intake or smoking in order to relax; or tending to eat more junk food because they are often short of time. All of these factors increase their risk of heart disease.

Women, stress and the risk of heart disease

Along with poor diet, lack of exercise and smoking, unmanaged stress may increase the risk for heart disease. Now medical experts are discovering that mental stress affects women in different, and in some cases, more devastating ways, especially if they already have coronary conditions. One study that…

Heart disease is the leading cause of death for men and women in the United States. Every year, 1 in 4 deaths are caused by heart disease. The good news? Heart disease can often be prevented when people make healthy choices and manage their health conditions. Communities, health professionals, and families can work together to create opportunities for people to make healthier choices. Make a difference in your community: Spread the word about strategies for preventing heart disease and encourage people to live heart healthy lives

“Based on the most recent data available, in the United States in 2021, 141,902 new colorectal cancers were reported and in 2022, 52,967 people died from colorectal cancer.

From 2017 to 2021, about 1 in 3 colorectal cancer cases were diagnosed at a localized stage, meaning the cancer had not spread outside the colon or rectum. Almost 4 in 10 colorectal cancers were found at a regional stage (the cancer had spread to nearby lymph nodes, tissues, or organs), and about 2 in 10 were found at a distant stage (the cancer had spread to distant parts of the body).

Overall, 64% of colorectal cancer patients had not died from their cancer 5 years later. However, survival varied by stage at diagnosis.

Survival is higher when colorectal cancer is found before it spreads to other parts of the body. Screening tests can prevent colorectal cancer or find it early, when treatment works best.”

Center for Disease Control and Prevention – CDC (U.S. Cancer Statistics Colorectal Cancer Stat Bite | U.S. Cancer Statistics | CDC)

Stage II colorectal cancer is divided into three subcategories: IIA, IIB and IIC.

The difference between the categories lies in the extent to which the cancer has spread.

• Stage IIA (T3, N0, M0): The cancer has grown into the outermost layers of the colon or rectum, but has not grown through them. It has not reached nearby organs or lymph nodes, and has not spread to distant organs.
• Stage IIB (T4a, N0, M0): The cancer has grown through all of the layers of the colon or rectum, but has not grown into other organs or tissues.
• Stage IIC (T4b, N0, M0): The cancer has grown through all of the layers of the colon or rectum, and has grown into nearby organs or tissues. The cancer has not spread to the lymph nodes Surgery
• Initial treatment for stage II colon cancer is surgery to remove the section of colon that contains the tumor and surrounding tissue with its blood vessels and lymph nodes.
• The most commonly recommended protocols for patients diagnosed with stage II colon cancer:

Colectomy

A colectomy (or colon resection) is abdominal surgery that removes the section of colon where the tumor is located, tissue containing blood and lymph vessels surrounding the colon (mesentery), healthy tissue margins on either side and, if possible, at least 12 lymph nodes.  Then the remaining ends of colon are reconnected with sutures or staples.  This connection is called an anastomosis.

There are two types of surgery:

• Open colectomy:  An incision is made in the abdomen, surgery performed through the opening, and the incision closed with sutures and/or staples.
• Laparoscopic colectomy:  Three small keyhole incisions are made in the abdomen to insert a lighted instrument and specially designed surgical instruments that can be manipulated within the abdomen.  Sometimes an incision is made just long enough for the surgeon’s hand to assist during laparoscopy. This is also known as minimally invasive surgery.If your lymph nodes are cancer-free (also known as node-negative), your diagnosis is stage II colon cancer
• The tumor, tissue on either side of it (the margins), and fat and lymph nodes attached to the colon are removed for further study by a pathologist.  The pathologist evaluates the cancer cells in the tumor itself, looks for cancer in the margins and other tissue, and studies as many lymph nodes as possible in order to provide an accurate diagnosis.

Chemotherapy

Treatment of node-negative stage II colon cancer is controversial. While surgery to remove the tumor in the colon is universally accepted as initial treatment, the value of chemotherapy after that surgery to keep cancer from recurring (coming back) is hard for patients and doctors to judge.

It’s estimated that between four and five percent of patients with stage II colon cancer will benefit from chemotherapy. However, there are also side effects, some severe, associated with chemotherapy. Very few patients will die as a result of chemotherapy.

Because of the risks of treatment, researchers are looking for ways to identify patients who are at higher risk for recurrence, who are most likely to benefit from chemotherapy.

Some factors have been identified that lead to higher risk for stage II patients including:

• T4 tumors that extend beyond the outer wall of the colon into adjacent tissues and organs
• Too few lymph nodes removed and examined (less than 12)
• Cancer cells in blood and lymph vessels surrounding the tumor (not the same as lymph nodes)
• Undifferentiated or poorly differentiated tumors
• Perforation (a hole) of the colon by the tumor
• A tumor that obstructs (closes off) the colonFor high-risk stage II patients, the number needed to prevent one recurrence or death is smaller, probably 15 to 30 patients.
• It may help your decision to think about the problem in terms of numbers:  In order to prevent one recurrence or death from all cases of stage II colon cancer, 25 to 50 patients need to receive chemotherapy. One in six of those patients will have a severe side effect; one in 100 to 200 will die as a result of treatment.

Chemotherapy regimens for high-risk stage II colon cancer:

• FOLFOX:  combination treatment with infusional 5-FU (fluorouracil), leucovorin, and oxaliplatin
• FLOX: combination with bolus 5-FU, leucovorin, and oxaliplatin (severe diarrhea is more common with FLOX than FOLFOX but outcomes are similar)
• Xeloda (capecitabine): oral “prodrug” which is converted to 5-FU in the tumor
• 5-FU and leucovorinThere are some indicators of a patient’s risk of recurrence of their cancer, but no clear information that higher risk means they may benefit from therapy  — thus there are research efforts underway to better define “risk” and develop treatments that will benefit the higher risk patient in a predictable way.
• Stage III colorectal cancer treatments:In this article
• Your doctor can discuss the advantages and disadvantages of the different chemotherapy regimens if you decide to proceed with chemotherapy after your surgery.  Chemotherapy usually lasts about six months.

Stage III Colorectal Cancer Treatments

Stage III colorectal cancers have spread outside the colon to one or more lymph nodes (small structures that are found throughout the body that produce and store cells that fight infection). Tumors within the colon wall, which also involve the lymph nodes are classified as stage IIIA, while tumors that have grown through the colon wall and have spread to one to four lymph nodes are classified as stage IIIB cancers. Those tumors, which have spread to more than four lymph nodes are classified as stage IIIC colon cancers.

Treatment involves:

• Surgery to remove the tumor and all involved lymph nodes if possible.
• After surgery, the patient will receive chemotherapy with 5-FU, leucovorin and oxaliplatin, capecitabine with oxaliplatin or capecitabine alone.
• Radiation may be needed if the tumor is large and invading the tissue surrounding the colon.

The five-year survival rate for stage III colon cancer is about 64%. Patients with one to four positive lymph nodes have a higher survival rate than people with more than five positive lymph nodes.

 Stage IV Colorectal cancer treatments:

Stage IV colorectal cancers have spread outside the colon to other parts of the body, such as the liver or the lungs. Cancer that has spread is also called “metastatic.” The tumor can be any size and may or may not include affected lymph nodes (small structures that are found throughout the body that produce and store cells that fight infection).

Treatment may include:

• Removal of the cancer surgically or another surgical procedure to bypass the colon cancer and hook up healthy colon (an anastomosis).
• Surgery to remove parts of other organs such as the liver, lungs, and ovaries, where the cancer may have spread.
• Chemotherapy to relieve symptoms and improve survival.
• Erbitux, Avastin, or Vectibix in combination with standard chemotherapy, depending upon tumor characteristics.
• Zaltrap is a drug also approved for use with chemotherapy in cases where the cancer has progressed or is resistant to treatment.
• Stivarga is a targeted therapy approved in patients whose cancer has progressed after previous therapy.
• Clinical trials of new chemotherapy regimens, or immunological therapy.
• Radiation to relieve symptoms.

The five-year survival rate for stage IV colon cancer is nearly 8% or less.

“After someone is diagnosed with colorectal cancer, doctors will try to figure out if it has spread, and if so, how far. This process is called staging. The stage of a cancer describes how much cancer is in the body. It helps determine how serious the cancer is and how best to treat it. Doctors also use a cancer’s stage when talking about survival statistics.

The earliest stage of colorectal cancers is called stage 0 (a very early cancer), and then range from stages I (1) through IV (4). As a rule, the lower the number, the less the cancer has spread.

The staging system most often used for colorectal cancer is the American Joint Committee on Cancer (AJCC) TNM system, which is based on 3 key pieces of information:

• The extent (size) of the tumor (T): How far has the cancer grown into the wall of the colon or rectum? These layers,from the inner to the outer.
• The spread to nearby lymph nodes (N): Has the cancer spread to nearby lymph nodes?
• The spread (metastasis) to distant sites (M): Has the cancer spread to distant lymph nodes or distant organs such as the liver or lungs
• The system described below is the most recent AJCC system effective January 2018. It uses the pathologic stage (also called the surgical stage), which is determined by examining tissue removed during an operation. This is also known as surgical staging. This is likely to be more accurate than clinical staging, which takes into account the results of a physical exam, biopsies, and imaging tests, done before surgery.
• Numbers or letters after T, N, and M provide more details about each of these factors. Higher numbers mean the cancer is more advanced. Once a person’s T, N, and M categories have been determined, this information is combined in a process called stage grouping to assign an overall stage.”.

American Cancer Society (Colorectal Cancer Stages | Rectal Cancer Staging | Colon Cancer Staging | American Cancer Society)

Part II Treatment & Care

Many colon cancer treatment options are available for colorectal cancer, including surgery, chemotherapy, and radiation. Here’s what to expect from each type of treatment and tips for recovery.

Polyp Removal and Other Precancerous Conditions

Precancerous conditions of the colon or rectum are changes to cells that make them more likely to develop into cancer. These conditions are not yet cancer, but there is a higher chance these abnormal changes will become colorectal cancer.

The most common precancerous conditions of the colon or rectum area:

–adenomas

–hereditary colorectal syndromes

If you have a precancerous condition, you will likely have regular follow-up and screening tests to find cancer as early as possible if it develops. Some precancerous conditions can be treated with surgery to help reduce the risk that they will become cancer.

Colorectal Cancer Treatment

Stages of the cancer with TNM system for colorectal cancer helps determine the RX.

The most commonly used colorectal cancer staging system is known as the TNM system, which has been established by the American Joint Committee on Cancer. The TNM staging system looks at three key factors to determine the stage of cancer:

• Tumor (T) looks at how far the primary tumor has grown into the wall of the colon or rectum, and if it has expanded into nearby areas.
• Lymph node (N) examines the extent of the cancer spread to nearby lymph nodes.
• Metastasis (M) refers to whether cancer has spread to other parts of the body, such as the liver, lungs or brain.

A number (0-4 stages) or the letter X is assigned to each factor. Using this colorectal cancer staging system, a higher number indicates increasing severity. For instance, a T1 score indicates a smaller tumor than a T2 score. The letter X means the information could not be assessed.

Stages of colorectal cancer diagnosis occurs in conjunction with the following TNM categories:

• T1-T2: If the cancer has grown through the muscularis mucosa and into the submucosa, it is considered T1. Or, if the cancer has grown into the muscularis propria, then it is classified as T2.
• N0: The cancer has not spread to the lymph nodes.
• M0: There has been no spreading to organs or other nearby areas
• Stage I colorectal cancer treatments

Once the T, N and M scores have been assigned, an overall stage is determined, and thus treatment options can be explored.

Here’s a quick rundown of the options available for colorectal cancer treatment from surgery to cutting-edge biologic therapy.

Colorectal Cancer: Treatment by Stages

STAGE 0 (IN SITU) Colorectal Cancer Treatment

Surgery for colon cancer

• Polypectomy: snaring and removing polyps containing cancer during a colonoscopy.
• Local excision: removal of flat colon growths “piecemeal” during colonoscopy.
• Open abdominal surgery to remove cancer, part of colon, and nearby lymph nodes in high risk situations where:
  • There is a spread to polyp stalk
  • There is spread to lymphatic vessels (not lymph nodes)
  • Cells look very abnormal under the microscope (high grade)
  • Surgical margins (edge of tissue) contain cancer cells or can’t be evaluated or contain cancer cells.
  • Local excision would be too time-consuming or difficult to perform.

Chemotherapy

Chemotherapy is not recommended for stage 0 colon cancer.

Stage I Colorectal Cancer Treatment

Surgery

Colectomy (resection): Abdominal surgery to remove the section of colon where the tumor is located, tissue containing blood and lymph vessels surrounding the colon (mesentery), healthy tissue margins on either side, and at least 12 lymph nodes, if possible. Then the remaining ends of colon are reconnected with sutures or staples. This connection is called an anastomosis.

Open colectomy: An incision is made in the abdomen, surgery performed through the opening, and the incision closed with sutures and/or staples.

Laparoscopic colectomy: Three small keyhole incisions are made to insert a lighted instrument and specially designed surgical instruments that can be manipulated within the abdomen. Sometimes an incision is made just long enough for the surgeon’s hand to assist during laparoscopy.

Chemotherapy

Chemotherapy is not recommended for stage I colon cancer.

Part III on continuation of treatments of other stages of this condition (Stage II & III)

“Your risk of getting colorectal cancer increases as you get older. Other risk factors include having:

• Inflammatory bowel disease such as Crohn’s disease or ulcerative colitis.
• A personal or family history of colorectal cancer or colorectal polyps.
• A genetic syndrome such as familial adenomatous polyposis (FAP) or hereditary non-polyposis colorectal cancer (Lynch syndrome).”

Center for Disease Control and Prevention – CDC (https://www.cdc.gov/colorectal-cancer/risk-factors/index.html)

Colorectal cancer is cancer that develops in the tissues of the colon and/or rectum. The colon and the rectum are both found in the lower part of the gastrointestinal (digestive) system. They form a long, muscular tube called the large intestine (or large bowel). The colon absorbs food and water and stores waste. The rectum is responsible for passing waste from the body.

If the cancer began in the colon, which is the first four to five feet of the large intestine, it may be referred to as colon cancer. If the cancer began in the rectum, which is the last several inches of the large intestine leading to the anus, it is called rectal cancer.

Colorectal cancer starts in the inner lining of the colon and/or rectum, slowly growing through some or all of its layers. It typically starts as a growth of tissue called a polyp. A particular type of polyp, called an adenoma, can then develop into cancer.

Adenocarcinoma is the most common type of colorectal cancer. Other colorectal cancers include gastrointestinal carcinoid tumors, gastrointestinal stromal tumors, primary colorectal lymphoma, leiomyosarcoma, melanoma and squamous cell carcinoma.

Cancer is a disease in which cells in the body grow out of control. When cancer starts in the colon or rectum, it is called colorectal cancer. Sometimes it is called colon cancer, for short.

Colorectal cancer affects men and women of all racial and ethnic groups, and is most often found in people aged 50 years or older. In the United States, it is the third most common cancer for men and women.

Of cancers that affect both men and women, colorectal cancer is the second leading cancer killer in the United States, but it doesn’t have to be.

Colorectal cancer screening saves lives.

Screening can find precancerous polyps—abnormal growths in the colon or rectum—so that they can be removed before turning into cancer. Screening also helps find colorectal cancer at an early stage, when treatment often leads to a cure. About nine out of every 10 people whose colorectal cancers are found early and treated appropriately are still alive five years later.

If you are aged 50 or older, get screened now. If you think you may be at higher than average risk for colorectal cancer, speak with your doctor about getting screened early.

While screening rates have increased in the U.S., not enough people are getting screened for colorectal cancer. In 2012, 65% of U.S. adults were up-to-date with colorectal cancer screening; 7% had been screened, but were not up-to-date; and 28% had never been screened.

Your risk of getting colorectal cancer increases as you get older. More than 90% of cases occur in people who are 50 years old or older.

Other risk factors include having:

*Inflammatory bowel disease, Crohn’s disease, or ulcerative colitis.

*A personal or family history of colorectal cancer or colorectal polyps.

*A genetic syndrome such as familial adenomatous polyposis (FAP)hereditary non-polyposis colorectal cancer (Lynch syndrome).

Lifestyle factors that may contribute to an increased risk of colorectal cancer include—

• Lack of regular physical activity.
• Low fruit and vegetable intake.
• A low-fiber and high-fat diet.
• Overweight and obesity.
• Alcohol consumption.
• Tobacco use. *Rectal bleeding or blood in your stool.
• *Diagnosing colorectal cancer:Treatment & Care
• Tests. Finding colon cancer early is key to beating it. That’s why doctors recommend a yearly fecal occult blood test, which tests for invisible blood in the stool, an early sign of colon cancer. One of the best tools for detecting colorectal cancer is a colonoscopy.
• *Persistent abdominal discomfort, such as cramps, gas or pain.
• *A change in your bowel habits, including diarrhea or constipation or a change in the consistency of your stool, that lasts longer than four weeks.
• *Signs and symptoms of colon-rectal cancer include:
• Many colon cancer treatment options are available for colorectal cancer, including surgery, chemotherapy, and radiation. Here’s what to expect from each type of treatment and tips for recovery.

*Treatment= Get details on treatment on Part II tomorrow’s article Thurs.

Colon Polyp Removal and Other Precancerous Conditions

Learn how colon polyps are removed and why it’s so important to stay on top of these and other precancerous conditions.

Colorectal Cancer Treatment

Here’s a quick rundown of the options available for colorectal cancer treatment from surgery to cutting-edge biologic therapy.

Colon Cancer: Treatment by Stage

Here you’ll find detailed information on how the various stages of colon cancer are treated — from stage 0 to stage IV and also recurrent colon cancer.

Rectal Cancer Treatment by Stage

Here you’ll find detailed information on how the various stages of rectal cancer are treated — from stage 0 to stage IV and also recurrent rectal cancer.

Colon Cancer Chemotherapy

Learn about the different ways chemotherapy is used to treat colon cancer and rectal cancer and the side effects of commonly used chemotherapy drugs.