What is Ulcerative Colitis?
Ulcerative colitis is a chronic inflammatory bowel disease (IBD) that primarily affects the colon and rectum. It causes long-lasting inflammation and sores (ulcers) in the innermost lining of the large intestine. Symptoms include persistent diarrhea, abdominal pain, and rectal bleeding. The exact cause of ulcerative colitis is unknown, though it is believed to result from an overactive immune response to intestinal bacteria in genetically predisposed individuals.
How is Ulcerative Colitis Related to Cancer?
Individuals with ulcerative colitis are at an increased risk of developing colorectal cancer. The risk is particularly higher if the disease has been present for more than 8-10 years, if it involves extensive areas of the colon, or if there is a family history of colorectal cancer. Chronic inflammation in the colon can lead to dysplasia, which are precancerous cells that can eventually turn into cancer.
What Types of Cancer are Associated with Ulcerative Colitis?
The most common type of cancer associated with ulcerative colitis is
colorectal cancer. This encompasses both colon cancer and rectal cancer. Less commonly, people with ulcerative colitis may also be at an increased risk for other types of gastrointestinal cancers, such as small bowel cancer, and bile duct cancer (cholangiocarcinoma).
Regular Surveillance: Patients with ulcerative colitis should undergo regular
colonoscopy screenings to detect dysplasia or early cancer. The frequency of these screenings usually increases with the duration and extent of the disease.
Medication: Some medications, such as 5-aminosalicylic acid (5-ASA) compounds, can help reduce inflammation and may lower cancer risk. Immunosuppressive drugs and biologics can also be used to control inflammation.
Lifestyle Changes: Maintaining a healthy diet, avoiding smoking, and reducing alcohol intake can contribute to overall health and may reduce cancer risk.
Surgery: In some cases, the surgical removal of the colon (colectomy) may be recommended, especially if there is significant dysplasia or cancer detected.
Changes in bowel habits, such as persistent diarrhea or constipation
Rectal bleeding or blood in the stool
Unexplained weight loss
Abdominal pain or cramping
Fatigue and weakness
If any of these symptoms are persistent or worsening, it is essential to consult a healthcare provider for further evaluation.
Colonoscopy: During this procedure, a flexible tube with a camera is used to examine the entire colon. Biopsies of suspicious areas can be taken for further analysis.
Imaging Tests: CT scans, MRI, and PET scans can help determine the extent of the disease and detect any metastasis.
Biopsy: A sample of tissue from the colon is examined under a microscope to look for cancer cells.
Surgery: Surgical removal of the cancerous section of the colon or rectum (colectomy) is often required. In cases where the entire colon is affected, a total colectomy may be necessary.
Chemotherapy: This treatment uses drugs to kill cancer cells and may be used before or after surgery to reduce the risk of recurrence.
Radiation Therapy: High-energy radiation is used to target and destroy cancer cells, often used in conjunction with surgery and chemotherapy.
Targeted Therapy: These drugs specifically target cancer cells with certain genetic mutations or characteristics, potentially leading to fewer side effects than traditional chemotherapy.
Conclusion
Ulcerative colitis significantly increases the risk of developing colorectal cancer due to chronic inflammation. Regular surveillance, appropriate medication, lifestyle changes, and, in some cases, surgery can mitigate this risk. Early detection through routine screening and prompt treatment are crucial for improving outcomes in patients with ulcerative colitis who develop cancer.
