Is It Colon Cancer? Symptoms and Diagnostic Tests - Gastroenterology and Hepatology

Is this colorectal cancer?

Hello Doctor: Recently, I've been troubled by something.
My girlfriend suspects she has colon cancer.
She mentioned that for a while now, despite eating a lot, her bowel movements are infrequent and thin, sometimes accompanied by blood, and at times, the stool is black.
She also feels a hard lump in her lower abdomen that is painful when pressed.
We took her to a gastroenterology department at a major hospital, but neither I nor the doctor could feel any lump.
The doctor mentioned it might be a lipoma and said there was no issue inside.
Since she reported blood in her stool, the doctor ordered a stool test, but the results are not out yet.
However, she keeps feeling that she is likely in the late stages of cancer because her symptoms match those she found online for late-stage cancer.
No amount of reassurance seems to help; she remains pessimistic and fixated on this.
I would like to ask: 1) Are these symptoms likely to indicate colon cancer, or could they be attributed to other conditions? 2) I am unsure what the stool test is checking for; I assume it may not detect malignancies.
Are there any specific tests that can directly check for colon cancer? I appreciate your time in addressing this; if this continues, I fear I might develop depression before she does.
Thank you very much.

Boris, 20~29 year old female. Ask Date: 2005/09/20

Dr. Yuan Hongdao reply Gastroenterology and Hepatology

Hello, I am not sure how old your girlfriend is, but generally, individuals in their 20s without a family history of colorectal cancer have a very low risk of developing it.
In young people, the presence of blood in the stool is mostly due to hemorrhoidal bleeding.
The best method for screening colorectal cancer is a colonoscopy.
If you are really concerned, it would be advisable to undergo a colonoscopy.
Sincerely, Dr.
Yuan Hong-Dao, Internal Medicine.

Reply Date: 2005/09/20

More Info

When it comes to concerns about colon cancer, it’s essential to approach the situation with a clear understanding of symptoms, diagnostic tests, and the overall context of gastrointestinal health. Your girlfriend's symptoms—changes in bowel habits, blood in the stool, and abdominal discomfort—are indeed concerning and warrant thorough investigation, but they do not definitively indicate colon cancer.

1. Symptoms and Their Implications: The symptoms your girlfriend is experiencing, such as thin stools, blood in the stool, and abdominal pain, can be associated with various gastrointestinal conditions, not just colon cancer. Conditions such as hemorrhoids, anal fissures, diverticulitis, or even benign polyps can cause similar symptoms. The presence of blood, especially if it is bright red, often suggests bleeding from the lower gastrointestinal tract, which could be due to less serious issues like hemorrhoids or fissures. However, the combination of symptoms, particularly the changes in bowel habits and the presence of blood, should not be ignored.

2. Diagnostic Tests: The stool test that the doctor ordered is likely a fecal occult blood test (FOBT) or a fecal immunochemical test (FIT). These tests are designed to detect hidden blood in the stool, which can be an early sign of colorectal cancer or other gastrointestinal issues. While these tests are useful, they are not definitive for diagnosing cancer. If the test is positive, further diagnostic procedures, such as a colonoscopy, would be necessary. A colonoscopy allows for direct visualization of the colon and rectum and enables the physician to take biopsies of any suspicious lesions.

3. Direct Diagnostic Methods: The most definitive way to diagnose colon cancer is through a colonoscopy. During this procedure, a flexible tube with a camera is inserted into the rectum and advanced through the colon. If any polyps or abnormal growths are found, they can be biopsied and sent for pathological examination to determine if they are cancerous. Additionally, imaging studies such as CT scans can help assess for any metastasis if cancer is diagnosed.

4. Addressing Anxiety and Mental Health: It’s understandable that your girlfriend is feeling anxious about her health, especially with the prevalence of information available online that can often lead to unnecessary worry. It’s crucial to provide emotional support and encourage her to discuss her fears with her healthcare provider. Sometimes, speaking with a mental health professional can also help manage anxiety related to health concerns.

5. Next Steps: While waiting for the results of the stool test, it would be beneficial for your girlfriend to maintain a balanced diet rich in fiber, stay hydrated, and avoid excessive stress. If the stool test is positive or if symptoms persist, a colonoscopy should be scheduled promptly. It’s also important to follow up with the healthcare provider to discuss any further testing or referrals to specialists, such as a gastroenterologist.

In summary, while your girlfriend's symptoms are concerning, they do not automatically indicate colon cancer. The stool test is a good first step, but further evaluation through a colonoscopy may be necessary for a definitive diagnosis. Encourage her to stay positive and proactive about her health, and ensure she has the support she needs during this time.

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