Colorectal cancer starts in the cells of the colon or rectum. A cancerous (malignant) tumour is a group of cancer cells that can grow into nearby tissue and destroy it. The tumour can also spread (metastasize) to other parts of the body. The colon and rectum are parts of the large intestine and the digestive system. The colon absorbs water and nutrients and passes waste (stool or poop) to the rectum. Colon and rectal cancers are grouped together as colorectal cancer because these organs are made of the same tissues and there isn’t a clear border between them.
Cells in the colon or rectum sometimes change and no longer grow or behave normally. These changes may lead to non-cancerous tumours such as hyperplastic and inflammatory polyps.Changes to cells of the colon and rectum can also cause precancerous conditions. This means that the abnormal cells are not yet cancer, but there is a chance that they may become cancer if they aren’t treated. The most common precancerous conditions of the colon and rectum are adenomas and hereditary colorectal syndromes.
But in some cases, changes to colon or rectal cells can cause colorectal cancer. Most often, colorectal cancer starts in gland cells that line the wall of the colon or rectum. These gland cells make mucus that helps stool move through the colon and rectum. This type of cancer is called adenocarcinoma of the colon or rectum. Rare types of colorectal cancer can also develop. These include small cell carcinoma and squamous cell carcinoma.

Colorectal polyps and colorectal cancer don’t always cause symptoms, especially at first. Someone could have polyps or colorectal cancer and not know it. That is why getting screened regularly for colorectal cancer is so important. If you have symptoms, they may include:
1) A change in bowel habits.
2) Blood in or on your stool (bowel movement).
3) Diarrhea, constipation, or feeling that the bowel does not empty all the way.
4) Abdominal pain, aches, or cramps that don’t go away.
5) Losing weight and you don’t know why.
If you have any of these symptoms, talk to your doctor. They may be caused by something other than cancer. The only way to know what is causing them is to see your doctor.

Your risk of getting colorectal cancer increases as you get older. Other risk factors include having:
1) Inflammatory bowel disease such as Crohn’s disease or ulcerative colitis.
2) A personal or family history of colorectal cancer or colorectal polyps.
3) A genetic syndrome such as familial adenomatous polyposis (FAP)external icon or hereditary non-polyposis colorectal cancer (Lynch syndrome).
4) Lifestyle factors that may contribute to an increased risk of colorectal cancer include:
a) Lack of regular physical activity.
b) A diet low in fruit and vegetables.
c) A low-fiber and high-fat diet, or a diet high in processed meats.
d) Overweight and obesity.
e) Alcohol consumption.
f) Tobacco use.

There are many types of colorectal cancer, the most common of which is adenocarcinoma. Other types include carcinoid tumors, gastrointestinal stromal tumors, colorectal lymphoma.
Hereditary colorectal cancers, meaning that several generations of a family have had colorectal cancer, include hereditary nonpolyposis colorectal cancer (HNPCC) and familial adenomatous polyposis (FAP).Here is an overview of some of the types of cancer in the colon and rectum:
● Adenocarcinoma
● Gastrointestinal Stromal Tumors (GIST)
● Lymphoma
● Carcinoids
● Turcot Syndrome
● Peutz-Jeghers Syndrome (PJS)
● Familial Colorectal Cancer (FCC)
● Juvenile Polyposis Coli

If you have symptoms that might be from colorectal cancer, or if a screening test shows something abnormal, your doctor will recommend one or more of the exams and tests below to find the cause:
1) Medical history and physical exam
Doctor will ask about your medical history to learn about possible risk factors, including your family history. You will also be asked if you’re having any symptoms and, if so, when they started and how long you’ve had them. You may also have a digital rectal exam (DRE). During this test, the doctor inserts a lubricated, gloved finger into your rectum to feel for any abnormal areas.
2) Tests to look for blood in your stool.
A stool test to check for blood that isn’t visible to the naked eye (occult blood), which might be a sign of cancer. These types of tests a fecal occult blood test (FOBT) or fecal immunochemical test (FIT).
3) Blood tests
Your doctor might also order certain blood tests to help determine if you have colorectal cancer. These tests also can be used to help monitor your disease if you’ve been diagnosed with cancer.
a) Complete blood count (CBC): This test measures the different types of cells in your blood. It can show if you have anemia (too few red blood cells). Some people with colorectal cancer become anemic because the tumor has been bleeding for a long time.
b) Liver enzymes: You may also have a blood test to check your liver function, because colorectal cancer can spread to the liver.
4) Tumor markers
Colorectal cancer cells sometimes make substances called tumor markers that can be found in the blood. The most common tumor marker for colorectal cancer is carcinoembryonic antigen (CEA).
Blood tests for this tumor marker can sometimes suggest someone might have colorectal cancer, but they can’t be used alone to screen for or diagnose cancer. This is because tumor marker levels can sometimes be normal in someone who has cancer and can be abnormal for reasons other than cancer.
Tumor marker tests are used most often along with other tests to monitor patients who have already been diagnosed with colorectal cancer. They may help show how well treatment is working or provide an early warning that a cancer has returned.
5) Diagnostic colonoscopy
A diagnostic colonoscopy is just like a screening colonoscopy, but it's done because a person is having symptoms, or because something abnormal was found on another type of screening test.
6) Biopsy
Usually if a suspected colorectal cancer is found by any screening or diagnostic test, it is biopsied during a colonoscopy. In a biopsy, the doctor removes a small piece of tissue with a special instrument passed through the scope. Less often, part of the colon may need to be surgically removed to make the diagnosis.
7) Lab tests of biopsy samples
Biopsy samples (from colonoscopy or surgery) are sent to the lab where they are looked at closely. .If cancer is found, other lab tests may also be done on the biopsy samples to help better classify the cancer and possibly find specific treatment options. a) Gene tests: If the cancer has spread (metastasized), doctors will probably look for specific gene changes in the cancer cells that might help determine which drugs will be more helpful in treatment than others.
b) MSI and MMR testing: Colorectal cancer cells are typically tested to see if they show high levels of gene changes called
microsatellite instability (MSI)
8) Imaging tests to look for color cancer
Imaging tests use sound waves, x-rays, magnetic fields, or radioactive substances to create pictures of the inside of your body.
9) Computed tomography (CT or CAT) scan
A CT scan uses x-rays to make detailed cross-sectional images of your body. This test can help tell if colorectal cancer has spread to nearby lymph nodes or to your liver, lungs, or other organs. CT-guided needle biopsy: If a liver or lung biopsy is needed to check for cancer spread, this test can also be used to guide a biopsy needle into the mass (lump) to get a tissue sample to check for cancer.
10) Ultrasound
Ultrasound uses sound waves and their echoes to create images of the inside of the body. A small microphone-like instrument called a transducer gives off sound waves and picks up the echoes as they bounce off organs. The echoes are converted by a computer into an image on a screen.
11) Magnetic resonance imaging (MRI) scan
Like CT scans, MRI scans show detailed images of soft tissues in the body. But MRI scans use radio waves and strong magnets instead of x-rays. A contrast material called gadolinium may be injected into a vein before the scan to get clear pictures.
12) Chest x-ray
An x-ray might be done after colorectal cancer has been diagnosed to see if cancer has spread to the lungs, but more often a CT scan of the lungs is done since it tends to give more detailed pictures.
13) Positron emission tomography (PET) scan
For a PET scan, a slightly radioactive form of sugar (known as FDG) is injected into the blood and collects mainly in cancer cells.
14) Angiography
Angiography is an x-ray test for looking at blood vessels. A contrast dye is injected into an artery, and then x-rays are taken. The dye outlines the blood vessels on x-rays.

Stage 0 colorectal Cancer
A polypectomy is performed during a colonoscopy and may remove all of the malignant cells. If the cells have affected a larger area, an excision may be performed. An excision is simply a minor, minimally invasive surgery that can often be performed during the colonoscopy.
Stage I colorectal Cancer
Surgery is performed to remove the affected area. This is called a partial colectomy and may involve rejoining the parts of the colon that are still healthy.
Stage II colorectal Cancer
Stage II cancers are treated with surgery to remove the affected areas. Chemotherapy may also be recommended in some cases. High grade or abnormal cancer cells, or tumors that have caused a blockage or perforation of the colon may warrant further treatment. If the surgeon was not able to remove all of the cancer cells, radiation may also be recommended to kill any remaining cancer cells and reduce the risk of a recurrence.
Stage III colorectal Cancer
The course of action for all categories of stage III colorectal cancer involves surgery to remove the affected areas, and chemotherapy. Radiation treatment may also be recommended for patients who are not healthy enough for surgery or for patients who may still have cancer cells in their bodies after surgery has taken place.
Stage IV colorectal Cancer
Patients with stage IV colorectal cancer may undergo surgery to remove small areas, or metastases, in the organs which have been affected. In many cases, however, the areas are too large to be removed. Chemotherapy may help to shrink the tumors so that surgery is more effective or to prolong life.
Chemotherapy treatments for stage IV colorectal cancer may include:
● FOLFOX (leucovorin [folinic acid], 5-FU, and oxaliplatin)
● FOLFIRI (leucovorin, 5-FU, and irinotecan)
● CapeOX (capecitabine and oxaliplatin)
● 5-FU and leucovorin, with or without bevacizumab
● Capecitabine, with or without bevacizumab
● FOLFOXIRI (leucovorin, 5-FU, oxaliplatin, and irinotecan)
● Irinotecan, with or without cetuximab
● Cetuximab
● Panitumumab

the five-year survival rate for people with colorectal cancer was 64.5 percent. Cancer is typically staged using the TNM system.
The five-year relative survival rates for each group are the following:
1) Localized: 90%. This describes cancer that remains in the part of the body where it started.
2) Regional: 71%. This describes cancer that has spread to a different part of the body.
3) Distant: 14%. This also describes cancer that has spread to a different part of the body but is typically referred to as “metastatic” cancer.

Cancer is a life threatening disease that can affect anyone regardless of race, age, and gender. Traditional cancer treatments like radiotherapy and chemotherapy often result in undesirable and uncomfortable side effects such as vomiting, numbness, nausea, and diarrhea to name a few. Herbal medicine is a complementary therapy that some people with cancer use to ease cancer symptoms. Herbal remedies for cancer such as those commonly found in traditional medicine contains antimutagenic, anti-inflammatory, and apoptosis inducing compounds that help in slowing the development of cancer and relieve treatment side effects for patients.

Herbal medicine has a wide variety of applications but all of them rely on the sustainable use of various plant parts such as flowers, leaves, bark, and roots. Each part of a plant features different medicinal properties and uses. Although herbal medicine has countless use cases, cancer care is one of the most practical applications because of how harsh traditional oncology treatments can be on patients.

Herbal remedies are a part of a growing field of medicine called integrative oncology. Research conducted on the use of herbal medicine for cancer complementary therapy has proven herbs can:
• Slows the spread of cancer
• Reduces the side effects of cancer treatment
• Boosts immune system strength and functionality
• Minimizes the symptoms of cancer
• Attacks cancer cells

Several herbs may help control the side effects of conventional cancer treatment. However, doctors do not recommend that cancer patients take herbal medicine while undergoing normal traditional cancer treatment. Herbal medicines may be likely less to cause side effects than traditional drugs. But patients may can still experience complications. Some herbs may can cause negative interactions with chemotherapy drugs. Closely monitor how you feel before and after taking herbal remedies. Patients should always consult with their doctor before trying herbs as a complementary therapy or the supplements to avoid complications.