Most of the time, blood in the stool is not due to
cancer. Hemorrhoids (rectal veins) are the main culprit.
Sometimes what people describe as blood may turn out to
be food residue from beats or tomatoes. So, if you notice
blood with a bowel movement, don’t panic. However, this
symptom should not be ignored and a physician should
evaluate any patient with rectal bleeding.
This refers to a new but persistent change in the size,
shape, frequency and consistency of the stool. In other
words, someone may notice the new onset of constipation
and/or diarrhea. What is important to notice is the change.
This is not referring to the person who has a lifelong history
of diarrhea and/or constipation. Instead, for example, a
person who always had a tendency towards diarrhea may
notice a few weeks of new constipation, poor bowel
evacuation, and perhaps more bloating and abdominal pain
in the setting of a colon cancer blocking the passage of fecal
If a cancer is narrowing the opening of the lower part
of the colon, the stool may become persistently pencil thin
with a decreased size and caliber (thickness). The important
feature to notice in this situation is that the stool is
persistently altered from what an individual would consider
Do not panic if you are saying to yourself, ” I always
have abdominal discomfort.” Abdominal discomfort is
common in healthy individuals without cancer. In the setting
of colon cancer, abdominal discomfort usually presents with
other symptoms described here, such as a change in bowel
habits and/or anemia. If the pain is from a cancer partially
blocking the colon, it is often associated with bloating,
cramping and nausea. If the pain is from the cancer itself, it
may be localized to one specific point in the abdomen and
be reproducible with palpation.
Anemia refers to a lowering of the red blood cell count.
Fatigue can be a result of anemia because the red blood
cells are responsible for delivering oxygen to the body
tissues. In the setting of colorectal cancer, the anemia may
be caused by a persistent, microscopic amount of chronic
blood loss in the stool. The anemia is not usually caused by
large amounts of blood lost directly into the stool. Instead, it
is low iron (iron deficiency) that often causes the anemia
seen with colon cancer. Why does this occur? Iron is
essential for the formation of functioning red blood cells.
Without iron, the body is unable to produce more red blood
cells. In the setting of microscopic, persistent bleeding from
colon cancer, iron is lost with the red blood cells and can
slowly deplete the total body stores of iron. The production
of new red blood cells is reduced and eventually the total
red blood cell count decreases causing anemia. For
menstruating women, iron deficiency is commonly seen
because of the monthly loss of blood with the period.
However, for men, iron deficiency is uncommon and always
needs to be further investigated by a physician.
Unexplained weight loss:
Most people want to lose weight. Occasionally,
someone may notice that they are losing weight without any
change in their diet or activity. Unexplained weight loss is
frequently associated with fatigue and should be evaluated
by a physician. Besides cancer, this symptom can be due to
depression, an eating disorder, food avoidance due to
abdominal pain, and malabsorption.
In our crisis-oriented health care system, we often wait
for symptoms of a disease before we seek medical
attention. Even worse, once symptoms present, we often
ignore them. In the case of colorectal cancer, do not ignore
the symptoms described above. Better yet, do not even
wait for symptoms to develop. If you are over the age of
50, you should be screened for this disease. If you have a
family history of cancer, discuss with your health care
provider when screening should begin; it may start at age 40
or earlier. Colorectal cancer is often preventable and
curable if caught early. Discuss the options for colorectal
cancer prevention and screening with your health care
provider. Take responsibility for your own health and learn
your family medical history.
With all the uncertainty in our lives, especially when it
comes to our own health, wouldn’t it be nice if colorectal
cancer was one less thing you had to worry about?