Colon cancer pain
Pain is more of an atypical symptom of colon cancer. The danger of this tumor disease is that the cancer in the intestinal wall can grow and spread unnoticed for a long time before the first symptoms appear. So there are no early symptoms. In addition to frequent constipation, blood in the stool, rapid weight loss and an inexplicable drop in performance, pain in the abdomen and back as well as during bowel movements or digestion can be non-specific symptoms of colon cancer. Persistent or recurring pain should be diagnosed by a doctor, even if it is rarely caused by colon cancer.
Why does colon cancer cause pain?
Tumors in the intestine can grow asymptomatic for a long time. If colon cancer causes pain, it can happen for a number of reasons. In almost all cases, the cancer is already well advanced with a locally large tumor and possible settlements, so-called “metastases”, in other areas and organs of the body. Initially, the cancer can grow into the inside of the intestine, so that digestion and elimination of the stool are impeded. Depending on the location of the cancer, pain during bowel movements can occur relatively early. This is especially the case if the tumor is located near the exit of the intestine in the rectum, the so-called "rectum". Blocking the digested food can also cause severe pain in higher parts of the intestine.
If there is a complete blockage in the large intestine, this is known as a "mechanical ileus". These are life-threatening symptoms that can be accompanied by enormous cramps and pain in the abdomen. Large colon cancer can also cause pain outside the lumen of the intestine. This is the case when it presses on surrounding organs and structures and displaces them. This can affect the spleen, liver, abdominal wall and other structures in the abdomen.
Less often, the pain can be traced back to the potentially existing metastases of colon cancer. These can form in the liver, lungs or bones, for example. There they can change the organ and cause pain. When colon cancer is discovered, there are already metastases in the liver in many cases, the capsule of which is very sensitive to pain and can be affected by cancer.
Read more on this topic at: Metastases in colon cancer
Where is the pain localized?
The location of the pain can vary. A distinction must be made between pain that is caused by the tumor locally in its original organ and pain that is triggered by potential metastases.
Many tumors are located in the middle parts of the colon. These are superficially under the abdominal wall, which means that the pain is also projected onto the stomach. They can occur in the lower abdomen, on the side or in the upper abdomen. Colon cancer that affects the rectum, on the other hand, can project its pain onto the lumbar spine or anus.
On the other hand, pain caused by metastases from colon cancer is more common. In particular, colon cancer settlements in the liver are not uncommon. They can lead to swelling of the liver, tension in the liver capsule, blockages in the blood vessels and, as a result, to jaundice. A typical side effect is pain in the right upper abdomen. Colon cancer can also cause lung metastases. They only cause pain if they grow into the edge of the lungs that are sensitive to pain. In rare cases, settlements also form in the bones. In principle, this can affect all bones and sometimes lead to severe pain. They can be located anywhere in the body and cause bone pain from the feet to the skull.
Back pain is a very non-specific symptom of colon cancer. Only in rare cases can they be traced back to the cancer itself; they are often caused by harmless tension or spinal complaints. In rare cases, however, colon cancer can be directly or indirectly responsible for the pain. In particular, tumors in the last section of the intestine called the "rectum" can cause pain in the tailbone and lower spine. This can also be related to the fact that the tumor grows strongly in the direction of the spine and presses on or infiltrates nerve plexuses there.
Bone metastases as a long-term consequence of colon cancer can also indirectly cause back pain. These can destroy the bones and the individual vertebral bodies and cause considerable pain. This can also result in instabilities in the spine, which can lead to secondary injuries.
Further information on this topic is available at: Back pain as a symptom of colon cancer
Abdominal pain can occur in the advanced stages of colon cancer. Colon cancer usually develops slowly from small precursors in the intestinal wall and does not cause symptoms for a long time. In most cases, pain in the abdomen also only occurs after a long time, when the tumor is already causing blockages inside the intestine and discomfort to the neighboring organs and structures in the abdomen.
Blockages in the intestine can initially lead to occasional constipation and painful bowel movements. Later, however, in an emergency, they can trigger a mechanical ileus, i.e. an intestinal obstruction. The pain of this disease is enormous and sometimes the intestinal obstruction can be an acutely life-threatening symptom.
Further information on this topic is available at: Intestinal obstruction
Over time, the tumor grows from the inner intestinal mucosa through the intestinal wall layers and can subsequently press and infiltrate the peritoneum, the abdominal wall or surrounding organs in the abdominal cavity. This can lead to considerable abdominal pain.
What can you do about the pain?
A distinction must be made between causal and symptomatic therapy. In the first place in the treatment of colon cancer must be the causal therapy, which consists of the removal of the colon tumor, all metastases and other cancer cells in the body. This can be achieved primarily through an operation and possibly subsequent chemotherapy.In advanced stages of the disease, the cancer cells have spread in the body to such an extent that a cure can no longer be assumed.
Read more about: Colon cancer surgery - everything you need to know!
In this case too, parts of the cancer can be removed in an operation to relieve the pain. In addition, symptomatic pain therapy should be given in the event of pain associated with cancer. This consists largely of pain medication, which is adapted to the severity of the pain according to a graduated scheme. For initial symptoms, drugs from the NSAID group are used, for example ibuprofen or indomethacin. More severe pain can in turn be treated with opioids. The best-known representatives of these drugs are morphine and fentanyl.
What is the terminal pain like?
The end stage is defined as stage 4 of colon cancer. At this stage, the cancer is no longer limited to the intestine, but has spread to other areas of the body and has formed so-called "distant metastases". The tumor size in the intestine is also often advanced in the final stage and is a few centimeters.
The pain in the terminal stage cannot be given in general terms. Many of the colon cancer patients suffer from very little pain. The distant metastases can sometimes be completely symptom-free, for example if they are not due to the liver capsule or pleura. In the final stage, surgery and chemotherapy cannot be expected to cure, which is why therapy is limited to relieving the symptoms. This direction of therapy is called “palliative”. If pain is present, all available drugs and other pain therapeutics can be exhausted in the end stage in order to make the pain bearable.
Can there be colon cancer without pain?
Colon cancer is very often symptom-free and pain-free; even in advanced stages, B symptoms such as weight loss and impaired performance often predominate. Even large tumors often cause pain only indirectly, for example via an intestinal obstruction or colonization in distant organs.
Read more on this topic at: Detecting Colon Cancer