Colon cancer: one of the deadliest neoplasms

Despite being the second most prevalent neoplasm – the third among men after lung and prostate cancer, and the second among women after breast cancer –, many in Italy have discovered, or newly discovered, colon cancer after the arrest of Mafia boss Matteo Messina Denaro, captured as a result of investigative work based on the treatment received by Andrea Bonafede – the fake name used by Denaro – for this disease.

In Italy there are around 49,000 new diagnoses of colon cancer every year (375,000 in Europe): a disease which is considered “silent”, since most patients discover it when it is already too late.

Among the causes of colorectal cancer there are obviously genetic factors, some are of a non-hereditary nature and others are related to nutrition and lifestyle.

Among nutrition-related factors, diets based on red meat, refined sugars and fat, high in calories and low in fibre, are linked to an increase in bowel cancer. In contrast, high consumption of fruit and vegetables seems to have a protective effect.

A second issue is the presence of polyps, i.e. those growths of various volumes composed of loose connective tissue rich in blood vessels, lined with epithelial tissue spreading all over the surrounding mucous membrane. Whereas single polyps, often caused by chronic irritation of the mucous membrane, are generally benign lesions, multiple polyps are a malformation. In both cases, however, removal of these tumour growths is essential to prevent any malignant neoplastic development. Patients undergoing polyp removal should also go for frequent check-ups.

Then there is familial adenomatous polyposis, a rare disease in which the mucous membrane of the large intestine loses its anatomical harmony and turns into a carpet of prominent formations and roundish outgrowths.

Non-hereditary factors include ageing, a history of colon polyps, and chronic inflammatory bowel disease.

To date, the survival rate of a patient diagnosed with colorectal cancer is 65 per cent at five years. However, in cases of relapses with metastases – such as the case of Messina Denaro, who is reported to have a relapse with metastases to the liver – chances of survival can be as low as 24-26 months, a timeframe whose variability is linked to the patient’s general clinical condition, the quantity of secondary cancers and their location, the tumour’s aggressiveness and spread, and the effects of treatment.