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Colorectal cancer

Carcinoma colorectale · Kolorektální karcinom (rakovina tlustého střeva a konečníku)

What it is

Nearly always starts as a polyp — which is why screening can prevent it.

Symptoms & signs

  • Change in bowel habit
  • blood in stool
  • iron-deficiency anaemia
  • weight loss
  • abdominal pain
  • incomplete emptying

🚩 Get help if…

  • call 112 / 911 now Swollen belly, vomiting and no stool or wind
  • see a doctor soon Blood in the stool or from the back passage
  • see a doctor soon Change in bowel habit lasting over 3 weeks
  • see a doctor soon Weight loss, tiredness or breathlessness (anaemia)

Where it strikes

Medical treatment

  • Colonoscopy with polypectomy
  • surgical resection
  • adjuvant chemotherapy (FOLFOX)
  • radiotherapy for rectal cancer
  • immunotherapy for MSI-high
  • blood-based screening test (Shield) — FDA-approved 2024 for average-risk adults; misses most pre-cancerous polyps, and a positive result still needs a colonoscopy

Natural & lifestyle

  • Screening from 45–50, by country
  • fibre-rich diet
  • limit processed and red meat
  • exercise
  • no smoking
  • alcohol limits
  • calcium and vitamin D

Emerging & experimental

  • Neoadjuvant dostarlimab (complete responses without surgery)
  • watch-and-wait protocols

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Structured exercise after chemotherapy — the CHALLENGE trial (2025) found about 28% fewer recurrences (80% vs 74% disease-free at five years) and fewer deaths trials support
  • Aspirin — lowers bowel-cancer risk in Lynch syndrome (CAPP2) and in long-term users; bleeding risk trials support
  • Vitamin D — higher levels go with better survival; trials show only a trend mixed evidence
  • Mistletoe extract — quality-of-life benefit in some studies, no proven survival benefit mixed evidence
  • Ivermectin and fenbendazole — anecdotal reports and laboratory activity; no human trials anecdotal / traditional

ICD codes