Early Signs & Treatment of Colon Cancer
An Interview with Professor Mertens

Blood in your stool? A sudden change in bowel habits? Don't ignore the warning signs. Colon cancer is treatable, but early detection is key. In this insightful interview, a leading gastroenterologist reveals the critical symptoms you need to know, the surprising ease of polyp removal, and the collaborative approach that's saving lives. Discover how a simple checkup could make all the difference, and why dismissing those "little signs" could be a dangerous mistake.

Peter Zombori: Welcome to this medical talk today with Professor Mertens from Zurich. He's a leading gastroenterologist. Thank you for joining this interview and helping us understand various aspects of colon cancer. So, my first question, Professor, is: what are the first signs of colon cancer?

Prof. Joachim Mertens: Thank you, Peter, for having me. It's great to be here. A very important question. The first signs of colon cancer patients usually present with a change in bowel habits. So, if you have a regular stool every day at more or less the same time and all of a sudden this pattern changes, that's usually a warning sign. The second important thing is blood in the stool. And I want to stress, I often have patients who say, "Yeah, I have a little blood in the stool, but I know I have hemorrhoids, and it's surely just the hemorrhoids." This is a dangerous concept because the presence of red blood in the stool doesn't necessarily mean it's not from a large polyp or potential colon cancer. 

So, just stay away from the idea that if it’s red blood, you don't need a checkup. General malaise, fatigue, and feeling unwell are also commonly reported symptoms.

So, three things to keep in mind: change in bowel habits, blood in the stool (red, dark, or otherwise), and general unwellness, which can also include unexplained weight loss, fevers, and night sweats, which you don’t usually have. These are all signs that prompt a professional checkup. 

Peter Zombori: Okay. That leads me to my second question: is colon cancer treatable, and how is it treated?

Prof. Joachim Mertens: Colon cancer today is, fortunately, very treatable. We have a whole arsenal of treatment options depending on the stage at which we find it. As a gastroenterologist, I'm particularly interested in finding polyps because it's important to understand the concept: a polyp, which is essentially the beginning of a small growth in the colon, can develop into cancer over time.

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Peter Zombori: And that's a concept you can easily find during a checkup?

Prof. Joachim Mertens: Absolutely. That's what makes colorectal cancer screening so valuable. I compare it to going to a dermatologist. If you found a brown spot that you hadn't had before and it kept growing, you'd likely have it checked and removed while it's still harmless. The colon's mucous membrane is not visible to the naked eye, so endoscopy is necessary. If you find a polyp at an early stage and remove it, it's the ideal treatment. If we find polyps with high-grade changes, indicating they're progressing towards cancer, we try to remove them endoscopically. We often succeed in fully removing them, saving the bowel and avoiding major surgery.

The next thing, if we find something that has grown deeper, we involve a bowel surgeon to remove the affected section. Depending on the stage, further treatment may be required to address potential spread to surrounding tissues or lymph nodes. But again, it depends very much on the stage of the disease that we find, and ideally, we'd find all polyps before they become cancerous.

Peter Zombori: Okay. But what if you're not going for regular screening and suddenly develop a significant problem?

Prof. Joachim Mertens: Usually, the cancer is found during an endoscopy. We then take a biopsy to determine the specific type and screen for genetic alterations or treatable mutations. This gives us a good understanding of the cancer. Then, within two to three days, we conduct a staging workup to assess for metastasis or more extensive disease. All findings are discussed in a tumor board with surgeons, oncologists, and radiologists to determine the best treatment options. This may involve immediate surgery followed by oncology treatment, or initial oncological treatment maybe combined with radiotherapy and no surgery at all. So again, this is a very individual thing but it’s important to see that a visit requires a lot of experts who need to come together to find the best path for each patient.

Peter Zombori: Thank you, Professor Mertens. We want to keep these interviews concise, so we'll stop here. It's been very interesting talking to you. We could continue, but for the sake of brevity, we'll conclude. Thank you so much. I know you're always busy, so I appreciate it even more.

Prof. Joachim Mertens: Thank you, Peter. It's been great. Thanks.

Peter Zombori: Thank you.