The cecum demarcates the beginning of your large intestine. This pouch-like section of intestine connects a portion of the small intestine, called the ileum, to the ascending colon. Although cecum (sometimes spelled caecum) cancer is a type of colon cancer, the signs and symptoms of this disease are sometimes elusive.
What The Cecum Does
In this part of your bowels, stool is not fully formed. Your cecum absorbs remaining nutrients and fluid from the stool, starting its transformation to the waste you see in your toilet. Anatomically, the cecum sits in the right lower area of your abdomen, where your appendix is positioned. Just like you can live without an appendix, which is attached to the cecum, it's possible to live without a cecum.
Is Cecum Cancer Common?
Your colon is divided into four main parts:
- The cecum and ascending colon
- The transverse colon
- The descending colon
- The sigmoid colon
There's only a 15 to 20 percent chance of developing cancer in the cecum, which is the least common place for colon cancer to occur, according to the American Cancer Society. The majority of cancers start in the rectum or the sigmoid colon, which are opposite the cecum.
The symptoms of cecum cancer can be difficult to detect. The most common symptoms of colorectal cancer include a feeling of fullness or pressure in the rectum, rectal bleeding and a frequent urge to defecate. Chances are, you will not experience these telltale symptoms with cecum cancer. Inflammations in the cecum, unlike the rectum or sigmoid colon, will not make you feel the urge to defecate or cause bowel habit irregularities, because the stool passing through the cecum is slushy and can easily bypass masses in this part of the intestine.
Unfortunately, the majority of cecum cancer symptoms are late – meaning the disease is already very advanced by the time you feel these symptoms that may include:
- Gas and bloating
- Fatigue – becoming tired easily
- Abdominal pain
- Weight loss
- Nausea and vomiting (large tumors in the right side of your colon can cause food to "back up")
The fact that rectal bleeding and bloody stools were not mentioned in this list is not by chance. A mass in the cecum can bleed, but usually by the time stool passes through the entire length of your colon you won't see the blood in a bowel movement.
When It's Not Cancer
The presence of symptoms alone does not mean you have cecum cancer. If you have concerns, talk to your doctor. He or she can order tests, including computed tomography (CT) scans or x-rays, to investigate the cause of your symptoms. Some other causes of similar symptoms include:
- Cecal volvulus – Although uncommon, your cecum and ascending colon can twist and cause a blockage in the bowels, called an obstruction. This torsion can lead to abdominal pain, swelling, cramps, nausea and vomiting. It may be caused by pregnancy, severe fits of coughing or abdominal adhesions – scar tissue in the abdomen – and most frequently affects people between the ages of 30 and 60.
- Inflammatory bowel disease – Including Crohn's and ulcerative colitis, IBD can elicit abdominal pain, irregular bowel movements and abdominal swelling during a flare-up.
- Acute appendicitis – Many of the symptoms of appendicitis mirror those of cecum cancer including abdominal pain, nausea and vomiting. The appendix is attached to the cecum; if you have disease in the cecum, there is a good chance the appendix can become inflamed.
Cecum cancer will not be found during a flexible sigmoidoscopy. This procedure only looks at the last portion of your colon. However, it can be found during a thorough colonoscopy, which usually begins at your cecum. In an endoscopic colonoscopy, the doctor advances the scope throughout your entire colon to look for suspicious growths, called polyps, and can possibly remove them with a procedure called a polypectomy.
If the cancer is too large to be removed in a polypectomy procedure, you may need surgery to remove it. The most common type of surgery for cecum cancer is called a right hemicolectomy – this surgery removes the right side of your colon and reattaches the remaining portion to your small intestine. Depending on the stage and grade of your cancer, your doctor might also encourage adjuvant treatments, including chemotherapy and radiation.
American Cancer Society. (2006). American Cancer Society's Complete Guide to Colorectal Cancer. Clifton Fields, NE: American Cancer Society.
John's Hopkins Medicine Colorectal Center. (n.d.). Stage II Colorectal Surgery. Accessed September 24, 2012.
National Digestive Diseases Information Clearinghouse. (n.d.). Anatomic Problems of the Lower GI Tract. Accessed September 24, 2012.