Cecum Cancer Symptoms and Treatment

Cecum cancer is a specific type of cancer that can develop at the very beginning of the colon. Signs and symptoms can be hard to spot until the cancer is advanced but may include abdominal pain, bloating, weight loss, and tarry stools.

Historical studies show that up to 20% of colorectal cancers occur in the cecum (in some studies it is much less common). Cecum cancer is usually found with a colonoscopy. But since the test isn't always able to reach the cecum, the prognosis is worse for this type of colon cancer.

This article will discuss the signs and symptoms of cecum cancer, and how it is diagnosed and treated.

Anatomy and Function of the Cecum

In order to better understand the symptoms you might expect from cecum cancer, it's helpful to review the anatomy and function of the colon in the digestive process.

After food is broken down into liquid by the stomach, it enters the small intestine, where the majority of nutrients are absorbed into the bloodstream. Digestive material then moves to the large intestine, which includes the colon. The function of the colon is to absorb remaining nutrients from digested material, and reabsorb water to create stool (poop).

Your colon is divided into five parts:

• Cecum: The cecum is the first part of the colon and is located in your right lower abdomen, near your appendix, and is the first stop for the digestive liquids from the small intestine. The cecum and the ascending colon make up what is known as the "right colon."
• Ascending colon: The ascending colon runs up along the right side of your abdomen to the transverse colon.
• Transverse colon: This portion of your colon runs horizontally across your upper abdomen from the right to the left.
• Descending colon: The descending colon runs down the left side of your abdomen, from the upper to the lower part.
• Sigmoid colon: The sigmoid colon connects the descending colon to the rectum and anus.

Cecum Cancer Symptoms

Common symptoms of colorectal cancer overall include a change in bowel movements, rectal bleeding, and a frequent urge to have a bowel movement that isn't relieved by defecating. Chances are you will not experience these telltale symptoms with cecum cancer. The symptoms of cecum cancer can be nonspecific and are often different than traditional colon cancer symptoms.

Because the waste passing through the cecum is slushy and can easily bypass masses in this part of the large intestine, inflammation in the cecum will not make you feel an urge to defecate or cause bowel habit irregularities (although it is sometimes associated with diarrhea).

Unfortunately, the majority of cecum cancer symptoms are not noticeable until the disease is already advanced. Potential symptoms may include:

• Anemia: Bleeding from this area of the colon is often microscopic, and not recognized until a healthcare provider finds that you have iron deficiency anemia on a complete blood count (CBC). Symptoms that go along with anemia, such as fatigue, shortness of breath, weakness, and a rapid heart rate, may be experienced. Anemia should always be investigated, especially in men and in postmenopausal women.
• Dark, tarry stools (melena): When bleeding occurs in the cecum and ascending colon, it usually causes black stools that can appear tar-like, rather than the bright red stools seen with bleeding further along in the digestive tract. 
• Gas and bloating: Gas and bloating may occur, but are often nonspecific, meaning they can have many possible causes and are often first attributed to another cause.
• Abdominal pain: When pain is present, it may be noted in the region known for pain with appendicitis, McBurney's point. This point can be located by drawing a line from your right hip bone to your belly button and locating the midpoint. Abdominal pain may be diffuse and difficult to pinpoint.
• Nausea and vomiting: Large tumors in the right side of your colon may cause food to "back up" into the small intestine and stomach, causing vomiting. Vomiting often is bilious (yellow in color).
• Weight loss: Unintentional weight loss is often seen with advanced tumors, and always should be investigated. Unintentional weight loss is defined as the loss of 5% of body weight or more without trying over a six-to-12 month period. This would be equivalent to a 150-pound person losing 7.5 pounds without taking steps to do so.

Diagnosis

A colonoscopy is the best test for visually detecting cancer of the cecum. In a colonoscopy, a healthcare provider advances a colonoscope through your entire colon, up to the cecum, looking for polyps or suspicious growths that could be cancerous. If polyps are detected, they can be removed during the procedure.

Because most colon cancers begin as precancerous polyps, a colonoscopy not only can detect cancer, but also prevent it by removing these polyps.

Barium enemas may be done but can be inaccurate. When this is the case, a virtual colonoscopy may be able to detect cancer of the cecum when other tests fail.

Other tests, such as a computerized tomography (CT scan) of your abdomen, may also be done to explore the area of your cecum and to look for evidence of any spread of cancer.

Unfortunately, flexible sigmoidoscopy, a test sometimes used to screen for colon cancer, only evaluates the left side of the colon and would miss cancers of the cecum and right colon.

Differential Diagnosis

The presence of the symptoms noted above does not mean you have cecum cancer. There are several different conditions that may have similar signs. Some of these include:

Cecal Volvulus

An uncommon condition, a cecal volvulus occurs when your cecum and ascending colon twist, causing an obstruction that blocks the passage of stool through your bowels. 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 often caused by previous surgery). It most frequently affects people between the ages of 30 and 60.

Inflammatory Bowel Disease

Inflammatory bowel disease (IBD), including disorders such as Crohn's disease and ulcerative colitis, can cause abdominal pain, swelling, and irregular bowel movements, among other symptoms. Not only can IBD mimic the symptoms of colon cancer, but it is also a risk factor for the development of colon cancer.

Acute Appendicitis

Because the appendix is connected to the cecum, the symptoms of appendicitis mirror those of cecum cancer, including nausea, vomiting, and abdominal pain that is worst in the right lower abdomen. However, cecum cancer can lead to inflammation of the appendix, which could result in a diagnosis of cecum cancer earlier than it would otherwise be made.

Treatment

During a colonoscopy, your healthcare provider may perform a polypectomy procedure. However, if a cancer is too large to be removed during a polypectomy, you may need additional surgery to remove it. The most common type of surgery for cancer of the cecum is called a right hemicolectomy. This surgery removes the right side of your colon and re-attaches the remaining portion to your small intestine.

Depending on the stage and grade of your cancer, your healthcare provider might also advise adjuvant treatments, including chemotherapy and radiation.

Prognosis

The prognosis is somewhat poorer for cancers of the cecum than for other colon cancers, most likely related to the greater difficulty in diagnosing the disease in the early stages.

Diagnosis can be more difficult for cancers of the cecum because symptoms differ from colon cancers further along in the colon, and because it's harder to visualize this area on screening tests. Compared with left-sided colon cancers, right-sided colon cancers, such as those of the cecum, have somewhat poorer survival rates.

Despite this prognosis, right-sided colon cancers are less likely to spread (metastasize) to the liver and lungs than left-sided colon cancers.

A Word From Verywell

If you have any signs or symptoms suggestive of cancer of the cecum, talk to your healthcare provider. Some of these symptoms can raise concerns about other serious conditions as well.

Fortunately, screening colonoscopies for colon cancer are saving lives, and hopefully will improve survival rates in the future.