Colorectal Cancer

Cancer of the colon, rectum, or the vermiform appendix.  Usually begins in the lining of the bowels and if left untreated then can grow into the underlying muscle layers and throughout the bowel wall.  It typically starts off as benign but can begin to spread over time.

Demographics: It is third most common cancer in men and women in the world and is usually seen in older individuals with high cholesterol diets, ulcerative colitis, and who have a genetic predisposition. 

Clinical Presentation: Early Stage Signs and Symptoms- Rectal bleeding, abdominal pain, pelvic pain, back pain, sacral pain, pain radiating down the legs, and changes in bowel patterns. 

                Advanced Stage Signs and Symptoms- constipation, diarrhea with mucus, nausea and vomiting, abdominal distention, weight loss, fatigue, and fever.(Goodman 2007)

Differential Diagnosis: Information collected during the patient history or physical exam could alert the physical therapist of potential red flags that would lead to a physician’s referral.  If the patient is over 50 years old, has a family history of cancer, has had bowel disturbances, has unexplained weight loss, or has back pain that us unchanged by positions or movement. (Dutton 2008)

Bottom Line: Refer out
If the patient presents with the red flags mentioned, the patient should be referred to their primary care physician for further testing.(Goodman 2007)

References:
Please refer to the "Colorectal Cancer" section of the reference list.