Colon Cancer vs. Ulcerative Colitis (UC)

Colon Cancer Symptoms vs. Ulcerative Colitis Differences

Picture of colon (colorectal) cancer.
Picture of colon (colorectal) cancer
Picture of Ulcerative Colitis
Picture of Ulcerative Colitis
  • Colon cancer is composed of unregulated abnormal cells that may spread to other organs in the body (metastasize), while ulcerative colitis (UC) is composed of acute or chronic inflammation of the membrane that lines the colon. Ulcerative colitis does not spread to other areas of the body.
  • Colon cancer and ulcerative colitis share symptoms, for example,
    • Frequent loose bowel movements with or without blood
    • Abdominal discomfort or pain
    • Anemia
    • Fatigue
    • Lethargy
    • The feeling of urgency to have a bowel movement (tenesmus).
  • The cause of colon cancer and ulcerative colitis is unknown, but they share risk factors of genetic or family history and smoking. Colon cancers usually arise from adenomatous polyps in the colon while ulcerative colitis does not arise from polyps.
  • Colonoscopy is recommended for early detection of colon cancer and ulcerative colitis.
  • Treatment of colon cancer is surgery with removal of the cancerous tissue and/or polyps while treatment for ulcerative colitis depends upon the severity of the disease, but the majority of patients with ulcerative colitis are treated with medication. However, surgery may be required for the diseased colon in some individuals.
  • The prognosis and life expectancy of colon cancer are less than that of ulcerative colitis. However, life expectancy and prognosis vary upon the extent of colon cancer disease before surgery. Ulcerative colitis, in contrast, is not considered a fatal disease but is considered a lifelong illness with normal life expectancy. With treatment with most individuals with ulcerative colitis having a good prognosis.

What Is Colon Cancer?

Cancer is the transformation of normal cells. These transformed cells grow and multiply abnormally. Cancers are dangerous because of their uncontrolled growth and potential for spread. Cancer overwhelms healthy cells, tissues, and organs by taking their oxygen, nutrients, and space.

In colon cancer, these abnormal cells grow and eventually spread through the colon wall to involve the adjacent lymph nodes and organs. Ultimately, they spread (metastasized) to distant organs such as the liver, lungs, brain, and bones.

Most colon cancers are adenocarcinoma tumors that develop from the glands lining the colon's inner wall. These cancers, or malignant tumors, sometimes are referred to as colorectal cancer, reflecting the fact that the rectum, the end portion of the colon, also can be affected. Anatomic differences in the rectum as compared to the rest of the colon require that doctors separately recognize these areas.

What Is Ulcerative Colitis (UC)?

Ulcerative colitis (UC) is an acute or chronic inflammation of the membrane that lines the colon (the large intestine or large bowel). The inflammation occurs in the innermost layer of the colon and may result in the formation of sores (ulcers). Ulcerative colitis rarely affects the small intestine except for the lowermost section, called the terminal ileum. The inflammation makes the colon empty frequently causing diarrhea. Ulcers form in places where the inflammation has killed the cells lining the colon. The ulcers bleed and produce pus and mucus.

UC initially causes inflammation in the rectum and may gradually spread to involve the whole colon. If just the rectum is involved, it is referred to as ulcerative proctitis.

Ulcerative colitis is one of the inflammatory bowel diseases (IBD), the other is Crohn's disease. An estimated 1 to 1.3 million people in the United States have inflammatory bowel disease. Ulcerative colitis generally is found in younger people and the diagnosis often is made in people between the ages of 15 and 30. Less frequently, the disease also can occur in people later in life, even past the age of 60. It affects both men and women equally, and there is a familial predisposition to its development. Those of Jewish heritage have a higher incidence of ulcerative colitis.

What Are the Signs and Symptoms of Colon Cancer vs. Ulcerative Colitis?

Colon Cancer Symptoms and Signs

Some individuals with colon cancer have no symptoms, and if they do have symptoms they often are minimalized and overlooked until the cancer becomes more severe. Cancer screening tests for colon cancer thus are important in individuals 50 years of age and older. Colon and rectum cancer can have many different symptoms and signs. If you have any of these symptoms, seek immediate medical help. You may notice bleeding from your rectum or blood mixed with your stool. It usually, but not always, can be detected through a fecal occult (hidden) blood test, in which samples of stool are submitted to a lab for detection of blood.

People commonly attribute all rectal bleeding to hemorrhoids, thus preventing early diagnosis owing to lack of concern over "bleeding hemorrhoids." New onset of bright red blood in the stool always deserves an evaluation. Blood in the stool may be less evident, and is sometimes invisible, or causes a black or tarry stool.

Rectal bleeding due to colon cancer may not be noticeable or chronic, and may only show up as an iron deficiency anemia, not colon cancer. Colon cancer may be associated with fatigue and pale skin due to the anemia. Changes in bowel movement frequency also is a symptom of colon cancer.

If the tumor in the colon becomes large enough, it may completely or partially block your colon. Symptoms of bowel obstruction include:

  • Abdominal distension: Your belly sticks out more than it did before without weight gain.
  • Abdominal pain: This is rare in colon cancer. One cause is tearing (perforation) of the bowel. Leaking of bowel contents into the pelvis can cause inflammation (peritonitis) and infection.
  • Unexplained, persistent nausea or vomiting
  • Unexplained weight loss
  • Change in frequency or character of stool (bowel movements)
  • Small-caliber (narrow) or ribbon-like stools
  • Constipation
  • Sensation of incomplete evacuation after a bowel movement
  • Rectal pain: Pain rarely occurs with colon cancer and usually indicates a bulky tumor in the rectum that may invade surrounding tissue after moving through the colon's submucosa.
  • Studies suggest that the average duration of symptoms (from onset to diagnosis) is 14 weeks.

Ulcerative Colitis Symptoms and Signs

Common symptoms of ulcerative colitis include:

  • Frequent loose bowel movements with or without blood
  • Urgency to have a bowel movement (tenesmus) and bowel incontinence (loss of bowel control)
  • Lower abdominal discomfort or cramps
  • Fever, lethargy, and loss of appetite
  • Weight loss with continuing diarrhea
  • Anemia due to bleeding with bowel movements

Because inflammatory bowel disease may be caused by a defect in the immune response system, other body organs may be involved, including for example:

  • Vision problems or eye pain
  • Joint problems
  • Neck or lower back pain
  • Skin rashes
  • Liver and bile duct disease
  • Kidney problems


Colon Cancer: Symptoms, Signs, Screening, Stages See Slideshow

What Are the Causes of Colon Cancer vs. Ulcerative Colitis?

Colon Cancer Causes

Most colorectal cancers arise from adenomatous polyps. Such polyps are comprised of excess numbers of both normal and abnormal appearing cells in the glands covering the inner wall of the colon. Over time, these abnormal growths enlarge and ultimately degenerate to become adenocarcinomas.

People with certain genetic abnormalities develop what are known as familial adenomatous polyposis syndromes. Such people have a greater-than-normal risk of colorectal cancer. In these conditions, numerous adenomatous polyps develop in the colon, ultimately leading to colon cancer. There are specific genetic abnormalities found in the two main forms of familial adenomatous polyposis.

Adenomatous polyposis syndromes tend to run in families, which are referred to as familial adenomatous polyposis (FAP). Celecoxib (Celebrex) has been FDA approved for familial adenomatous polyposis. After six months, celecoxib reduced the mean number of rectal and colon polyps by 28% compared to placebo (sugar pill) 5%.

Hereditary nonpolyposis colorectal cancer (HNPCC) is another group of colon cancer syndromes, which also run in families. In these syndromes, colon cancer develops without the precursor polyps. HNPCC syndromes are associated with a genetic abnormality. A test is available to identify this genetic abnormality. People at risk for this type of colon cancer can be identified through genetic screening. Once identified as carriers of the abnormal gene, these people require counseling and regular screening to detect precancerous and cancerous tumors. HNPCC syndromes sometimes are linked to tumors in other parts of the body.

Other risk factors for developing colon cancer include:

  • Ulcerative colitis or Crohn's disease (IBD)
  • Breast, uterine, or ovarian cancer now or in the past
  • A family history of colon cancer
  • Colon cancer usually occurs before age 40 years.

Ulcerative Colitis Causes

The cause of ulcerative colitis is uncertain. Researchers believe that the body's immune system reacts to a virus or bacteria, causing ongoing inflammation in the intestinal wall. Although UC is considered to be a problem with the immune system, some researchers believe that the immune reaction may be the result, not the cause, of ulcerative colitis.

Emotional stress or food sensitivities do not cause ulcerative colitis; however, these factors may trigger symptoms in some people.

Risk factors for inflammatory bowel disease include:

  • Genetic or family history: There is a high similarity of symptoms among identical twins, particularly with Crohn's disease. A person has a greater risk of getting the disease if a first-degree relative such as a parent or a sibling is affected.
  • Infectious agents or environmental toxins: No single agent has been associated consistently as a cause of inflammatory bowel disease. Viruses have been found in tissue samples from people with inflammatory bowel disease, but there is no incriminating evidence that these are the sole cause of the disease.
  • Immune system: Several changes in the immune system have been identified as contributing to inflammatory bowel disease; however, none have specifically been proven to cause either ulcerative colitis or Crohn's disease.
  • Smoking: If you smoke, you increase your risk of developing Crohn's disease by twofold. In contrast, smokers have only one-half the risk of developing ulcerative colitis.
  • Psychological factors: Emotional factors do not cause inflammatory bowel disease. However, psychological factors may modify the course of the disease. For example, stress may worsen symptoms or cause a relapse, and may affect the response to therapy.

What Are the Treatments for Colon Cancer vs. Ulcerative Colitis?

Colon Cancer Treatment

Polyps, if suggestive of being either cancer-related or cancer-specific in appearance and if few in number, maybe removed during colonoscopy (polypectomy). Sometimes only a polyp is found to be cancerous, and removal (polypectomy) of the polyp may be all that is necessary.

Although the primary treatment of colon cancer is to surgically remove part of the colon or all of it (colectomy) in some patients, chemotherapy after surgery can improve the likelihood of being cured if the colon cancer has spread to nearby lymph nodes.

Radiation treatment (radiation therapy) after surgery does not improve cure rates in people with colon cancer, but it is important for people with rectal cancer. Radiation may reduce tumor size if given before surgery. This can improve the chances that the tumor will be removed successfully. Radiation before surgery also appears to reduce the risk of cancer coming back after treatment. Radiation plus chemotherapy before or after surgery for rectal cancer can improve the likelihood that cancer will be cured.

Usually, only a portion of the colon is removed to treat colon cancer. In rare circumstances, such as in longstanding ulcerative colitis or in cases where large numbers of polyps are found, then the entire colon may need to be removed. Most colon cancer surgery will not result in a colostomy (a piece of colon is diverted and opens through a portion of the abdominal wall) being necessary as the bowel having been cleaned out prior to surgery can then safely be reconnected (resection) after a portion is removed. In rectal cancer sometimes, a colostomy is necessary if it is not safe or feasible to reconnect the portions of the rectum and anus that remain after cancer involved area is removed.

Surgery may also be done to relieve symptoms in advanced cancer such as when cancer has caused a bowel obstruction. The usual procedure is a bypass for obstructions that cannot be cured. Rarely, colon cancer, such as with such severe blockage (obstruction), a resection cannot be done.

Ulcerative Colitis Treatment

Treatment for ulcerative colitis depends on the severity of the disease. Most people with ulcerative colitis are treated with medication. If you have significant bleeding, infection, or complications, surgery may be required to remove the diseased colon. Surgery is the only cure for ulcerative colitis.

Ulcerative colitis may affect individuals in different ways, and treatment is adjusted to meet the needs of the specific individual. Emotional and psychological support is also important.

The symptoms of ulcerative colitis come and go. Periods of remission, in which symptoms resolve, may last for months or years before relapsing. You and your healthcare team, together, need to decide whether medications will be continued during remission times. Medications help manage ulcerative colitis, and stopping them will cause a relapse.

Ulcerative colitis is a lifelong illness and cannot be cured. Routine medical check-ups are necessary and scheduled colonoscopies are important to monitor your health and to make sure that you are managing your ulcerative colitis, and that it is not spreading.

What Is the Cure Rate and Life Expectancy for Colon Cancer vs. Ulcerative Colitis?

Colon Cancer Cure Rates and Life Expectancy

  • If your tumor is limited to the inner layers of your colon, you can expect to live free of cancer recurrence five years or more 80%-95% of the time depending on how deeply the cancer was found to invade into the wall.
  • If cancer has spread to your lymph nodes adjacent to the colon, the chance of living cancer-free for five years is 30%-65% depending upon the depth of invasion of the primary tumor and the number of nodes found to have been invaded by colon cancer cells.
  • If cancer has already spread to other organs, the chance of living five years drops to 8%.
  • If cancer has reached your liver but no other organs, removing part of your liver may prolong your life with as many as 20%-40% of patients living cancer-free for five years after such surgery.

Ulcerative Colitis Cure Rates and Life Expectancy

  • Ulcerative colitis is not a fatal illness, but it is a lifelong illness that has no cure.
  • Most people with ulcerative colitis continue to lead normal, useful, and productive lives, even though they may need to take medications every day, and occasionally need to be hospitalized.
  • Maintenance medication has been shown to decrease flare-ups of ulcerative colitis.
  • Surgery may be required in some patients, but it is not required in every patient with ulcerative colitis.
  • Routine cancer screening is a must for those who do not undergo surgical removal of the colon.

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Colon Cancer Symptoms and Signs

Some people with colon cancer have little or no symptoms until the cancer has become more severe. When symptoms of cancer of the colon do occur, they include bleeding from the rectum, anemia, bloody diarrhea, abdominal distension, nausea, vomiting, and constipation.

Ulcerative Colitis. NIH. Updated: Sep 2014.

Colorectal Cancer - Patient Version. NIH. 2020.

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