56-Year-Old Woman Suffers from Long-Term Constipation—Colon Cancer Was the Real Culprit!

Summary: A 56-year-old woman, previously in good health with regular bowel movements, began experiencing constipation, reduced appetite, and unexplained weight loss six months prior to her diagnosis. Initially believing it to be successful weight loss, she eventually developed persistent bloating, abdominal pain, and severe constipation with bowel movements only every 4–5 days. After undergoing gastrointestinal endoscopy, she was diagnosed with stage II colon cancer and refractory constipation. Her treatment included surgery, chemotherapy, and immune and intestinal nutrition therapy. Today, she is in stable condition with no signs of recurrence.

Treatment Overview:

- Age & Gender: Female, 56 years old

- Diagnosis: Stage II colon cancer, refractory constipation

- Hospital: PLA Joint Logistics Support Force 988 Hospital

- Treatment Duration: Multiple hospitalizations over nearly one year, followed by long-term follow-up

- Therapy Used: Capecitabine tablets, oxaliplatin injection, laparoscopic sigmoidectomy, thymalfasin injection for immune and intestinal support

- Outcome: Stable condition, good physical status

1. Initial Consultation

In October 2019, the patient visited our hospital accompanied by her family. She reported being generally healthy and slightly overweight before the symptoms started. Over six months, she experienced a gradual onset of constipation, reduced food intake, and unintentional weight loss. She initially thought she was losing weight successfully but later felt weak and bloated, with bowel movements occurring only every 4–5 days. Following a visit to a local hospital where gastrointestinal cancer could not be ruled out, she came to us for further evaluation. Upon examination, she appeared fatigued but not severely underweight, weighing around 130 pounds. Blood tests revealed elevated tumor markers: CEA at 7.28 ng/ml and CA-125 at 116.1 KU/L. Based on her history and symptoms, we suspected refractory constipation caused by declining intestinal function possibly linked to a tumor. She was admitted for further treatment.

2. Diagnostic Process and Treatment Plan

To determine the cause of her symptoms, we performed gastroscopy and colonoscopy. The results showed chronic superficial gastritis and a 3–4 cm adenocarcinoma in the sigmoid colon. Further staging confirmed stage II colon cancer. Given the size and location of the tumor, we concluded that it was the underlying cause of her constipation. After multidisciplinary discussions, we proposed a treatment plan involving neoadjuvant chemotherapy, laparoscopic surgery, and adjuvant chemotherapy. Two cycles of preoperative chemotherapy using capecitabine and oxaliplatin were administered to shrink the tumor and target potential microscopic metastases. Subsequently, she underwent a laparoscopic radical resection of the sigmoid colon cancer. Postoperatively, she received six more cycles of chemotherapy along with thymalfasin to enhance immunity and support gut health.

3. Recovery and Outcomes

Following surgery, her constipation resolved completely. During chemotherapy, she experienced typical side effects such as nausea, fatigue, bloating, and diarrhea. However, three months after completing treatment, her energy levels improved significantly. Her bowel habits stabilized to once every 1–2 days, with normal, soft yellow stools. There were no recurrences of abdominal pain or bloating. After nearly a year of intermittent hospital visits, she regained her overall health. Follow-up tumor marker tests returned to normal levels, and imaging scans showed no evidence of cancer recurrence or metastasis.

4. Key Lifestyle Recommendations

After a successful recovery, maintaining a healthy lifestyle is crucial for preventing recurrence:

- Focus on easily digestible foods like soups, smoothies, and semi-liquid meals. Use a blender to process high-protein foods for better digestion.
- Avoid spicy, oily foods, alcohol, and smoking. Eat small, frequent meals throughout the day.
- Maintain a positive mindset and engage in moderate exercise, avoiding heavy labor or intense workouts.
- Monitor your weight and avoid rapid weight gain, as obesity is a known risk factor for colon cancer.
- If you notice changes in bowel habits—such as persistent diarrhea, constipation, blood in stool, or altered stool shape—seek medical advice promptly.

5. Final Thoughts

This case highlights how persistent constipation can sometimes signal an underlying serious condition like colon cancer. Many people dismiss early symptoms as common digestive issues, delaying critical diagnosis. It's essential to seek timely medical evaluation when unusual bowel patterns persist. Regular health screenings can also play a vital role in early detection and prevention of such diseases.