[Verse 1]
A quiet polyp stirs inside the bowel's lining,
Normal cells go rogue, their quiet order declining.
First the APC gate comes crashing to the floor,
Growth without a brake pedal, cells keep wanting more.
Then KRAS flips the switch, the signal stuck on go,
TP53 drops its guard, the final wall lets go.
Adenoma turns carcinoma, slow and sure,
But one in seven skips that road - microsatellite's the lure.
[Chorus]
APC, KRAS, P53, that's the climb,
Three mutations, one sick staircase, every time.
Right side bleeds you quiet, tired, pale, and thin,
Left side squeezes narrow, apple-core caves in.
Follow the sequence, know the side,
That's how colorectal cancer's classified.
[Verse 2]
Right side of the colon's wide, the stool runs loose and watery,
A tumor there can bleed for months and stay a hidden mystery.
Iron-poor and tired, anemia's creeping sign,
Hidden blood in secret, occult along the line.
Left side's narrow, muscled tight, built to push and squeeze,
A tumor there chokes off the lane, your habits start to tease.
Constipation, ribbon stools, the imaging tells it plain,
An apple-core lesion pinching tight, obstruction's quiet reign.
[Chorus]
APC, KRAS, P53, that's the climb,
Three mutations, one sick staircase, every time.
Right side bleeds you quiet, tired, pale, and thin,
Left side squeezes narrow, apple-core caves in.
Follow the sequence, know the side,
That's how colorectal cancer's classified.
[Verse 3]
When colon cancer's found, the surgeon plans the cut,
Take the segment, take the vessel, take the fatty gut -
Full mesentery comes along, the lymph nodes riding home,
Twelve at minimum in the bag before you call it done.
Stage three means it's jumped to nodes, adjuvant comes in view,
FOLFOX drips through weary veins when pathology turns true.
Oxaliplatin, five-FU, leucovorin in the mix,
Chemo mops the stragglers up after the surgeon's fix.
[Verse 4]
But lower down, the rectum hides within the pelvis' bowl,
Heald in eighty-two decided mesorectum was the goal.
Total mesorectal excision, envelope intact,
Shiny fascia, clean and whole - that's the gold-standard fact.
Low anterior resection saves the sphincter, stitches new,
Abdominoperineal takes it all, a permanent route.
Stage two or three gets neoadjuvant first, before the knife,
Radiation plus chemotherapy to shrink the tumor's life.
[Chorus]
APC, KRAS, P53, that's the climb,
Mesentery, twelve nodes, FOLFOX every time.
Mesorectum, Heald's design, envelope held tight,
Shrink it first with neoadjuvant, then you do it right.
[Bridge]
Total neoadjuvant therapy, give the chemo first in full,
Then watch and wait if scans come clean, no tumor left to pull.
Complete response, no visible trace, the rectum stays in place,
Some patients keep their plumbing, dodge the permanent bag's embrace.
And if the cancer wanders off to settle in the liver,
That's another chapter's work - the metastasectomy giver.