by When my father was diagnosed with colon cancer, he had no symptoms. It was luck that took him to the doctor’s office for the screening that saved his life. Colon cancer can be aggressive, but it can be caught early or prevented altogether.
Colorectal cancer is the third most common cancer in men and the second most common in women worldwide. According to Cancer Research UK, over 41,000 new cases of colorectal cancer are diagnosed each year. However, crucially, more than half of these cases are preventable and more than one in two people diagnosed with bowel cancer in England live with their disease for 10 years or more.
Although colorectal cancer has historically affected people over the age of 50, a 2017 study shows an alarming rise in colorectal cancer cases among millennials who have twice the risk of developing colorectal cancer compared to those born in 1950. Dr Zaid Ardalan, consultant gastroenterologist at The Alfred hospital in Melbourne, Australia says “this change could be attributed to lifestyle changes, such as diet, physical activity, and obesity rates”.
What is the difference between bowel, colorectal and colon cancer?
There is a lot of confusion about the terms “bowel cancer”, “colorectal cancer” and “colon cancer”; types of cancer that occur in different parts of the digestive system. Dr Katherine Aitkens, clinical oncologist, explains what they refer to: “We usually use the term ‘bowel cancer’ to talk about colon or rectal cancer, sometimes called ‘colorectal cancer’. There are other parts of the bowel that can be cancerous such as the small bowel or the anus, which are less common.”
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What is colon cancer?
Colon cancer specifically refers to cancer that starts in a part of the large intestine called the colon. The colon, which is about five feet long, is the long tube primarily responsible for transporting digested food to the rectum and ultimately out of the body. Colon cancer develops when certain polyps, or abnormal cells, within the inner lining of the colon multiply, gradually transforming from a non-cancerous state to a cancerous state.
Colon cancer usually develops gradually and progresses through different stages over several years. However, with advances in screening tests and treatment options, early detection can prevent polyps from becoming cancer and, even if cancer does develop, there are many treatments that can help control.
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When to see a doctor
Colon cancer can be present without symptoms. Because of its slow progression, regular screening is needed to detect problems early (more on this below). However, if you notice any of the following common signs or symptoms for more than two weeks, do not hesitate to contact your doctor for further evaluation.
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A change in bowel habits such as diarrhea, constipation, or a feeling of incomplete bowel emptying
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Blood in the stool or on toilet paper after cleaning
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Abdominal pain, pains or cramps that won’t go away
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Constant bloating. A bloated stomach can have different causes, but persistent bloating that lasts for two weeks or is accompanied by symptoms such as vomiting or blood in the stool requires evaluation.
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unintentional weight loss
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Fatigue and shortness of breath
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Vomiting
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What causes colon cancer?
Colon cancer, like many cancers, results from a combination of genetic, environmental and lifestyle factors. In particular, it affects proportionately more men than women and individuals of Black ethnicity more than other racial groups. And while it most commonly affects people aged 50 and over, there has been a steady increase in cases among people aged 20 to 49, with an annual increase of about 1.5 per cent.
What lifestyle choices can increase the risk?
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Red and processed meat: Eating too much red meat and processed meat such as ham and bacon has been proven to increase the risk of colon cancer. In fact, 13 per cent of bowel cancer cases in the UK are linked to eating these meats, according to Cancer Research UK. The Government recommends that people should not eat more than 70g of red and processed meat a day, which is the equivalent of about two sausages
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Lack of fiber: In the UK, 30 per cent of bowel cancer cases are caused by eating too little fibre. “A simple way to include more fiber in your diet,” recommends Dr. Zaid Ardalan, gastroenterologist, “is to eat two servings of fruit and five servings of vegetables daily.” Some of the best examples include kiwifruits (with the skin), raspberries, blackberries, avocado, broccoli and Brussels sprouts.
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Smoking: Smoking increases your risk of developing colon cancer. More research is needed before a similar direct connection is made to the galvanic
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Excessive alcohol consumption: When asked to define this, Mr. Christopher Chan, a colorectal surgeon, pointed to the 2020-2025 Dietary Guidelines for Americans., which suggests limiting intake to two or fewer drinks per day for men, and one or fewer drinks per day for women
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Obesity: Cancer Research UK estimates that 11 per cent of bowel cancers in the UK are linked to being overweight or obese. Keeping BMI lower reduces the risk
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Lack of exercise: Physical activity has been shown to reduce your risk of colon cancer
What medical conditions can increase the risk?
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Family history of colon cancer: If a member of your immediate family has bowel cancer, your risk increases, and you should talk to your doctor about early screening
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Inflammatory bowel disease: Conditions such as chronic ulcerative colitis, which is characterized by persistent inflammation and ulceration in the colon and rectum, and Crohn’s colitis, which causes inflammation in the colon as part of Crohn’s disease, raise the risk of developing colon cancer.
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Inheritance conditions: Conditions such as Lynch syndrome, a genetic predisposition, are associated with increased risks especially of colorectal and endometrial cancer. Familial adenomatous polyposis, an inherited disorder that results in the formation of multiple colon and rectal polyps, can predispose an individual to developing colon cancer.
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Family history of polyps or having many polyps: These are detected during screening
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Can you prevent colon cancer?
The good news is that lifestyle changes can play a significant role in preventing more than half of all bowel cancers. Mr Chan emphasizes that we can reduce the chance of developing the condition by minimizing risk factors. To reduce the risk of colorectal cancer, it is recommended that you:
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Drink alcohol only in moderation
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Maintain a healthy weight
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Quit smoking
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Adopt a healthy diet, incorporating plenty of fruit and vegetables and reducing consumption of red meat and processed foods. Some studies suggest that drinking coffee may also help reduce the risk of colon cancer
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Reduce stress and adopt an “anti-inflammatory lifestyle”. “While it may not get as much attention in mainstream discussion, there is growing evidence to support stress reduction as a way to reduce inflammation in the body,” says Mr Chan.
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Keep track of your family medical history, as genetics can play a role in an individual’s predisposition to certain types of cancer
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Why screening is vital
Screening tests can detect precancerous polyps before they become cancerous tumors. If left undetected, the cancer grows, spreading to lymph nodes and, in advanced stages, spreading to other organs such as the liver or lungs.
Refinement age and overview
In England, a bowel cancer screening home test kit is offered to everyone aged 60 to 74 every two years, although this is expanding to include those aged 50 to 59. In Scotland, screening starts at age 50, and in Wales it is 51. The screening test is an FIT (faecal immunochemical test) which looks for tiny traces of blood in a faecal sample, which can be a sign of polyps. If the test finds anything unusual you may be asked to go to hospital for further tests to rule out or confirm cancer, such as a colonoscopy.
“The gold standard for screening is still colonies,” says Dr Ardalan. Although sometimes viewed with dread, a colonoscopy is a painless medical procedure in which a flexible tube with a camera is used to examine the inside of the colon and rectum for abnormalities such as polyps or signs of cancer. Colonies are vital for screening for colorectal cancer and diagnosing gastrointestinal conditions, and if you have symptoms or concerns you should ask for one.
In recent years, the NHS has expanded its screening programme, urging people to start screening for colorectal cancer at age 50. However, Dr Ardalan sees a significant shift towards screening even earlier, starting at age 45 – a trend fueled by the growing number of cases. incidence of colorectal cancer among younger demographics.
For those with a family history of the disease, Mr Chan recommends screening “five years before your family member’s age when the disease is diagnosed”.
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What treatment options are available?
Treatment varies based on the size of the cancer, whether it has spread to other organs, its genetic code and your age and overall health.
“Treatment should always be discussed by a multidisciplinary panel of cancer specialists. The final treatment plan may include surgery, chemotherapy and/or radiotherapy, used selectively or in combination. Immunotherapy, a newer targeted treatment, is suitable for certain tumors with specific genetic profiles,” explains Mr Chan.
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Management of colon cancer diagnosis
“What I tell patients is that being physically active, eating healthily and being mentally resilient helps patients with the success and tolerance of cancer treatment,” says Dr. Ardalan. Recent studies show that engaging in movement-based activities such as yoga, tai chi and dance therapy, as well as practicing meditation, can have a profound impact on the well-being of cancer patients. These activities have been shown to reduce hospitalizations and reduce common side effects of cancer treatment such as anxiety, depression and fatigue.
The most important takeaway is that colon cancer can be caught early, or even prevented. Despite undergoing many life-threatening surgeries, my father is now cancer-free. I hope this advice will encourage others to prioritize their well-being, seek testing, and talk openly about symptoms if they arise.
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