When my father was diagnosed with colon cancer, he had no symptoms. It was luck that brought him to the doctor’s office for the screening that saved his life. Colon cancer can be aggressive, but it can also 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, more than 41,000 new cases of colorectal cancer are diagnosed every year. Crucially, more than half of these cases are preventable and more than one in two people diagnosed with bowel cancer in England survive the disease for ten years or more.
Although colorectal cancer has historically affected people over the age of 50, a 2017 study shows a concerning rise in colorectal cancer rates among millennials, who are now twice as likely to develop colorectal cancer compared to those who were born in 1950. Dr. Zaid Ardalan, consultant gastroenterologist at The Alfred Hospital in Melbourne, Australia, says that “this shift can be attributed to lifestyle changes such as diet, physical activity and obesity”.
What is the difference between colon, colorectal and colon cancer?
There is a lot of confusion about the terms “colon cancer”, “colon cancer” and “colon cancer”; types of cancer that occur in different parts of the digestive system. Dr. Katherine Aitkens, a clinical oncologist, explains what they refer to: “We normally use the term ‘bowel cancer’ to talk about bowel or rectal cancer, also called ‘colorectal cancer’. There are other parts of the intestine that can cause cancer, such as the small intestine or anus, which are less common.
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What is colon cancer?
Colon cancer specifically refers to cancer that begins in a part of the large intestine known as 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 occurs when certain polyps, or abnormal cells, multiply within the inner lining of the colon, gradually changing it from a non-cancerous state to a cancerous state.
Typically, colon cancer develops gradually and progresses through different stages over several years. However, advances in screening tests and treatment options mean that early detection can prevent polyps from becoming cancerous, and even if the cancer does develop, there are many treatments that can help control it.
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When should you consult a doctor?
Colon cancer can be present without symptoms. Due to the slow progress, regular screenings are necessary 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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Changes in bowel habits, such as diarrhea, constipation, or the feeling of incomplete emptying of the intestines
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Blood in the stool or on toilet paper after wiping
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Abdominal pain, aches or cramps that won’t go away
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Persistent bloating. Stomach bloating can have several causes, but persistent bloating that lasts more than 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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Vomit
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What causes colon cancer?
Colon cancer, like many other cancers, is the result of 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 people aged 50 and over often suffer from it, there has been a steady rise in cases among people aged 20 to 49, with an annual increase of about 1.5 percent.
What lifestyle choices can increase risk?
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Red and processed meat: It has been proven that eating too much red meat and processed meat such as ham and bacon increases the risk of colon cancer. According to Cancer Research UK, 13 percent of bowel cancer cases in Britain are linked to eating this meat. The government recommends that people eat no more than 70 grams of red and processed meat per day, which amounts to about two sausages
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Lack of fiber: In Britain, 30 percent of bowel cancer cases are caused by eating too little fiber. “A simple way to include more fiber in your diet,” suggests gastroenterologist Dr. Zaid Ardalan, “is by consuming two servings of fruit and five servings of vegetables every day.” Some of the best examples are kiwis (with 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 association with vaping is made
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Excessive use of alcohol: When asked to define this, Mr. Christopher Chan, a colorectal surgeon, pointed to the Dietary Guidelines for Americans 2020-2025, which suggests limiting intake to two drinks or less per day for men, and one drink or less per day for women
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Obesity: Cancer Research UK estimates that 11 percent of bowel cancers in Britain are linked to being overweight or obese. Maintaining a lower BMI reduces the risk
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Lack of exercise: Physical activity has been shown to reduce the risk of colon cancer
What medical conditions can increase the risk?
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A family history of colon cancer: If a member of your immediate family has had colon cancer, your risk increases and you should talk to your doctor early about screening
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Inflammatory bowel disease: Conditions such as chronic ulcerative colitis, characterized by persistent inflammation and ulcers in the colon and rectum, and Crohn’s colitis, which causes inflammation in the colon as part of Crohn’s disease, increase the risk of developing colon cancer.
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Inherited conditions: Conditions such as Lynch syndrome, a genetic predisposition, are associated with increased risks, particularly of colorectal and endometrial cancer. Familial adenomatous polyposis, an inherited condition that leads to the formation of numerous colon and rectal polyps, can also predispose the individual to developing colon cancer
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A family history of polyps or having many polyps: These are detected during the screening
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Can you prevent colon cancer?
The good news is that lifestyle changes can play an important role in preventing more than half of all colon cancers. Mr Chan emphasizes that by minimizing risk factors we can reduce the chance of developing the condition. To reduce the risk of colorectal cancer, you are advised:
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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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Maintain a healthy diet, consume plenty of fruits and vegetables and reduce consumption of red meat and processed foods. Some research suggests that drinking coffee may also help lower the risk of colon cancer
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Reduce stress and embrace an “anti-inflammatory lifestyle.” “While it may not receive as much attention in mainstream discussions, there is increasing evidence to support stress reduction as a means of reducing inflammation in the body,” says Mr Chan.
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Keep track of your family’s medical history, as genetics can play a role in predisposing individuals to certain types of cancer
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Why screening is crucial
Screening tests can detect precancerous polyps before they become cancerous tumors. If left undetected, the cancer grows, spreading to the lymph nodes and, in advanced stages, to other organs such as the liver or lungs.
Screening age and overview
In England, everyone aged 60 to 74 is offered a home test kit for bowel cancer screening every two years, although this is expanding to people aged 50 to 59. In Scotland, screening starts from the age of 50, and in Wales it is from the age of 51. screening test is a FIT (fecal immunochemical test) that looks for small traces of blood in a stool sample, which can be a sign of polyps. If the test shows 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 colonoscopy,” says Dr. Ardalan. Although sometimes viewed with trepidation, a colonoscopy is a painless medical procedure that uses a flexible tube with a camera to examine the lining of the colon and rectum for abnormalities such as polyps or signs of cancer. Colonoscopies are crucial for screening for colorectal cancer and diagnosing gastrointestinal diseases, and if you have symptoms or concerns, you should request one.
In recent years the NHS has expanded its screening programme, urging people to start screening for colorectal cancer at the age of 50. Dr. incidence of colorectal cancer among younger demographic groups.
For people with a family history of the disease, Mr Chan suggests screening should be carried out “five years before your relative’s age at diagnosis of the disease”.
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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, selectively or in combination. Immunotherapy, a newer targeted treatment, is suitable for certain tumors with specific genetic profiles,” Mr Chan explains.
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Managing a colon cancer diagnosis
“What I tell patients is that success and tolerance of cancer treatment is enhanced by patients staying physically active, eating healthy and being mentally resilient,” says Dr. Ardalan. Recent studies indicate that practicing movement-based activities such as yoga, tai chi and dance therapy, as well as practicing meditation, can have profound effects on the well-being of cancer patients. These activities have been shown to reduce hospitalizations and alleviate common side effects of cancer treatments, such as anxiety, depression and fatigue.
The most important advice is that colon cancer can be detected early or even prevented. Despite numerous life-threatening surgeries, my father now lives cancer-free. I hope this advice encourages others to prioritize their wellbeing, get tested and talk openly about symptoms if they arise.
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