Keep a colon check

Dr Ekta Jain

Are you experiencing discomfort or bloating sensation in stomach or lower abdomen lately? Have you recently noticed changes in your eating habits or in your appetite? Have you spotted blood in your stool? If the answer to any of the above questions is ‘yes’, you must immediately undergo a thorough medical examination because in some cases these symptoms might point to the presence of colorectal cancer. 

Given the overlapping of these symptoms with those of several other medical problems such as acidity, gastric bloating, constipation, gastrointestinal infection or indigestion, colorectal cancer may often remain undiagnosed and its symptoms mistaken and treated for relatively minor health concerns in the initial stages. In many cases, these symptoms are also overlooked by patients themselves in the initial phase, especially by people over 50 years until they experience an exacerbation.

Colorectal cancer is one of the most common forms of digestive cancers worldwide. Until somewhere around 10 years back, colorectal cancer, also known as cancer of the large bowel (colon or rectum), had the lowest incidence in India as compared to other countries in South East Asia. However, in recent years, owing to increasing urbanisation and adoption of western lifestyles, our country has seen a steady increase in the number of people, especially older adults, affected with this type of cancer. The malignant disease, which initiates in the inner lining of the bowel, if not treated early, can turn fatal. In India, colorectal cancers are the sixth most common cause of cancer-related deaths.

A recent study by the American Cancer Society reveals that someone born in 1990s has double the risk of getting early colon cancer, and almost four times the risk of early rectal cancer as compared to someone who is born in 1950s. Overall, the underlying risks for colorectal cancers are rising, and increasing steadily among younger adults and the Millennials. Many colon and rectal cancer patients today are in the most productive years of their lives.

Lifestyle risks 

Colorectal cancer generally begins with benign growth of cells in the colon known as polyps, which can turn cancerous within a short time. In the past few decades, dietary and lifestyle considerations have emerged as major risk factors for this malignancy, apart from the genetic factors. Colorectal cancer is now the third most common type of cancer in men (accounting for 10 per cent of all cases globally) and the second most common in women (9.4 per cent). More than 60 per cent of all cases of colorectal cancer are encountered in developed countries. However, in majority of the people, the exact causes of colon and rectal cancers still remain unknown.

Although the role played by specific nutritional factors leading to this cancer has not been underlined comprehensively, experts believe that irregular diet patterns and too much intake of red meat, highly refined and starchy foods, and sugars (especially sucrose) is linked to an increased risk of colorectal cancer. Besides these, excessive consumption of processed foods and binge eating over a long time may also cause liver and kidney damage. 

Not processing damage

Processed and packaged foods with reduced salt content are normally garnished with additives that are worse for the intestinal mechanism. Processing and packaging techniques used in the market may remove several nutrients, especially vitamins and fibre present in the original food matter, which also adds to the risk of this type of cancer over the long term. 

While eating a diet low in fresh fruits and vegetables and high in animal fat can be a major risk factor, adherence to other unhealthy lifestyle practices can multiply the risk. Cancer of the colon or rectum has been noticed more commonly in people who perform little exercise and are overweight or obese. Besides, medical evidence also suggests that the recent surge in colorectal cancers is affected by high levels of stress, diabetes, sedentary and unhealthy lifestyle habits, including addiction to alcohol and smoking for more than 20 years or more. 

Detection and treatment

In most cases, colorectal cancers are detected quite late. However, with recent medical developments in the management of cancers, even patients with advanced cancers of the colon, rectum, or ovaries now have chances for long-term survival. While there are different forms of treatment including colon resection surgeries, radiotherapy, and chemotherapy, the choice generally depends on several factors (including size and location of the tumour, the stage of the cancer, whether it is recurrent, and the overall state of health of the patient). Yet, prevention is better than cure, almost always, and early detection is the key to successful treatment.

— The writer is a pathologist, CORE Diagnostics, Gurugram

Minimise the danger

Here are a few things that can help in lowering the overall risk and reducing mortalities related to colorectal cancers:

• Eat a healthy diet consisting of cereals and wholegrain instead of ready-made and refined food. Eat fruits and vegetables daily and cut down on fat intake. Also, limit intake of processed food, saturated fats, and red meat. These are major negative factors.
• Do some moderate exercise everyday and lead an active life. Ditch the lift for the stairs; go for a morning walk. Avoid a sedentary life, as much as possible.
• Give up smoking, alcohol and other unhealthy lifestyle habits. These increase the risk of almost all types of cancers.
• Do not ignore any basic symptoms such as pain, lumps in the abdomen, constipation, or blood in the stool. Undergo regular screenings once in a year after you turn 50. You should be extra cautious if you have a family history of this type of cancer, or you had gastrointestinal problems such as Crohn's disease few years back.
• If you are experiencing more than one symptoms of this disease, make sure to consult a gastroenterologist, who may advise further tests, such as imaging and even a biopsy. Almost nine out of 10 cases of colorectal cancer can be cured entirely if diagnosed early.
• Go for regular screenings, stool testing, and preventive colonoscopies (once a year) after the age of 40.