DR. WALKER

Understanding Colon Cancer

What is the colon?

The colon is a long tubular part of the digestive system and classically divided into 5 individual parts; ascending colon, descending colon, transverse colon, sigmoid colon, and rectum. The colon is also known as the large intestines. The colon is connected to the small intestines in a section called the cecum. The cecum, technically, is the widest part of the colon and is about 5 cm in length. The colon’s major function is to further digest food received from the small intestines. The colon also reabsorbs electrolytes and water as it forms stool.

What is colon cancer?

Colon cancer is a type of cancer that begins in the large intestines and is the second leading cause of cancer death in adults. Often, people do not know that they have cancer as symptoms are not usually present in the early stages. As the cancer grows however, symptoms may become more noticeable. Generally, cancer occurs when normal cells of the colon develop a mutation preventing them from growing normally. At this point, the damaged cells continue to grow and divide however without restriction and eventually form a tumor. As these tumor cells grow, they invade adjacent tissues, increasing the cancer reach.

Common symptom of colon cancer?

Rectal bleeding/blood in stool. Rectal bleeding/blood in the stool. Bright red blood or dark colored stool maybe signs of colon cancer or rectal cancer. Typically, you may notice blood on toilet paper or blood in the toilet bowl or may be mixed in with stool. Keep in mind, however, that this blood could, be signs of inflamed or bleeding hemorrhoid tissues or anal fissures. Additionally, bleeding could still be present, but not visible in toilet bowl. This is considered “occult bleeding” which could be discoverable during guaiac sampling.
Changes in bowel habits. Examples of these changes could include either constipation or diarrhea. Additionally, changes in the frequency or the caliber of the stool may occur.
Unexplained weight loss. This is common in that many people with colon cancer find it difficult to maintain weight secondary to reduce appetite. Additionally, some patients with diarrhea, especially chronically, tend to lose weight as a result.
Belly pain. Some may present with abdominal pain/cramps in the belly, which could be a sign of colon or rectal cancer. Pain may also include gassy pain, or just discomfort.
Incomplete evacuation. This includes the feeling that your bowel is not emptying completely. This includes thin or pencil-like stool caliber.
Weakness. Many patients with colon cancer are also deficient in red blood cells or hemoglobin which carry oxygenated blood to tissues. This condition causes to people feel tired, sluggish, or fatigued. This condition is generally called anemia, which is commonly one of the presenting signs.

Are there risk factors colon cancer?

Age. The median age of colon cancer diagnosis is 68 years old for men and 70 years old for women. As we get older, however and with additional comorbidities, the risk of mortality tends to increase with each subsequent year.
History of polyps. There are several types of polyps, some of which are unlikely to become cancerous; like hyperplastic polyps. Others that are benign (non-cancerous) to include inflammatory pseudopolyps. Adenomatous polyps or adenomas however, take years to grow, and are most often associated with the development of colon cancer. Specifically, villous adenomas are most often associated with becoming cancers. The number of polyps as well as the size of the polyps at diagnosis are important factors regarding malignancy risk.
Family history. This is another important risk factor in the development of colon cancer. Specifically, if a first- degree relative; parents, sibling, or child have had polyps or colon cancer you are by default at a higher risk.
Sedentary lifestyle. Physical inactivity may result an increased risk for colon cancer in part that it could lead to obesity. Excess weight also plays a role in how the disease progresses as well as influencing the outcome regarding management and prognosis of the disease.
Smoking. Smoking to include chewing tobacco products or chewing tobacco increase risk for colon cancer. Cigarette smoking also increase oxidative damage to the DNA and is a known source of chronic inflammation. These are factors that contribute to the recurrence of the disease.
Alcohol. Generally speaking, 1 or 2 servings of alcohol per day for men, and 1 serving per day, for women is considered the limit. Remember however that even small amounts of alcohol, long-term, can increase risk for developing cancer.

What can I do to preventing colon cancer?

Screening. Generally, colon cancer screening begins around age 45 and is recommended to continue until at least age 75. If known colon cancer history in first-degree relative, then screening should begin earlier.

Some additional supplements to consider:

Diet. Increasing consumption of green leafy vegetables have been shown to be protective factors against colon cancer. This includes things like kale, sea vegetables, and spinach. Additionally, consumption of processed red meat (hotdogs, and deli meat) has been shown to increase risk for colon cancer. Processed red meats should be replaced with things like wild caught salmon, mackerel, and sardines. Additionally, chronic consumption of foods high in carbohydrates have been linked to increased risk for colon cancer.
Increased high fiber foods. These include artichokes, avocados, okra, brussels sprouts, sweet potatoes, berries, walnuts, almonds.
Green tea. Free radical tends to destroy DNA causing mutation. Green tea is thought to reduce the formation of cancer cells due to its high antioxidant levels. High antioxidants levels help to neutralize free radicals. This intern lower oxidative damage to DNA and therefore decrease in risk for not just for colon cancers but for almost all cancers.
Herbs and other spices. Some fresh herbs that are known for their anti-inflammatory effects; include ginger, turmeric, basil, oregano, parsley, and garlic.
Low-dose aspirin. There is substantial evidence that taking a low-dose daily aspirin can reduce the risk of colon cancer. At least one study showed that taking a low-dose daily aspirin resulted in almost a 50% risk reduction cancer.
Multivitamin. Well documented history that probiotics, vitamin D3, and omega-3 fish oil are protective supplements against colon cancer. These tend to reduce overall inflammation which is protective against several different types of malignancies.
Diabetes. Excessive abdominal body fat has been linked to insulin resistance which has been associated with colon cancer.
Smoking cessation. Men who smoke have almost a 30% increase the risk of dying from colon cancer than non-smokers and women had more than a 40% increase risk of dying from colon cancer, when compared to non-smokers. One study suggested that smoking cessation was linked to almost 80% improvement survival overtime, when compared people who did not quit.