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Colon Cancer: A Worryingly Common Disease

HIGHLIGHTS:

  • People who overindulge in the following types of food are at a greater risk of colon cancer than the general population: fatty foods, large amounts of red meat, meat that has been grilled and charred, pickled marinated foods, salty foods and foods that are low in fiber.
  • If you experience any irregular symptoms, such as alternating between constipation and diarrhea or chronic constipation, it could be a signal that you are developing colon cancer. An appointment with a doctor is necessary to carry out a thorough diagnosis.
  • NBI (narrow band imaging) technology involving a colonoscopy provides a highly detailed and accurate picture of the colon tissue, so that any abnormalities can be identified from the outset.

 

From the latest statistics released in 2018, it was found that cancer is the 2nd biggest killer worldwide and the 3rd in new cases found*.

Additionally, it is estimated that more than 3,000 deaths per year resulting from colon cancer are not officially reported, with those over the age of 50 as well as those under the age of 50 with a family history of colon cancer especially at risk.

The trend clearly suggest that if Thai people do not undergo colon cancer screening in greater numbers, aforementioned cancer rates could be doubling over the next decade.

These numbers and statistics may come as a shock to many of you, but this form of cancer can be identified early on through a colonoscopy. Where a pre-cancerous polyp is found, it can be removed in up to 90% of cases. Alternatively, in cases of early stage colon cancer, treatment is available that can provide a cure for the disease.

Many forms of cancer develop with no clear cause. Colon cancer is no different in this regard, although there are certain risk factors as follows:

  • A previously diagnosed colonic polyp can, if left untreated, potentially transform into colon cancer.
  • Being over the age of 50 means the risk of colon cancer is twice as high. However, the disease can also be found in young men and women, as well as teenagers.
  • Having a family history of colon cancer, especially when the person who developed the disease was younger than 60.
  • Having chronic constipation.
  • Regularly eating fatty food, large amounts of red meat, chargrilled meats, pickled or marinated foods, and salty foods, as well as foods that are low in fiber.
  • Being overweight and no regular exercise.
  • Smoking.

Early stage colon cancer tends not to display any symptoms. Patients often neglect the proper care of their colon and digestive system. That being said, if you experience any of the following irregular symptoms, please consult your doctor in order to undergo a thorough diagnosis: alternating between constipation and diarrhea or chronic constipation, reduction in stool size, bloody stools, sudden and undiagnosed loss of weight, nausea, exhaustion or feeling overly tired.

Colon cancer screening techniques

Screening for colon cancer during its initial stages is the most effective way to prevent or halt the disease. Doctors recommend that the following forms of screening should be carried out from the age of 50 upwards, regardless of gender:

  • A fecal occult blood test (FOBT) should be done annually. The test takes a small fecal sample for analysis, while patients are required to stop the consumption of any meat or blood nourishing vitamin supplements for three days prior to the test.
  • A sigmoidoscopy is recommended every five years. This form of screening involves insertion of an endoscopic device into the anus to check for any irregularities affecting the lower region of the colon. It can also be used to cut a small tissue sample to be sent for analysis.
  • A colonoscopy provides a full and clear image of the patient’s colon and is also suitable for removing suspicious tissue samples for pathological examination.
  • Narrow band imaging (NBI) uses the latest endoscopic technology, providing a more accurate and detailed picture of colon tissue than ever before. The technique allows medical staff to identify any abnormalities in the tissue of the colon during its initial stages or when the polyp is smaller than 2.5-3 centimeters in length. Additionally, NBI gives doctors the opportunity to cut out any suspicious polyps immediately.

Colon cancer treatment

If a patient’s cancer is in the 1st stage, doctors will usually perform surgery to remove the cancerous tissue. However, if the cancer is in its 2nd or 3rd stages, with a higher chance of making a return, chemotherapy medication and radiation therapy will also be considered, both of which can be undertaken either pre- or post-surgery.

In addition to surgical removal of the cancer and radiation therapy, patients whose cancer is in the 4th stage may be required to undergo supplementary courses of chemotherapy. Furthermore, where the cancer has spread to the surrounding organs, doctors will need to give careful consideration to how they will treat those organs on a case-by-case basis.

Targeted therapy is another choice for treatment of colon cancer.

We have seen that although the true causes of colon cancer remain unknown, the disease can affect any of us. That being said, the risk factors mentioned above are the result of a person’s lifestyle. Therefore, the most effective form of prevention is to make suitable modifications to our diet and lifestyle habits. This means avoiding foods that are high in fat, increasing the amount of fiber we consume, drinking plenty of water and not forgetting to exercise regularly, as well as training ourselves to excrete properly in order to prevent constipation.

Moreover, people over the age of 50 or those with a heightened genetic risk of colon cancer should undergo annual screening assessments, including an FOBT, which has been proven to lower the rates of colon cancer fatalities, while colonoscopy examinations should be carried out every 10 years. All of these steps can help protect against colon cancer, or successfully treat the disease where it is identified in its initial stages.


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Reference*

http://www.nci.go.th/th/File_download/Nci%20Cancer%20Registry/HOSPITAL-BASED%202016%20Revise%204%20Final.pdf

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Pathipat Durongpongkasem, M.D. Summary: Internal Medicine Gastroenterology