The risk of developing colon cancer in one’s lifetime ranges from 1 in 23 in men to 1 in 25 in women. All age groups are at risk of developing colon cancer but one of the overlooked factors is that it can be prevented. It is estimated that about 75% of cases can be prevented if certain precautionary measures are followed. This article will focus on different ways one can lower the chances of getting colon cancer and ways to deal with it if diagnosed.
About colon cancer
Colon cancer develops in the large intestine as non-cancerous (benign) bumps/clumps of cells called polyps inside the colon lining. These polyps have the tendency to turn into cancerous cells over time. Colon cancer can occur at any age but is more commonly seen in older age groups (>50 years).1 The chance of polyps' turning into cancer depends on their type. The types of polyps are:
- Adenomatous polyps - (adenomas - known as a precancerous condition)
- Hyperplastic polyps and inflammatory polyps - not cancerous but in some conditions can be larger and will need monitoring of their growth.
- Sessile serrated polyps (SSP) and traditional serrated adenomas (TSA) - similar to adenomas.
The size and number of polyps are linked with the development of colon cancer. Hence, it is important to seek medical advice if these issues arise.
Ways to prevent colon cancer
Colon cancer screenings
Getting regular screening tests is the best prevention strategy against colon cancer. These tests help look for any pre-cancerous signs before the symptoms arise so preventive measures can be administered. The commonly used screening tests are:
- Colonoscopy - A small instrument with a camera used to see the inside of the colon and remove any polyps if found.
- Fecal Immunochemical Test (FIT) or Faecal Occult Blood Test (FOBT) - testing of the stool sample to find traces of blood which might be a sign of cancer
After the age of 45 annual screening is recommended, but if you have a familial history of colon cancer, inflammatory bowel disease (IBD), or Crohn’s disease it is best to discuss with your doctor for early testing options.2
Having a good diet
Maintaining a diet containing a lot of whole grains, fibrous fruits, and vegetables is proven to lower the risk of colon cancer.3 Try to have three or more servings of whole grains each day, as well as 22 to 34 grams of fibre, depending on your age and gender.
Pay attention to whole-grain foods including 100% whole-wheat in bread, cereals, and pasta as well as fruits, vegetables, beans, and legumes. It is also best to reduce the consumption of red meat and processed meats (bacon, sausage). Try to consume less than 3 servings each week to reduce colon cancer risk.4 Maintaining a low-fat diet showed a reduction in the formation of non-cancerous polyps but no direct correlation to a reduction in colon cancer risk3. But, less fat means better gut health which is one of the prevention strategies for colon cancer.
Being physically fit
Being active and getting regular exercise are proven to reduce the risk of colon cancer. Studies indicated there was a 20% reduction in colon cancer with recreational physical activity3. Pick up an activity that you enjoy, it may be walking, running, swimming, or hiking but ensure to stay consistent with it. Keep a watch on your weight as being overweight is linked with colon cancer risk. Focus on eating healthy and getting at least 30 minutes of physical activity every day. Try getting a workout buddy to stay motivated and someone to keep you accountable.
Avoid smoking
It goes without saying that quitting smoking is the best thing you can do for your well-being . Smoking is a proven cause of many types of cancer including colon cancer. If you have been smoking for a long time, do not worry you can still quit. Reach out for support in your family and community. Talk with your doctor about alternative methods to slowly quit smoking.
Reduce alcohol consumption
Alcohol consumption is linked with an 8% increased risk of colon and rectal cancers, as well as a 24%, increased risk of developing polyps.3 Hence it is better to reduce the intake of alcohol or completely avoid it.
Maintain the right levels of calcium and vitamin D
A higher intake of vitamin D is associated with the reduction of early-onset colorectal cancer5 and calcium consumption has been shown to reduce the formation of polyps. Try to consume between 1000 and 1200 mg of calcium and roughly 1000 IU of vitamin D daily. Try to consume fortified dairy foods, green leafy vegetables, eggs, and tuna, they are excellent sources of calcium and vitamin D.4 Get tested for calcium and vitamin D levels. Based on your levels the doctor will prescribe you supplements.
Some other ways of colon cancer prevention can be:
- Taking anti-inflammatory medications, such as aspirin, which showed a 40% reduction of colorectal cancer occurrence .3
- Getting non-cancerous colon and rectal polyps treated or removed.
- Taking vitamin supplements and antioxidants to compensate for any reduction of nutrition not met by diet.
Symptoms, diagnosis and treatment
What are the symptoms?
Early-stage colon cancer might not cause any symptoms. But once the tumour grows bigger and spreads to the surrounding organs the symptoms start showing. Commonly seen colon cancer symptoms include:
- Abdominal pain
- Abdominal mass/bloating (feeling full)
- Loss of appetite
- Nausea and vomiting
- Unexplained weight loss
- Change in bowel movement habits
- Anaemia (iron-deficiency)
- Rectal bleeding
You may experience other symptoms such as
- Shortness of breath if the cancer has spread to your lungs
- Pain in bones and weakness if the cancer has spread to your bones.
- Jaundice if the cancer has spread to your liver.
The mentioned symptoms can also be related to other diseases and if you experience any of these symptoms visit your doctor to get the proper diagnosis.
How is it diagnosed?
Based on your symptoms, health, or familial history your doctor will recommend a full physical abdominal check-up along with other tests such as:
- Imaging tests - Colonoscopy, digital rectal exams for the presence of polyps, and sigmoidoscopy (test visualise the lower part of the colon-sigmoid colon).
- Biopsy - testing of the polyps to see the presence of cancerous cells.
- Stool testing - Testing the stool sample to find the presence of blood and cancer cells from hidden polyps.
If you are at a higher risk of developing colon cancer, discuss it with your doctor and come up with a screening routine that is a good fit for you.
How is it treated?
The treatment of colon cancer depends on the stage of cancer, the location of the tumour, and how much it has spread in the body. Your doctor will also consider other factors such as your overall health, side effects, and how well you respond to certain treatments while coming up with a personalised treatment plan. The commonly used treatment strategies are:
- Surgery to remove polyps/tumours
- Radio therapy
- Chemotherapy
- Ablation therapy (burning/freezing of tumours)
- Targeted therapy or immunotherapy.
The treatment plan will be a combination of the methods mentioned above. Discuss with your doctor to get a treatment plan that you are comfortable with. There are many clinical trials for different colon cancer subtypes. So ensure to ask your doctor if you qualify for a clinical trial for your colon cancer type.
Risk factors
There are various risk factors involved in the development of colon cancer. Some factors can be manageable like dietary and lifestyle choices. Other factors like familial history of colon cancer or age are not controllable. Some well-known risk factors are:
- Over the age of 50 years
- Familial history and hereditary factors (genetic)
- Personal history of developing polyps
- Being obese
- Type-2 diabetes
- Leading a sedentary life
- Consuming lots of red and processed meats
- Smoking and excess alcohol consumption
- Presence of IBD, colitis or Crohn' s disease.
Things to remember
Colon cancer can be prevented if you take care of your overall well-being and have regular screening tests done. Make sure you have a healthy lifestyle with a good diet, get enough vitamins (vitamin D mainly), iron, and a good amount of physical activity. These factors subsequently reduce your risk of getting colon cancer. If you are above 45 years old, contact your physician or local GP to find out more about the existing colon cancer screening programs and how you can get a testing routine.
Summary
Although colon cancer affects a majority of people, it is easily preventable. Take charge of your health today and stay on top of your routine colon cancer screenings. Reach out to support groups within your community if you have a history of colon cancer in your family. It is equally important for you to take care of your mental health along with your physical health.
References
- Colon cancer - Symptoms and causes [Internet]. Mayo Clinic. Available from: https://www.mayoclinic.org/diseases-conditions/colon-cancer/symptoms-causes/syc-20353669
- Six ways to lower your risk for colon cancer [Internet]. Available from: https://www.cancer.org/latest-news/six-ways-to-lower-your-risk-for-colon-cancer.html
- Wilkins T, McMechan D, Talukder A. Colorectal cancer screening and prevention. American family physician. 2018 May 15;97(10):658-65.
- 8 Ways to Prevent Colon Cancer [Internet]. Available from: https://siteman.wustl.edu/prevention/8-ways/8-ways-to-prevent-colon-cancer/
- Kim H, Lipsyc-Sharf M, Zong X, Wang X, Hur J, Song M, Wang M, Smith-Warner SA, Fuchs C, Ogino S, Wu K. Total vitamin D intake and risks of early-onset colorectal cancer and precursors. Gastroenterology. 2021 Oct 1;161(4):1208-17.
- Sawicki T, Ruszkowska M, Danielewicz A, Niedźwiedzka E, Arłukowicz T, Przybyłowicz KE. A review of colorectal cancer in terms of epidemiology, risk factors, development, symptoms and diagnosis. Cancers. 2021 Jan;13(9):2025.