Colorectal Cancer Awareness Month

Preventable. Treatable. Beatable! - That’s the motto of Colorectal Cancer Awareness Month.

Colorectal cancer is the second-leading cause of cancer death overall in the United States, this year, the American Cancer Society estimates that there will be over 100,000 new cases of colon cancer and more than 44,000 new cases of rectal cancer in the United States alone, leading to more than 50,000 deaths from the disease nationwide.

There is good news though - with appropriate screening, colorectal cancer can often be nipped in the bud - so to speak.

The low-down on Screening

No one really likes the idea of going to get a colonoscopy. I think we can all agree on that.

Medical professionals understand that some people will avoid the screening tests altogether because of embarrassment or fear, either of the test or something around the test. The good news is that there are many different screening options available for colorectal cancer (CRC).

When people can discuss their situation with their doctor and find the screening option that they’re comfortable with, and gives their doctor a good understanding about their risk, the compliance for screening and needed follow up tests increases.

What that means is that having more options, and more choice about CRC screening has led to increased amounts of people that are actually being screened for CRC. And when indications of CRC are found earlier, they are often more responsive to treatment and outcomes may be better. So what options are available?

There are Basically Two Main Methods of Colorectal Cancer Screening - Visual Tests or Stool Tests

 

Visual Tests

  • Colonoscopy

  • Computed tomographic colonography (CTC)

  • Double- contrast barium enema

  • Flexible sigmoidoscopy

Stool Tests

  • Fecal immuno- chemical test (FIT)

  • High- sensitivity guaiac-based fecal occult blood test (gFOBT)

  • FIT-DNA test (Cologuard®)

 

“The slow course of growth from precancerous polyp to invasive cancer provides a unique opportunity for the prevention and early detection of CRC. Screening can prevent cancer through the detection and removal of precancerous growths and can detect cancer at an early stage, when treatment is usually more successful. As a result, screening reduces CRC mortality both by decreasing incidence of disease and by increasing the likelihood of survival.”

-American Cancer Society, Colorectal Cancer Facts &Figures 2017-2019

Some testing options are more complex requiring a person to prepare ahead of time and potentially be sedated and miss work for the procedure, and others are minimally complex and can be mostly completed at home.

Each method of testing has its own risks and benefits. Each has differs as far as how often the test needs to be run as well. The best way to decide what test is right for you is to discuss it with your doctor based on your individual situation.

CRC screening is typically recommended when people are 50 years of age or older, though when there is an increased risk of the development of CRC, such as a family history or certain medical conditions, screening may be indicated sooner.

The most important thing is to be screened and following-up with appropriate testing as your physician indicates.

The Effect of Screening? Or Something Else?

Taking a look at two groups of people - those under age 50 and those over age 50 - data shows that there is a decrease of death rates from CRC in one group and and increase in the other.

We polled our Facebook followers to ask in which group of individuals they thought the death rate was increasing. Here’s what they said:

 
Results from our poll showed that most people thought the death rates for Colorectal Cancer are increasing for people younger than 50.

Results from our poll showed that most people thought the death rates for Colorectal Cancer are increasing for people younger than 50.

 

Most of our audience guessed correctly.

While the rates of death from CRC in the 50 and older age group have decreased between 2005 to 2014 (by about 1% per year in individuals 50-64 years of age and by 3% per year in those 65 and older), death rates from CRC in adults younger than 50 years of age have increased by about 1% per year over the same time period.

What specifically accounts for the increased death rates from CRC in the younger population vs the decrease in the older population? The answer is unknown…though most researchers believe the increased death rates in the younger than 50 population may be due to an increased sedentary lifestyle and a higher prevalence of obesity and/or unfavorable dietary patterns in children and young adults.

If you’re concerned about your risks, what can you do to mitigate them, or at least know how to handle them? Lets take a look at some common colorectal risk factors.

Risk factors

Factors that may increase your risk of colon cancer include:

  • General Factors:

    • Age: Even though the data showed that the death rate for CRC was increasing year over year for the younger than 50 group, the great majority of people diagnosed with colon cancer are older than 50. (Probably a good reason why the general screening that we talked about earlier tends to start at 50 years of age).

    • Race:  There are some differences in the likelihood of developing CRC based on race. (Other differences impact screening choices, the risk of false-positives from certain screening tests, as well as the actual likelihood of developing CRC). African-Americans for instance have a greater risk of colon cancer than do people of other races.

  • Medical conditions:

    • A personal history of colorectal cancer or polyps:  If you've already had colon cancer or adenomatous polyps, you have a greater risk of colon cancer in the future. Your doctor will make adjustments to your personalized screening protocol based on findings. The important thing is that your medical provider understand what’s going on out of sight. Again, CRC is generally a slower progression from polyps to full blown cancer, so it’s important not to miss your scheduled follow-ups in order to stay on-top of your treatment plan.

    • Radiation therapy for cancer:  Radiation therapy directed at the abdomen to treat previous cancers increases the risk of colon and rectal cancer.

    • Inflammatory intestinal conditions: Chronic inflammatory diseases affecting the colon, like ulcerative colitis and Crohn's disease, can increase the risk of colon cancer.

    • Diabetes: People with diabetes and insulin resistance have an increased risk of colon cancer.

  • Family Factors:

    • Inherited syndromes: Genetic syndromes passed through generations of your family can increase your risk of colon cancer. These syndromes include familial adenomatous polyposis and hereditary nonpolyposis colorectal cancer, which is also known as Lynch syndrome.

    • Family history of colon cancer: You're more likely to develop colon cancer if you have a parent, sibling or child with the disease. If more than one family member has colon cancer or rectal cancer, your risk is even greater.

  • Lifestyle Factors:

    • Obesity: People who are obese have an increased risk of developing colon cancer as well as an increased risk of dying from colon cancer when compared with people considered normal weight.

    • Low-fiber, high-fat diet: Colon cancer and rectal cancer may be associated with a diet low in fiber and high in fat and calories. Research in this area has had mixed results. Some studies have found an increased risk of colon cancer in people who eat diets high in red meat and processed meat.

    • A sedentary lifestyle:  An inactive lifestyle makes a person more likely to develop colon cancer. Getting regular physical activity (at least 150 minutes of moderate-intensity activity, or 75 minutes of vigorous-intensity activity each week [or a combination of these], spread throughout the week may reduce your risk of colon cancer. Even if you’ve had a sedentary lifestyle for a while now, indications show that developing a healthier routine of exercise as discussed above may still reduce the likelihood of developing or dying from CRC.

    • Smoking: People who smoke may have an increased risk of colon cancer.

    • Alcohol:  Use of alcohol (more than one drink a day for healthy people in most situations) increases your risk of colon cancer.

Keep an Eye Out for Symptoms

Because most people with colon cancer won’t experience noticeable symptoms in the early stages of the disease, it’s important to rely on regular screening as a tool to really understand what’s going on in your colon/rectum.

However, if you do happen to notice a change in any of the following it might be a good idea to share it with your doctor. Remember - that’s what they’re there for! If you notice something that’s strange for your body, it might be an indication of an underlying health problem that you should get checked out.

Signs and symptoms of colon cancer may include:

  • A change in your bowel habits, including diarrhea or constipation or a change in the consistency of your stool, that lasts longer than four weeks.

  • Rectal bleeding or blood in your stool.

  • Persistent abdominal discomfort, such as cramps, gas or pain.

  • A feeling that your bowel doesn't empty completely.

  • Weakness or fatigue.

  • Unexplained weight loss.

Where To Go From Here?

Remember the motto for colorectal cancer awareness month?

Preventable. Treatable. Beatable!

With appropriate teamwork with your medical provider and screening that’s tailored to your situation, lifestyle, and other risk factors, there’s a good chance that that motto will be true in your case. As cancer screening and treatment continue to make advances, the outlook for people likely to develop CRC will likely improve as well; but there are positive steps that a person can take today to reduce their risk.

Modifications in diet and exercise are relatively easy to accomplish, and can have positive affects on both reducing CRC as well as improving the likelihood of surviving CRC.

If you’re interested in making changes to reduce your risk factors and would like some help, feel free to schedule an appointment with one of our naturopathic physicians or oncologists. We’re always here to help. 480-990-1111

Preview - The Microbiome and Your Health:

One aspect we didn’t touch on in this article is the role of our microbiome on CRC. In the large intestine, for example, bacterial cells outnumber host cells 10-to-1, and these organisms are increasingly thought to play both a positive and negative role in tumor development through its influence on immune response and inflammation.

We’ll discuss that topic in greater detail in a future post dedicated entirely to understanding the microbiome.