Some years ago, I attended the funeral of my former schoolmate who died in his mid-30s from complications of colon cancer.
This young doctor, who was working in the USA had for a long while complained of abdominal upset and been treated for ulcers and indigestion until he started bleeding while passing stool. It was then that he was taken through an examination of his large intestines that cancer of the colon was diagnosed. He was taken through surgery and other advanced treatments but it was too late, he did not make it. It was a sad situation. One so young dying of a disease that is mostly seen in the elderly!
The colon is the second last part of the digestive system, commonly known as the large intestines. It helps in absorbing salt and water from the residues of digestion and transporting these residues to the rectum in preparation for expulsion by defecation.
The colon has three parts: the ascending, transverse and descending colon. In a way, it is arranged like a square, missing the lower line.
Colon cancer usually starts as small polyps, which are non-cancerous (benign) clumps of cells that form on the inside of the colon. Some polyps may change into cancerous cells, which then eat into the surrounding colon and spread to other parts of the body.
Risk factors for colon cancer include:
Age – risk increases as people get older. Mostly in people over 50 years but more cases are being seen in younger people.
A family history of cancer – this could be due to a genetic link or sharing the same environmental exposures.
Ethnicity – people of African and Eastern European descent, especially the Jews.
Over-consumption of processed meats like; sausages, frankfurters, salami and burnt pieces of barbeque.
Lack of regular physical activity.
A diet low in fruit and vegetables.
High-fat diet
Overweight and obesity.
Heavy alcohol intake.Tobacco use.
Note:
Risk factors refer to things that make one more likely to get a medical condition. In this case, it does not mean everyone with these risk factors will develop colon cancer and that those with none of the risk factors cannot develop it.
Screening
Most of the time, colon cancer is diagnosed only after symptoms develop. This unfortunately happens when the disease is already quite advanced and therefore survival is slim. When colon cancer is detected during screening before one develops symptoms, it is often treatable. Unfortunately, polyps, the early stage of cancer of the colon do not produce symptoms and can only be seen by screening. Initially, screening was only recommended for people 50 years and over and those in their 40s with a family history of cancer. However, because of the increased number of younger people diagnosed with colon cancer recently, the age for screening has been lowered to 45 years. A number of screening tests are available:Colonoscopy is the gold standard. It involves a doctor looking at the colon using a tube gadget with a light at its front to illuminate the walls of the colon.
To prepare for the procedure, you will be given medication the day before to help empty and cleanse your bowels. You will be asked not to eat anything in preparation for the procedure. Before the procedure commences, you will be given some medicine to help you relax. The doctor will then ask you to lie on your left side and will gently introduce the colonoscope through the anus and gently push it through the colon. The tube is about half an inch wide and is flexible so that it can bend at the corners of the colon. Air is blown as the tube proceeds through the colon to make the walls of the colon visible.
The doctor looks out for any abnormalities in the colon and if they see any, take a small sample called a biopsy for further examination under a microscope.Fecal occult blood test (FOBT). It is not an invasive test and is done on stool. It tests for the presence of very minuscule quantities of blood in stool that is not visible to the naked eye. Stool is not supposed to have blood so any trace in stool, regardless of the amount is a sign that something is not right. Unlike colonoscopy which often detects polyps before symptoms arise, FOBT detects the very earliest onset of symptoms.
Colon cancer can be treated successfully, especially if detected early. There are things we can do to reduce our risk of developing it and we should try our best to do so. For those over 45 years, it is wise to think about screening.
By Dr. Miriam Laker-Oketta
