Cancer and Healthy

Cancer of the colon and/or rectum is the second leading cause of cancer death in the United States. Fortunately, colon cancer is usually slow-growing and screening tests can detect it before it spreads.

There are several main risk factors for colorectal cancer, including:

• History of the disease in a close family member
• Previous occurrence of the disease or a history of precancerous colon polyps
• Personal history of inflammatory bowel disease
• Rare genetic mutations
• Race: Blacks have a higher incidence of colon cancer than other racial groups and a lower survival rate

What are the symptoms of colon cancer? The main symptoms include:

• A change in bowel habits
• Narrow, pencil-thin stools
• Rectal bleeding or blood in your stool
• Persistent abdominal discomfort
• A feeling that your bowel doesn't empty completely
• Unexplained weight loss

The American Cancer Society recommends colonoscopy beginning at the age of 50 for people at average risk of the disease. If you have a personal or family history of the disease, or if you are African-American, your doctor may recommend earlier and/or more frequent screenings. There are a number of screening tools available, including barium enema, sigmoidoscopy, fecal occult blood test (which detects hidden blood in the stool), colonoscopy and virtual colonoscopy.

Colonoscopy is currently the test of choice for colon cancer screening. It allows the doctor to view the entire colon and remove polyps or take tissue samples from suspicious areas.

Fortunately, there are steps you can take in your everyday life to reduce your risk of colorectal cancer. Make sure you:

• Eat plenty of fruits, vegetables and whole grain foods. These foods contain nutrients, fiber and antioxidants that may play a role in cancer prevention. Aim for five or more servings of fruits and vegetables every day and include a variety of them in your diet.
• Limit fat consumption, especially saturated fat. Saturated fats are mainly from animal sources, although the tropical oils - coconut, palm and palm kernel - are highly saturated fats.
• Eat a varied diet. While studies haven't proven conclusively that you can totally prevent colon cancer, there is evidence that certain vitamins and minerals reduce the risk. Vitamins and minerals linked to lower incidence of colon cancer are vitamin-B6, calcium, folic acid and magnesium. It certainly makes sense to enhance your diet with a wide variety of nutritious, low-fat foods.
• Limit alcohol consumption. Men should have no more than two drinks per day, women no more than one drink a day. A drink is defined as 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of 80-proof liquor.
• Stop smoking. If you're struggling with quitting, talk to your doctor. There are effective medications that can assist you in your efforts.
• Stay physically active and maintain a healthy weight. Talk to your doctor before starting an exercise program. The current recommendations call for at least 30 minutes of moderate activity at least 5 days a week.

There is some evidence that certain medications can reduce risk of colon cancer. However, there is currently not enough evidence to recommend these medications for people who have an average risk of colon cancer. If you have an increased risk of the disease, you might discuss the benefits vs. risks of these medications, including:

• Aspirin. There is some evidence linking reduced risk of colon polyps and cancer to regular aspirin use. However, it seems that this isn't true for low-dose aspirin or short-term use. It may be that it would take large doses over a prolonged period to have a beneficial effect, but using aspirin in this manner may cause other problems, such as gastrointestinal bleeding and ulcers.
• Nonsteroidal anti-inflammatory drugs other than aspirin. These drugs include ibuprofen (Advil, Motrin and others) and naproxen (Aleve, others). Some studies have indicated NSAIDs may reduce the risk of polyps and cancer, but side effects include ulcers and gastrointestinal bleeding. Some NSAIDs have been linked to increased risk of heart problems.
• Celecoxib (Celebrex). These drugs are known as COX-2 inhibitors and they work similarly to the NSAIDs for pain relief. Some evidence suggests they may reduce the risk of precancerous polyps in people who have been diagnosed with these polyps in the past. However, COX-2 drugs carry a risk of heart problems and two COX-2 inhibitor drugs were removed from the market because of this.

Many people are embarrassed about the screening required for colorectal cancer or worried about discomfort from the procedure. Don't let this stop you from undergoing these tests - it might just save your life.