March is a very important month for many of us, not just because of St. Patrick’s day, the arrival of Spring and Doctor’s day but because it is colon cancer awareness month. The war on cancer was officially declared by Richard Nixon in 1971 but the tools to prevent and cure cancer were not as prevalent then as they are now. Since that time, tremendous strides have been made in the early detection and prevention of colon cancer. While colon cancer is a serious disease, if it is detected early in the first stage, it can have a greater than 90% survival rate but an undetected cancer that has spread may have a less than 5% survival. The proper application of diagnostic tools can lead to the eradication of colon cancer and prolonged survival.
Colorectal cancer is the third most common cause of cancer in the United States and affects both men and women. The disease is very well understood and the formation of colon cancer can be traced along a very well defined pathway. While genetic mutations play a large role in the formation of colon cancer, only about 20% of the colorectal cancers are usually genetic, with the remaining cases developing as a result of several factors, including diet, environment, toxins and inflammatory conditions. The overwhelming majority of cancers will start as an adenomatous polyp that will continue to grow and spread into a colorectal cancer. This well defined progression from polyp to cancer forms the basis for preventative screening as the predictive nature of the disease allows for a cure by removal or pre-cancerous polyps that would otherwise invariably lead to colon cancer.
Increasing age, alcohol use, tobacco use, low fiber intake, increased red meat intake and genetics all play a role as risk factors for colon cancer. Since we know that colon cancer starts as a polyp and develops in a particular way, it is easy to establish a protocol for early detection. Colonoscopies done by age 50 will allow polyps to be detected and removed. A strong family history may necessitate undergoing a colonoscopy prior to age 50 but this is based on history and other factors. Colonoscopies may be repeated every 1, 3, 5 or 10 years depending on what is found. In the interim, a noninvasive test called a hemmocult can be done yearly to detect blood in the stool. If the test is positive, it may act as an early warning side for a polyp in the colon that may be bleeding. Both of these diagnostic tools are extremely important in detecting colon cancer.
Aside from the importance of a colonoscopy to detect cancer early, a healthy lifestyle and avoidance of high risk behaviors can prevent the formation of cancer in the first place. Minimizing red meat, burnt food high in charcoal and carbon content, avoidance of smoking and alcohol all can be used in prevention. Some studies have suggested calcium, aspirin and other anti-inflammatories may interrupt the progression of a polyp to cancer, while others recommend high fiber diets and exercise. A multi-faceted approach is needed to prevent colorectal cancer. Remember, be good to your colon and it will be good to you.