How can we prevent colorectal cancer?

How can we prevent colorectal cancer?

How common is colorectal cancer? How does it start? Can we prevent it?

Colorectal cancer (CRC) means colon cancer and rectum cancer. Colon means the large intestine that contains stool, and the rectum is the last part of it. CRC is the third leading cause of cancer-related death in both men and women in the world. But it is preventable because it commonly arises from a polyp and if you do a colonoscopy and a polyp is found, by removing the polyp you can just stop to start cancer. Even though cancer has already started, it is highly curable if detected in its early stages. About 1 in 20 Americans develop colorectal cancer in their lifetime. Colorectal polyps affect about 20% to 30% of Americans. But there is no population data in our country.

What is the chance of curability in different stages? What should we do to prevent colorectal cancer?

The fallacy or irony of fate is that polyp and early cancer do not produce any significant symptoms; that is enough to bring a person to a doctor or a colorectal surgeon. So cancer advances day by day from stage 1 to stage 4. The curability of stage 1 is near about 100% but the curability of stage 4 is almost zero. The five-year survival rate of stage 2 is 80 percent and stage 3 is 65 percent. In spite of all treatment modalities; the median survival of stage 4 disease is 18 months only. So, to avoid colorectal cancer-related death, you have to do screening tests. That means even though you have no symptoms of colorectal cancer, you have to go to an expert colorectal surgeon who does the colonoscopy test routinely and regularly. In western countries, colorectal cancer begins at the age of 55 to 60. To develop cancer through a polyp usually takes 6 to 10 years. That’s why they start doing full colonoscopy at the age of 45 to 50 and continue it every 10 years. But in our country colorectal cancer starts 5 to 10 years earlier than the western countries. Moreover, stomach cancer is also as common as colorectal cancer in our country. That’s why we suggest starting endoscopy of upper GIT and full colonoscopy at the age of 40 and doing it every10 years up to the age of 70. That means everybody should do both the procedure at age of 40, 50, 60, and 70 years. We do both tests under sleep and you will not able to remember when the test has been done so easily. In the intervening years (each year) you should do only a stool test named as stool for OBT (occult blood test). If OBT becomes positive, that means possibly you already developed a polyp; to check it and if found to remove it you should do an extra full colonoscopy in that year.

Do food habits and lifestyle matter?

There is some evidence that diet may play a significant role in colorectal cancer. Take a diet that is high in fiber and low in fat such as Isperghul/ Isobghul, whole grains, fruits, vegetables, ripen wood apple/ Paka bel. Try to avoid processed meats, preserved food, and chemical fertilizers.   Completely avoid textile colours in food. As you don’t know whether food producers used food colour or textile colour, it is better to avoid all food mixed with artificial colour. Completely avoid smoking and alcohol. These measures may help you and your family from colorectal cancer and many other cancers.

Risk factors of CRC:

Cancer occurs due to certain changes in gene/ chromosome/ DNA. The following factors can increase the risk of colorectal cancer.

·        Age: 90% of the people diagnosed with colorectal cancer are over the age of 50.

·        Family history of colorectal cancer (especially parents or siblings)

·        Personal history of Crohn’s disease or ulcerative colitis for ten years or longer

·        Personal and family history of colorectal polyps

·        Personal history of breast, uterine, or ovarian cancer

Colorectal cancer symptoms (You must visit a colorectal surgeon with these symptoms):

Colorectal cancer is usually asymptomatic in its early stages and is detected during routine screenings. Colorectal cancer symptoms include:

·        A change in bowel habits:  constipation, diarrhea, frequency of the bowel movements

·        Narrow/smaller shaped stools

·        Bright red or very dark blood in the stool

·        Ongoing abdominal or pelvic pain and bloating

·        Unexplained weight loss

·        Nausea or vomiting

·        Feeling tired all the time

It is important to note that other common health problems can cause some of the same symptoms. For example, hemorrhoids are a common cause of rectal bleeding but do not cause colorectal cancer. Abdominal pain and weight loss are typically late symptoms, indicating possible extensive disease. Anyone who experiences any of the above symptoms should see a colorectal surgeon as soon as possible.

Which Doctor is best for sceening, prevention and treatment of colorectal cancer?

The colorectal surgeon is best for screening, preventing, and treatment of colorectal cancer.

Who is a colorectal surgeon?

A colorectal surgeon should have an MS degree on Colorectal Surgery &/or is the faculty of Bangabandhu Sheikh Mujib Medical University (BSMMU). He/she has huge knowledge, expertise, and experience in this field enough to do both medical and surgical treatment. There are very few colorectal surgeons in Bangladesh. A colorectal surgeon can provide you with the best treatment for piles (hemorrhoid), colon cancer, rectum cancer, Anal cancer, fistula, abscess, anal fissure, rectal prolapse, incontinence, constipation, chronic dysentery, abdominal pain, IBS, ulcerative colitis, Crohn’s disease, tuberculosis, polyps, vomiting, abdominal gas, per rectal bleeding, anal pain, pilonidal sinus, obstructed defecation (ODS), rectocele, rectal intussusception, pelvic floor descend. He/she can do a colonoscopy, LASER Surgery, Laparoscopic surgery, rubber band/ring ligation, injection sclerotherapy, Longo, STARR, rectopexy, fistula surgery, Colon/rectal/anal cancer treatment, APR, Anterior resection, colectomy, etc with a better outcome than other specialists.

Peter Jefferson

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