COLORECTAL CANCER

The colon refers to the large intestines, while the rectum is the lowest part of these intestines near the anus. Although this type is one of the leading causes of cancer-related deaths, it can be cured if caught early.

Who is at risk?
The following have a higher risk of developing colorectal cancer: Older people [especially above 60 years] People who have regular diets rich in fats and red meat. Diets rich in vegetables and whole grain cereals and breads protect against cancer of the colon. People with cancer in other parts of the body such as the breast, uterus, ovary, or other parts of the colon. Those with a family history of breast or colon cancer. People with inflammatory bowel disease. Those with polyps of the colon [swellings in the colon]. Smokers. Those who drink alcohol.

Symptoms and signs

If you have colon or rectal cancer, you may experience the following, although in early cancer one may have no symptoms: Blood in the stool. Changes in bowel habits such as diarrhoea, constipation. Thin/narrow stool. Abdominal pain. Weight loss. Abdominal discomfort.

Diagnosis
Diagnosis is made by colonoscopy or proctoscopy. This involves placement of a scopea device with a light and camerainto the colon or rectum to visualise the inside of the intestine. This enables the doctor to see [and even remove or take a biopsy] of any abnormal growth. Alternatively, one can do a barium enemaa procedure that introduces dye into the colon, and then an x-ray done to visualise the lumen or hollow of the intestine. Abnormalities, including masses, can be detected this way, although colonoscopy is a more accurate method. If suspicious tissues are found during colonoscopy, a biopsy is taken which is examined in the lab to look for cancer cells.

Other tests are carried out to determine the stage of the disease by assessing for spread to surrounding and distant tissues. These may include abdomino-pelvic ultrasound scans, chest x-rays and CT scans. They may also carry out blood tests to look for tumour markers.

Treatment
Treatment may entail surgery, chemotherapy, or radiotherapy or a combination of these methods. Largely, the stage of the disease will determine the mode of treatment. Your doctor will advise on the best method depending on your condition. The doctor will also monitor your response to treatment and look for ant recurrence using tests such as blood tumour marker tests.

Prevention
To reduce the risk of developing colorectal cancer, one should focus on minimising the risk factors that can be modified, including avoiding smoking, alcohol, reducing fat and red meat in your diet, and eating more fibre-rich foods such as fruits, whole cereals, and vegetables. In addition, regular screening can detect either early cancer, which may be curable, or it may detect pre-cancerous polyps, which can be removed through colonoscopy to prevent advancement to cancer. Precancerous polyps do not yet have cancer, but are likely to develop it with time. Screening is recommended for those over 40, and more so those at higher risk. Screening may entail: Digital rectal examinationwhere the doctor uses a finger to feel for any abnormalities in the rectum. Stool test for occult bloodthis may detect even minute bleeding. Colonoscopy is recommended every three to five years at the age of 50 and above [for people who have a relative with colon cancer, screening needs to start much earlier than the age at which the relative was diagnosed with cancer]. It will also be recommended if the digital examination or occult blood is suspicious. Barium enema may also be carried out if the digital examination or occult blood test were abnormal.

It is important to note that regular screening and modification of diet habits can prevent development of cancer or result in early detection. Detected early, colorectal cancer is usually curable.