The news of Chadwick Boseman’s death to colon cancer left our whole house reeling and longing for something to ease the pain or distract us or both. We spent the whole night watching reruns, using Marvel’s Black Panther and a collection of Boseman’s other movies as a distraction. But distractions only last for so long. True comfort was found in talking about colon cancer risks, testing and prevention.
What is the colon?
The colon is a part of the digestive system with “five parts, each of which absorbs water and nutrients, solidifies stool, and moves waste toward the rectum.”1 In healthy people, the colon looks like a U-shaped tube and its main role of “is to process indigestible food material. As we eat, the small intestine digests and absorbs [most] of the nutrients that will become fuel. What remains then passes to the colon.”2 According to the Cleveland Clinic the colon is made up of five parts beginning with the Cecum, which receives digested food waste from your small intestine and moves it along to the ascending colon, and ending with the sigmoid colon, which is responsible for “turning food waste into a solid mass that resembles the poop that you typically see in your toilet bowl.”2
Together these parts “work to process food waste (feces) and move that food waste to your rectum.”3
What is colon cancer? Why is it dangerous?
Colon cancer is a type of cancer that forms in the colon. According to the Cleveland Clinic4 it is often the result of the development of certain “polyps or growths in the inner lining of your colon,” which left undetected or untreated can become cancerous and spread to other areas of the body. In addition, the Mayo Clinic notes that “Colon cancer usually begins as small clumps of cells called polyps that form inside the colon,” and while polyps generally aren’t cancerous, some can turn into colon cancers over time.”5
Detection: Symptoms
According to the Mayo Clinic, while the presence of polyps often don’t cause symptoms, and “many people with colon cancer don’t have symptoms at first,” there are several symptoms that may indicate a problem. These symptoms include:
- A change in bowel habits, such as more frequent diarrhea or constipation.
- Rectal bleeding or blood in the stool.
- Ongoing discomfort in the belly area, such as cramps, gas or pain.
- A feeling that the bowel doesn’t empty all the way during a bowel movement.
- Weakness or tiredness.
- Losing weight without trying.5
Detection: Screenings
Screenings are an important part of detection and prevention because some patients with colon cancer may be asymptomatic, and some symptoms may not appear in patients until after the development and progression of polyps. Regular screening tests, such as colonoscopies, are used by doctors to look for the presence of polyps in the colon. A colonoscopy is “an examination of the inside of your large intestine (colon). It’s helpful for diagnosing gastrointestinal diseases, such as inflammatory bowel disease and colon cancer.”6 In addition to looking for the presence of polyps, procedures can be performed during the colonoscopy to inspect the health of the colon and remove any polyps that are found as a method to prevent colon cancer.
While the colonoscopy is the most common form of screening, the Cleveland Clinic notes that blood tests, such as the fecal immunochemical test (FIT), which tests for hidden blood in your poop may be used. Additional tests that may reveal genetic or physical signs of cancer include DNA tests, virtual colonoscopy, DNA tests, and other blood tests.
Risk Factors
Different cancers have different risk factors and simply having a risk factor, whether environmental, habitual or genetic, does not mean that you will develop colon cancer or even develop polyps within the colon. But, it is important to know and understand your risk factors so that you can be proactive in prevention. According to the American Cancer Society7 the most common risk factors for colon cancer include:
- Age. It is more common after age 50, however, younger adults can get it. Colorectal cancer is rising among people who are younger than age 50, and the reason for this remains unclear.
- Your racial and ethnic background. American Indian and Alaska Native people have the highest rates of colorectal cancer in the United States, followed by African American men and women. Jews of Eastern European descent (Ashkenazi Jews) have one of the highest colorectal cancer risks of any ethnic group in the world.
- Sex at birth. Men who have colorectal cancer are more likely to die from it than women.
- Cholecystectomy. People who have had their gallbladder removed (cholecystectomy).
- Family or personal history of colorectal polyps or colorectal cancer. If you have a history of polyps (adenomas), you are at increased risk of developing colorectal cancer. This is especially true if the polyps are large, if there are many of them, or if any of them show dysplasia.
- If you’ve had colorectal cancer. If you’ve previously had colorectal cancer, even though it was completely removed, you are more likely to develop new cancers in other parts of the colon and rectum.
- A personal history of inflammatory bowel disease. If you have inflammatory bowel disease (IBD), including either ulcerative colitis or Crohn’s disease, your risk of colorectal cancer is increased.
Research into other risk factors is ongoing, which further underscores the importance of regular and preventive screenings.
Treatment
If colon cancer develops, many treatments are available that can help control it. The course of treatment will depend on the stage of colon cancer, the location, and other risk factors. The treatments include medicines, radiation and chemotherapy therapy, targeted therapy, immunotherapy options, and surgery. According to the Cleveland Clinic, new treatments are continuously developed, but at the time of this article, surgery remains the most often recommended course of colon cancer treatment. Even among surgical options, there are different colon cancer surgeries and procedures including:
- Polypectomy: This surgery removes cancerous polyps.
- Partial colectomy: This surgery removes the section of your colon that contains a tumor and some surrounding healthy tissue, and reconnects healthy colon sections in a procedure called anastomosis.
- Surgical resection with colostomy: In this surgery, surgeons remove the section of the colon with the tumor, and your bowel is moved to an opening in your abdominal wall so your poop is collected in a bag.4
Your doctor and oncology team can help you discuss the best option for your particular stage of cancer and how aggressive it has grown.
Prevention:
Julie Wilkinson, BSN, RN in an article on colon health explains that “colon health depends on several lifestyle factors, including lifestyle decisions about diet, exercise, smoking, and excessive alcohol use.” Wilkinson recommends “following a healthy lifestyle and routine colonoscopy screenings” to help prevent and detect cancer, noting that “early detection saves lives.” The Mayo Clinic and Cleveland Clinic also concur with Wilkinson by recommending that people take the following preventive steps:
- Eating a healthy diet
- Getting regular screenings
- Limit red meat and highly processed foods
- Increase fruits and vegetables
- Increasing diet and exercise
- Maintain a healthy weight
- Stop smoking
- Keep Track of Family History
Conclusion
Colon cancer has risen to the third most common cancer diagnosed in the U.S. When detected early, it can be prevented and treated. Healthcare providers and oncologists recommend routine colonoscopies for middle-aged and older adults to screen for cancer, beginning at age 40 for minorities and 50 for non-minorities. Through colon cancer screening, healthcare providers are able to catch and treat colon cancer before it causes symptoms, which means they are also able to begin treatment before it spreads. Recent survival rate data, according to the Cleveland Clinic, “show that more than 90% of people treated for early-stage colon cancer were alive five years after diagnosis.”5 Other sources provide survival rates based on diagnosis stage. While 90% of early treatments result in fewer deaths, the mortality rates decline significantly for later stages.
So, be sure to get screened and make sure you are addressing the risk factors and prevention techniques to reduce and eliminate your risk of colon cancer.
Sources
- Colon anatomy: Pictures, features, and function
- Where Is the Colon Located? And How It Works
- Large Intestine & Colon: Function, Anatomy & Location
- Colon Cancer: Symptoms, Stages & Treatment
- Colon cancer – Symptoms and causes – Mayo Clinic
- Colonoscopy: Prep & Procedure Details
- Colorectal Cancer Risk Factors | Hereditary Colorectal Risk Factors | American Cancer Society
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