All you need to know about colorectal cancer
Rapid urbanization and adoption of western culture have led to many lifestyle diseases that Indians have never faced before. Colorectal Cancer (CRC) is one such disease that can be attributed to the negative impact of changing lifestyle and food habits. It is often called a ‘western lifestyle disease’. Consumption of tobacco, alcohol, a diet high in processed meat &low in fiber, Obesity, and low physical activity are common causes of Colon Cancers.
Colon cancer prevalence in India: Colorectal Cancer is the 3rd most common Cancer in world, with over a million new cases added every year. In India, over 50,000 new Colorectal Cancer cases are detected every year, and this number is rising at an alarming rate of over 20% each year! Between men and women, the ratio of Colorectal Cancer stands at 4.4 and 3.9 per 1,00,000 respectively. As per the Cancer Registry data of the Mumbai region which also reflects a trend across India, it is the 10th & 8th most common cancer in men and women respectively. As compared to the western world where CRC is the 3rd most common Cancer, India has a lower incidence of CRC, but by virtue of the population of over one billion and accounting for the unreported & misdiagnosed cases the statistics are quite alarming. In India, projected number of new cases of CRC by 2025 would about 83, 000 cases. This can be attributed to rapid urbanization and adoption of western lifestyle.
What is Colorectal Cancer?
Colon is part of our digestive system. As the food keeps passing along the digestive tract, nutrients within it get absorbed. The Colon which is also called as Large Intestine turns the liquid form of unused food into solid by absorbing water, which is expelled as feces or stool. CRC is a disease in which Cancer cells form in the tissues of the Colon or the Rectum. Our body has around 30 trillion cells which have pre-programmed rules governed by our genes about how to behave. In simple words, Cancer cells have psychopaths within, they defy all these rules and multiply fast, grow out-of-control, invade nearby structures of our body, and can spread to a distant location within the body in late stages to form a new tumor.
What are the sign and symptoms?
Generally, it is seen in a population above age of 45, with complaints of changes in bowel habits like repeated history of constipation or diarrhea, bloating, the passage of blood or mucus in the stool, unexplained weight loss, easy fatiguability, pain or swelling in the abdomen or drop in Hemoglobin levels, during routine investigations. Persons with a strong family history of CRC may have these features in their twenties even. In around 20% of the cases, patients first present with advanced disease with bowel obstruction and have to undergo an emergency surgery.
What are the risk factors of delayed diagnosis?
Compared to other digestive Cancers, CRC relatively has far better prognosis, still early diagnosis is of utmost importance for cure from Cancer. Lack of awareness about the significance of these symptoms, seeking late help from the doctor, ignorance about own family history of Cancer, remote access to certain diagnostic modalities and health expertise in rural areas are the main reasons for its late diagnosis. Very often it could be a sign or symptom, such as change in stool color to red or black, which should be immediately consulted about. At times, bleeding from the rectum is assumed to be due to common ailments like Piles by the patient, and even treatment from quacks is sought till late stages of Cancer. CRC itself and as a part of some other diseases (Cancer Syndromes) can run along the familial lineage. It is of crucial importance to know who in our relations has had what disease at what age, and the exact relationship with him or her, as it helps in risk stratification and recommendation for screening for CRC.
Early screening is a must for early detection: Among the multiple screening methods, the most important is recommending a Colonoscopy at the age of at least 45, for the average-risk population. Patients having a family history of CRC or those showing sign/ symptoms as mentioned above should seek early Colonoscopy after discussion with your doctor. The frequency of repeat Colonoscopy will be decided in accordance with patient’s age, family history and findings of the first Colonoscopy.
Lifestyle modification can be effective tool for prevention: Lifestyle modification can be an important adjunct to screening. Avoiding risk factors and adopting certain protective measures can be of great help. Avoid smoking and alcohol consumption which are carcinogenic. Studies also suggest that avoiding high-calorie foods, red and processed meat also reduce the risk of CRC, perform regular physical exercise with moderate intensity (for at least 30 minutes), and maintain healthy body weight to minimize the chances of CRC. One should eat a diet having vegetables, fruits and whole grains which are high in fiber. High fiber diet not only reduces the risk of CRC, but also of Heart Diseases.
