Colon cancer facts and new research related to it

To mark Colorectal Cancer Awareness Month, Life speaks with a gastroenterologist on how to reduce risks

Rates of colorectal cancer, once considered a disease affecting mainly developed countries with western eating habits, has, since 2008, seen a dramatic rise in Asian countries. “Back in the old days, the number of patients suffering from colon cancer in Western countries was two to four times higher than in Asia,” explained gastroenterologist Dr Thawat Mongkolporn. “But these days the eating habits of people in some countries in Asia, such as Thailand and Japan, has been greatly influenced by western nations. And medical professionals have noted that the higher the consumption of junk food, the higher the incidents of cancer of the colon.”

Colorectal cancer — also referred to as colon or bowel cancer — is the third most common form of cancer among people worldwide after lung and breast cancer, said Dr Thawat, based on statistics compiled in 2012. It is the fourth most common cause of cancer-related deaths after lung, liver and gastric cancer.

In Thailand, colorectal cancer has remained in the top three of the most common cancer types (second among men and third among women). Figures released last year by the Thai Society of Clinical Oncology saw over 11,000 new cases of colon cancer each year and almost 7,000 deaths reported annually.

Chances of falling victim to colorectal cancer increase with old age, meaning those over 50 are at a higher risk of suffering from the disease. Genetic factors have also been found to be responsible for the development of cancer cells. People who have suffered ulcerative colitis — a condition in which the lining of the colon becomes inflamed and develops ulcers — for over eight years are also more likely to have cancer of the colon if left unattended.

One of the most significant risk factors, however, is people’s poorer eating habits, stressed Dr Thawat.

“Medical studies have found evidence to support the hypothesis that colorectal cancer is associated with what people eat,” the specialist noted. “After World War II, a large number of Japanese people relocated to the US. At first, it was found that incidents of colon cancer among these Japanese was quite slow — pretty much the same as people in other Asian countries. But later, among the second generation of these Japanese Americans, it was found that with the change of eating habits (American diets), the occurrence of colon cancer became noticeably higher.”

Lack of exercise, lack of vitamin D, as well as excessive consumption of alcohol and cigarettes also escalate the risk of colorectal cancer. But, according to Dr Thawat, diets that are high in fat and meat, yet low in fibre are mostly to blame when it comes to the malignancy.

“Age and genetics are uncontrollable risk factors,” commented the specialist. “But the one thing you can control is how you eat and live your life.”

One of the reasons people still suffer from colorectal cancer, despite the availability of state-of-the-art screening technologies is because the cancer cells are not detected early enough. This is especially true in Thailand, where patients are often diagnosed with the malignancy when the cancer is already into an advanced stage. Considering the spectrum of colon cancer symptoms is quite broad — blood in stools, irregular bowel movements, loss of appetite, sudden weight loss, to no symptoms at all — early screening is key.

Those above the age of 50 with a family history of cancer who are experiencing signs of colorectal cancer will first be advised to have fecal occult blood examination to detect if there is any blood in their stool. If there is, then they will likely be required to undergo sigmoidoscopy or colonoscopy, depending on the severity, to see the inside of the colon and rectum to discover if there are tumours.

“If the cancer is detected in its early stages, then surgery can be performed to remove the tumours. It’s completely curable. However, chemotherapy might be necessary for later stages of the disease. For cases that have progressed to a more advanced stage, where cancer cells have spread to nearby organs, palliative care will be put into practice. This is why medical experts keep stressing the importance of early screening,” he advised.

Changing one’s eating habits are crucial. Cutting down on junk food and sticking to the way our ancestors eat is probably one of the easiest, yet effective, ways of preventing colon cancer.

“Think of how people lived their lives in the past,” the doctor said. “They woke up early and went out to their rice field exposing themselves to sunlight. They ate simple diets — like rice, boiled or steamed vegetable with chilli paste. They went to bed early. And they lived long. Such a lifestyle was the secret to their longevity. So, besides screening, the best prevention is to eat healthy — less fat, less meat and higher fibre.”

Age and genetics are uncontrollable risk factors, but the one thing you can control is how you eat and live your life

Go Blue Stop Colon Cancer is a colorectal cancer awareness campaign, running through March at Samitivej Hospitals. Go Blue lapel pins are available at 100 baht each at customer service counters and cashiers at Samitivej Sukhumvit and Samitivej Srinakarin Hospitals. All proceeds will be donated towards providing free sigmoidoscopy for the underprivileged, with a high risk of colorectal cancer, nationwide.