Colon Cancer

Colon Cancer: Overview

The colon's importance seems often to be glossed over and patronized by today's mainstream approach, in which the colon is thought of simply as the body's sewer, without regard for its many critical, dynamic biologic functions.  Consequently, rates of death from colon cancer are at an all time high in our country's history.  Colon cancer is now the third most common cancer in the U.S.

Diagnosis and Tests

Laboratory Findings:
  • Biopsy of colonic tumour is necessary for definitive diagnosis.
  • Occult or gross blood in stool.
  • Leukocytosis and increased sedimentation rate indicate inflammation or necrosis of the tumour.
  • Microcytic anaemia, iron-deficiency type, due to chronic blood loss.
  • Decreased serum potassium as a result of potassium loss from mucus-secreting villous tumour of the rectum.
  • Increased serum carcioembryonic antigen – this test is used to monitor the adequacy of treatment and evidence of recurrence.
  • Decreased serum protein reflects protein loss in stool or poor dietary intake.

Treatment and Prevention

Colorectal cancer is one of the most preventable cancers.  No matter what your age, there is a lot you can do to lower your risk of developing it: there are many lifestyle changes that will successfully lower your risk.

The best way to detect colorectal cancer is to have screening tests performed on a regular basis after the age of 50 or sooner if there is a family history of this cancer or if you have had a predisposing condition.  These tests may find non-cancerous tumors, called polyps, that sometimes develop into cancer.  By finding them early and having them removed, you can prevent cancer from ever starting.  Colorectal cancer screening tests include checking a stool sample for hidden blood, sigmoidoscopy, colonoscopy and barium enema.  Talk to a health care professional about which ones may be right for you.

Complications

Complications can include intestinal hemorrhage, peritonitis due to perforation, obstruction of the colon.

Signs, symptoms & indicators of Colon Cancer:

Lab Values - Chemistries

Counter-indicators

Symptoms - Bowel Movements

Bowel movement changes may be a sign or symptom of Colon Cancer Bowel movement changes

In general, you should see a specialist if you are over 40 and have the following symptoms:

  • A change in normal bowel habits towards looser and/or more frequent stools that has lasted for over 6 weeks
  • Any bleeding from the rectum.

Significant red blood in stools may be a sign or symptom of Colon Cancer (Frequent/significant) red blood in stools

In general, you should see a specialist if you are over 40 and have the following symptoms:

  • A change in normal bowel habits towards looser and/or more frequent stools that has lasted for over 6 weeks
  • Any bleeding from the rectum.

Conditions that suggest Colon Cancer:

Symptoms - Cancer

Risk factors for Colon Cancer:

Autoimmune

Ulcerative Colitis often increases risk of Colon Cancer Ulcerative Colitis

Inflammatory bowel disease increases the risk of colon cancer.

Crohns Disease often increases risk of Colon Cancer Crohn's Disease

Inflammatory bowel disease increases the risk of colon cancer.

Diet

Inadequate Fiber Intake may increase risk of Colon Cancer Inadequate Fiber Intake

Low fiber intakes have been strongly linked to an increased risk for developing colon cancer.

Effects of a High Fat Diet may increase risk of Colon Cancer Effects of a High Fat Diet

A connection between high fat consumption and breast and colon cancer (two of the most deadly forms of the disease) has appeared in many studies.

Family History

Habits

Problems Associated With A Sedentary Lifestyle may increase risk of Colon Cancer Problems Associated With A Sedentary Lifestyle

Risk of developing breast and colon cancers is significantly increased in those who spend a lot of time sitting, according to research presented in November of 2011 at the American Institute for Cancer Research.

Infections

Bacterial Dysbiosis may increase risk of Colon Cancer Bacterial Dysbiosis

A putrefaction dysbiosis is accompanied by an increase in fecal concentrations of various bacterial enzymes which metabolize bile acids to tumor promoters.

Medical Procedures

Counter-indicators

Metabolic

Nutrients

Vitamin D Requirement may increase risk of Colon Cancer Vitamin D Requirement

British Medical Journal, January 2010: Those with a higher level of vitamin D in their blood are less likely to develop bowel cancer than those with low levels.  A study has concluded that those with the highest levels of the vitamin were at 40% lower risk of developing the disease compared with those with the lowest levels.  Researchers at the International Agency for Research on Cancer (IARC) in Lyon, France, and Imperial College London looked at vitamin D quantities in 1,248 people with bowel cancer and 1,248 controls in the largest ever study of the subject.

Supplements and Medications

Counter-indicators
Counter-indicators
Frequent/regular aspirin use may decrease risk of Colon Cancer Frequent/regular aspirin use

Aspirin has been found to reduce the risk of colorectal cancer by up to 60%, with researchers finding that 600mg of aspirin per day for 25 months substantially reduces cancer incidence after 5 years in carriers of hereditary colorectal cancer.

Symptoms - Cancer

Symptoms - Food - General

Short-term low-carb dieting may increase risk of Colon Cancer Long-term/short-term low-carb dieting or discontinued low-carb diet

Studies at Harvard and elsewhere involving tens of thousands of women and men showed that regular meat consumption increases colon cancer risk as much as 300%.  [New England Journal of Medicine 323 (1990): p.1664; Cancer Research 54 (1994): p.2390] As one Harvard School of Public health researcher noted, because of the meat content, two years on the Atkins Diet "...could initiate a cancer.  It could show up as a polyp in 7 years and as colon cancer in ten." [Nutrition Action Healthletter January/February 2004: p.1]

Symptoms - Food - Intake

High grilled meat consumption often increases risk of Colon Cancer (Occasional/high) grilled meat consumption

You can increase your cancer risk by eating too much grilled red meat or chicken or even meat pan-fried at a very high temperature.  Meat or chicken that is well-done or burnt appears to be the most problematic.  The worrisome chemicals created by grilling meats are called heterocyclic amines (HAs).  They form during grilling, broiling, or even searing meat in a very hot frying pan – when the very high temperatures break down the amino acid creatinine.  There is also some concern that fats from the meat dripping onto coals create additional chemicals in smoke that may land back on the meat.

It is tragically ironic that after McDonald's CEO apparently dropped dead of a heart attack in 2004, their new CEO was in the operating room with colo-rectal cancer only 16 days later, and died in January of 2005.

A study of 276 patients with colon cancer links well-done red meat colon cancer.  [Carcinogenesis (Vol.  22, No.  10: pp.1681-84)]

(High) processed meat consumption may increase risk of Colon Cancer (High) processed meat consumption

One study has revealed that every 50 grams of processed meat consumed daily increases the risk of colorectal cancer by 50%.

Symptoms - Gas-Int - General

(History of) colon polyps often increases risk of Colon Cancer (History of) colon polyps

Usually cancer of the colon starts with a polyp or growth.  Polyps can be removed long before they turn into cancer by using a colonoscope.  If the polyp has turned cancerous, but is found early, survival rates are excellent.

Colon Cancer suggests the following may be present:

Tumors, Malignant

Recommendations for Colon Cancer:

Drug

Aspirin is highly recommended for Colon Cancer Aspirin

A study published in 2012 followed more than 500 colon-cancer patients in the Netherlands aged 70 and older, over 100 of which were prescribed daily low-dose "baby" aspirin after the cancer diagnosis.  Between 1998 and 2007, the death rate for those prescribed aspirin was about half that of the non-aspirin users, with the greatest benefit occurring among those with more advanced cancer and in those who received no chemotherapy.  [Journal of the American Geriatrics Society, November 23, 2012]

In October of 2012, a study published in the New England Journal of Medicine also showed that aspirin therapy could improve colon cancer survival rates.

Hydrazine Sulfate may help with Colon Cancer Hydrazine Sulfate

See the link between Cancer (General) and Hydrazine Sulfate.

Preventive measures against Colon Cancer:

Botanical

Arabinogalactans may help prevent Colon Cancer Arabinogalactans

The longest recognized use of Larch Arabinogalactan is probably as a source of dietary fiber.  It has been shown to increase the production of short-chain fatty acids, principally butyrate and proprionate.  These special fatty acids are critically important for the health of the colon: Having an adequate supply of these fatty acids is thought to make colon cells more resistant to both tumor promotion and a variety of intestinal disease.

Green Tea may help prevent Colon Cancer Green Tea

Regular and substantial consumption of green tea may provide protective effect against this type of cancer.

Diet

High/Increased Fiber Diet usually prevents Colon Cancer High/Increased Fiber Diet

The Canadian Cancer Society recommends a higher fiber and lower fat diet to help lower the risk of cancer, especially colon and rectal cancers.

Low/Decreased Fat Diet usually prevents Colon Cancer Low/Decreased Fat Diet

There has been much recent research on the relationship between cancer and dietary fat – possibly more than on any other component of the diet.  A connection between high fat consumption and breast and colon cancer (two of the most deadly forms of the disease) has appeared in many studies.  Experts recommend that you consume no more than 20-25% of calories from fat.  That's about half of the fat that most Americans eat.  You should also choose modest amounts of appopriate vegetable oils.

Increased Fish Consumption often prevents Colon Cancer Increased Fish Consumption

Study subjects who ate two or more servings of fish weekly had a much lower risk for esophageal, stomach, colon, rectum, and pancreatic cancers than those who avoided fish.  In fact, the rates of these types of cancer were 30-50% lower among fish eaters.  High fish consumption was also associated with lower risks for cancers of the larynx (30% lower risk), endometrial cancer (20% lower risk), and ovarian cancer (30% lower risk).

Cabbage Family Vegetables often prevents Colon Cancer Cabbage Family Vegetables

Vegetables from the cabbage family (cruciferous vegetables) may reduce the risk of colon cancer.  [The National Cancer Institute booklet, "Diet, Nutrition, & Cancer Prevention: A Guide to Food Choices"]

Alcohol Avoidance may help prevent Colon Cancer Alcohol Avoidance

You should drink under one alcoholic drink a day because drinking alcohol increases your risk of colorectal cancer.  Since it can have both positive and negative effects on your health, you may wish to talk to a health care professional about how alcohol may affect you.

Animal/Saturated Fats Avoidance may help prevent Colon Cancer Animal/Saturated Fats Avoidance

Eat no more than 2-3 servings of red meat per week – the less red meat you eat, the better.  Choose chicken, fish, or vegetarian alternatives such as beans instead.

Increased Fruit/Vegetable Consumption may help prevent Colon Cancer Increased Fruit/Vegetable Consumption

The fiber of choice for prevention of colorectal cancer seems to be psyllium, pectin or guar gum.  The amount of pectin in approximately two servings of fruit rich in pectin such as pears, apples, grapefruit, and oranges is 15gm.  Psyllium or guar gum are obtained by supplement.  The RDA of total fiber is 20-30gm.  In Scotland, where the average fiber intake is 2-3gm per day, there is a very high incidence of colon cancer.

For years, dietary fiber has been promoted by nutrition researchers and practitioners for colon cancer prevention.  However, in two recent studies high-fiber diets did not decrease risks of colon cancer.  The two studies are significant contributions to the literature, but they can not and do not close the discussion.  If anything, they underscore the real need for further research and analysis. 

Both studies, for example, involved only short-term (four-year) adjustments to the diet.  One of them involved the use of wheat bran.  Colon cancer is a disease that can take decades to develop.  Convincing epidemiological evidence suggests that a healthy diet has its greatest preventive effect as a lifelong commitment, not a stopgap measure.  While wheat bran does not appear to provide any protective benefit, a high fruit and vegetable diet may still provide benefit in preventing colorectal cancer.

Dr. Tim Byers, M.D., M.P.H.  from the University of Colorado School of Medicine stated in the same issue of NEJM that "...observational studies around the world continue to find that the risk of colorectal cancer is lower among populations with high intakes of fruits and vegetables and that the risk changes on adoption of a different diet, but we still do not understand why." [NEJM, January 22, 1999, NEJM 342: pp.1149-55, pp.1156-62, 2000.]

Plant-Based Nutrition may help prevent Colon Cancer Plant-Based Nutrition

Diets high in fiber-rich foods may reduce the risk of cancers of the colon and rectum.  [The National Cancer Institute booklet "Diet, Nutrition, & Cancer Prevention: A Guide to Food Choices"]

Milk/Dairy Products may help prevent Colon Cancer Milk/Dairy Products

A long-term high consumption of milk, but not calcium, vitamin D or fermented milk, was associated with a reduced risk of colon cancer in a study of 9,959 men and women aged 15 years or older without history of cancer at baseline who were
followed for 24 years.  [Eur J Clin Nutr 2001, 55(11): pp.1000-7]

In contrast, a massive 2003 study (almost 150,000 subjects) found that increased calcium and vitamin D intake (from supplements) was probably responsible for reduced risk of this cancer [American Journal of Epidemiology 158 (2003): p.621].  Dairy products were found NOT to be protective [Cancer Causes Control 14 (2003): p.1].  Bearing in mind the other negative aspects of dairy product consumption, using multiple vitamin supplements instead may be the better choice.

Drug

NSAIDs often prevents Colon Cancer NSAIDs

Aspirin and other NSAIDs have been previously reported to protect against the development of colorectal cancer.  [Gastroenterology, March 1998]

Habits

Aerobic Exercise may help prevent Colon Cancer Aerobic Exercise

Try to get at least 30 minutes of physical activity every day.

Tobacco Avoidance may help prevent Colon Cancer Tobacco Avoidance

Smoking increases your risk of colorectal cancer.

Hormone

Mineral

Nutrient

Vitamins

Folic Acid often prevents Colon Cancer Folic Acid

Long-term use of a multivitamin containing 400mcg of folic acid, found mostly in leafy green vegetables, beans and nuts, may reduce the risk of colon cancer in women by as much as 75%.  The investigators in one study found that folic acid obtained from dietary supplements had a stronger protective effect against colon cancer than folic acid consumed in the diet.  In other words, although foods naturally high in folate may provide other beneficial micronutrients, consumption of these foods is probably less effective than use of supplements and fortified foods in enhancing folate status.  [Annals of Internal Medicine October 1, 1998;129: pp.517-524]

Multiple Vitamin Supplement often prevents Colon Cancer Multiple Vitamin Supplement

In October of 2003, a massive study of almost 150,000 people was published and found that those who reported they regularly took multivitamin supplements were less likely to be diagnosed a decade later with colon cancer [American Journal of Epidemiology 158 (2003): p.621].  Breaking down the various nutrients, it is thought that perhaps it was the increased calcium and vitamin D intake from supplements that was responsible for the reduced risk [Cancer Causes Control 14 (2003): p.1] Note that dairy products were NOT found to be protective.

KEY

Weak or unproven link: may be a sign or symptom of; may increase risk of
Weak or unproven link:
may be a sign or symptom of; may increase risk of
Strong or generally accepted link: is often a sign or symptom of; often increases risk of; often suggests
Strong or generally accepted link:
is often a sign or symptom of; often increases risk of; often suggests
Definite or direct link: strongly suggests
Definite or direct link:
strongly suggests
Weakly counter-indicative: may decrease risk of
Weakly counter-indicative:
may decrease risk of
Strong counter-indication: often contraindicates
Strong counter-indication:
often contraindicates
Definitely or absolutely counter-indicates: decreases risk of
Definitely or absolutely counter-indicates:
decreases risk of
May be useful: may help with; may help prevent
May be useful:
may help with; may help prevent
Moderately useful: often helps with; often prevents
Moderately useful:
often helps with; often prevents
Very useful: is highly recommended for; usually prevents
Very useful:
is highly recommended for; usually prevents