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Thursday, July 17, 2025

Colon Cancer: Does Early Screening Save Lives?

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1774 days ago
20200908

HEALTH PLUS MED­ICAL COR­RE­SPON­DENT

“All I ex­pe­ri­enced was gen­er­al­ized fa­tigue, but be­ing a sleep-de­prived fa­ther of a new ba­by, I thought that was nor­mal,” shares a male pa­tient di­ag­nosed with Colon Can­cer at 31 years of age. On try­ing to do­nate blood for his wife, who re­cent­ly de­liv­ered their beau­ti­ful ba­by girl, a red flag came up. His haema­to­log­i­cal analy­sis re­vealed low­er than nor­mal iron lev­els and his blood count fell in the Anaemic range. Luck­i­ly, his physi­cian in­sist­ed up­on screen­ing for Col­orec­tal Can­cers and a colonoscopy was one such test.

Fol­low­ing this test, the young fa­ther was di­ag­nosed with Stage 4 Colon Can­cer. “It was a dev­as­tat­ing blow to us,” said this young, male pa­tient. “I had a fam­i­ly his­to­ry, so I knew it was pos­si­ble and was ex­pect­ing it in my fifties, but I thought I had time. I am 31.”

An­oth­er such case, a 35-year-old moth­er of two com­plained to her health care physi­cian of feel­ing nau­se­at­ed all the time. She was di­ag­nosed with ir­ri­ta­ble bow­el syn­drome and giv­en med­ica­tion for de­pres­sion.

Still, the nau­sea per­sist­ed. An­oth­er di­ag­no­sis of a stom­ach virus fol­lowed with treat­ment, but her nau­sea con­tin­ued. A colonoscopy to test for col­orec­tal can­cer re­vealed what re­al­ly ailed her. She had stage 3 colon can­cer. This pa­tient had no such fam­i­ly his­to­ry and was not ex­pect­ing such a di­ag­no­sis ever in her life­time.

Re­cent­ly, the world said good­bye to ac­tor, Chad­wick Bose­man who played King T’Chal­la in Black Pan­ther and base­ball leg­end Jack­ie Robin­son in 42. He was di­ag­nosed in 2016 at the age of 39 years.

His pri­vate strug­gle and trag­ic death from Colon can­cer at the age of 43 has been es­pe­cial­ly jar­ring to the med­ical com­mu­ni­ty, as it high­lights an alarm­ing trend.

Col­orec­tal can­cer, which caus­es tu­mours in the colon and rec­tum, most com­mon­ly af­fects peo­ple who are 50 and old­er. But ex­perts have been trou­bled by the grow­ing body of re­search show­ing a steady rise in the num­ber of young peo­ple di­ag­nosed. While col­orec­tal can­cer screen­ing with colono­scopies be­gin­ning at the age of 50 has un­doubt­ed­ly saved lives, col­orec­tal can­cer re­mains a preva­lent and chal­leng­ing dis­ease. In the next 15 years, more than one in 10 colon can­cers and a quar­ter of all rec­tal can­cer cas­es will be di­ag­nosed in pa­tients younger than the tra­di­tion­al screen­ing age of 50, re­port­ed by re­searchers at Har­vard Health.

Ad­di­tion­al­ly, ac­cord­ing to a March 2020 re­view from the Amer­i­can Can­cer So­ci­ety, the rate of col­orec­tal can­cer among peo­ple younger than 50 has been in­creas­ing in re­cent years. In 2018, the ACS changed its guide­lines to ad­vise per­sons to start reg­u­lar­ly screen­ing for col­orec­tal can­cer at 45, five years younger than the age pre­vi­ous­ly rec­om­mend­ed. Peo­ple who are more at risk be­cause of an in­flam­ma­to­ry bow­el dis­ease or fam­i­ly his­to­ry of col­orec­tal can­cer should be­gin even ear­li­er.

Dr David Ram­say, a US based gas­troen­terol­o­gist said he’s seen sev­er­al pa­tients in their 30s with col­orec­tal can­cer over the past two years. “In the past, if a younger pa­tient had rec­tal bleed­ing, a doc­tor might have dis­missed it as a case of he­m­or­rhoids,” Ram­say said. “Now, if there’s any red flag like that, a pa­tient needs to see a gas­troen­terol­o­gist.

Col­orec­tal Can­cer is the third most com­mon can­cer in Trinidad & To­ba­go; (12%) in men and women (11%). For the US, it is the sec­ond lead­ing cause of can­cer deaths, ac­cord­ing to the Cen­ters for Dis­ease Con­trol and Pre­ven­tion. In 2014, an es­ti­mat­ed 136,830 new cas­es were di­ag­nosed with 50,310 deaths at­trib­uted to the dis­ease.

It’s al­so pre­ventable, treat­able and beat­able if it’s caught ear­ly through screen­ings for and re­moval of polyps be­fore they be­come can­cer­ous. The Amer­i­can Can­cer So­ci­ety says that half of all colon can­cer deaths a year could be pre­vent­ed if every­one old­er than 50 got screened.

This lack of aware­ness and ear­ly screen­ing is a prob­lem, ex­perts say — one that is be­lieved to be a ma­jor rea­son col­orec­tal can­cer is usu­al­ly not caught in young peo­ple un­til the dis­ease has ad­vanced in­to lat­er stages where sur­vival rates are much low­er. Ac­tor Chad­wick Bose­man was di­ag­nosed in 2016 with Stage 3 colon can­cer, which pro­gressed to Stage 4 be­fore his pass­ing on Au­gust 28. “It’s an ab­solute tragedy,” said William Can­ce, the Amer­i­can Can­cer So­ci­ety’s chief med­ical and sci­en­tif­ic of­fi­cer. “To think that he is gone at 43 from a pre­ventable death is so sad. He was in great shape, with no lifestyle re­lat­ed risk fac­tors so clear­ly there’s some­thing else, and what that is, is an ac­tive area of re­search.”

Here’s how ex­perts say we — both pa­tients and doc­tors — can work to pre­vent deaths from colon can­cer.

Know the Symp­toms, Nor­mal­ize the Con­ver­sa­tions

Not many pa­tients feel com­plete­ly com­fort­able talk­ing about the symp­toms as­so­ci­at­ed with col­orec­tal can­cer, even dur­ing doc­tors’ vis­its, said Can­ce, a sur­gi­cal on­col­o­gist.

“You’re talk­ing about chang­ing bow­el habits,” he said. “I have blood in my stool. I’m con­sti­pat­ed to­day and then I have di­ar­rhoea to­mor­row.’ It’s so per­son­al.”

That ret­i­cence to dis­cuss symp­toms may play a role in de­layed di­ag­no­sis as there is sig­nif­i­cant em­bar­rass­ment as­so­ci­at­ed and stig­mas that come with it.

Can­ce urges health care providers to in­cor­po­rate ques­tions about bow­el symp­toms in­to their rou­tine con­ver­sa­tions with pa­tients, so peo­ple don’t have to wres­tle with bring­ing up the sub­ject them­selves, treat­ing bow­el symp­toms as com­mon like a flu, a cough or a rash maybe. In nor­mal­iz­ing dis­cussing bow­el symp­toms, red flags won’t be missed.

Col­orec­tal can­cer risk fac­tors you can change

Many lifestyle-re­lat­ed fac­tors have been linked to col­orec­tal can­cer. In fact, the links be­tween di­et, weight, and ex­er­cise and col­orec­tal can­cer risk are some of the strongest for any type of can­cer. Many stud­ies have found a link be­tween red meats (beef, pork, and lamb) or processed meats (such as hot dogs, sausage, and lunch meats) and in­creased col­orec­tal can­cer risk. Sim­i­lar­ly, stud­ies show a high­er risk of col­orec­tal can­cer with in­creased al­co­hol in­take es­pe­cial­ly among men.

When to see a doc­tor

Many peo­ple with colon can­cer ex­pe­ri­ence no symp­toms in the ear­ly stages of the dis­ease. When symp­toms ap­pear, they'll like­ly vary, de­pend­ing on the can­cer's size and lo­ca­tion in your large in­tes­tine.

See a doc­tor if you no­tice any per­sis­tent symp­toms that wor­ry you, such as the fol­low­ing:

• A per­sis­tent change in your bow­el habits, in­clud­ing di­ar­rhoea or con­sti­pa­tion or a change in the con­sis­ten­cy of your stool

• Rec­tal bleed­ing or blood in your stool

• Per­sis­tent ab­dom­i­nal dis­com­fort, such as cramps, gas or pain

• A feel­ing that your bow­el doesn't emp­ty com­plete­ly

• Weak­ness or fa­tigue

• Un­ex­plained weight loss

The im­por­tance of Screen­ing

Screen­ing is the process of look­ing for can­cer or pre-can­cer in peo­ple who have no symp­toms of the dis­ease. Reg­u­lar col­orec­tal can­cer screen­ing is one of the most pow­er­ful tools for pre­vent­ing col­orec­tal can­cer.

From the time the first ab­nor­mal cells start to grow in­to polyps, it usu­al­ly takes about 10 to 15 years for them to de­vel­op in­to col­orec­tal can­cer. With reg­u­lar screen­ing, most polyps can be found and re­moved be­fore they have the chance to turn in­to can­cer. Screen­ing can al­so de­tect a col­orec­tal can­cer ear­ly, when it's small and eas­i­er to treat.

When col­orec­tal can­cer is caught in Stage 1, Can­ce shares, sur­vival chances are in the “mid-90s.” By the time it pro­gress­es to Stage 3, the rate is be­tween 60 and 80 per­cent. At Stage 4, sur­vival chances drop to be­tween 10 and 20 per­cent. Can­ce said he hopes Bose­man’s death will gal­va­nize more peo­ple to get screened.

“In the end, for screen­ing, we al­ways say the best test is the one that gets done,” Can­ce con­cludes.

Look out for HEALTH PLUS every Tues­day for more in­for­ma­tive and health­ful ar­ti­cles. If you have any ques­tions or con­cerns re­gard­ing this top­ic, please email Guardian­Health­Plus2020@gmail.com


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