How to prevent Colorectal Cancer?

Fond of red meat cooked by barbequed or grilled methods? Better hold back on it to avoid colorectal cancer

Colorectal cancer is a silent killer and ranks third in frequency of cancer occurrences in men and second in women. They are the fourth leading cause of cancer mortality.

The basis of colorectal cancer is the genetic change in the epithelial cells of mucosa. This is brought about by certain mutagens present in diets rich in red meat, especially those cooked by barbeque or grilled methods, and also diets rich in fat content.

Genetic risk factors -Some colorectal cancers occur on account of an inherent genetic defect, giving rise to two basic categories:

• Familial polyposis syndromes
• Hereditary non polyposis cancer

Signs and symptoms of Colorectal cancer

• Bleeding per rectum
• Altered bowel habits (i.e., frequent constipation)
• Abdominal pain and distension
• Weight loss and fatigue
• Vomiting
• Anaemia

How is Colorectal cancer diagnosed ?

Through clinical examination and history, an oncologist pinpoints the diagnosis aided by:

• Faecal occult blood test
• Colonoscopy and biopsy
• CT scan, PET-CT scan (used to stage the disease)

Treatment Options for Management of colorectal cancers

Localized colorectal cancers are managed by upfront surgery followed by chemo radiation if required. However, advanced cancers may require chemo-radiation to downstage the disease followed by surgery.

Surgical procedures typically individualized by site of colorectal cancers are:

• Hemicolectomy
• Proctocolectomy, where the diseased portion of the bowel along with its lymphatic drainage is removed and intestinal continuity restored by anastomosing the cut ends by sutures or staplers.

Rectal cancer

The surgical procedures for the rectum are far more intricate and for long have been dreaded because of the predominance of ablative procedures like abdominoperineal resections, which are associated with a permanent colostomy (i.e. a stoma on the surface on the abdomen through which all fecal contents are evacuated).

Sphincter saving procedures for quick recovery

These are designed to restore intestinal continuity after resection of the diseased segment so that the natural pathway is restored and patients do not need a colostomy. The procedures are:

• Anterior resection
• Low anterior resection of rectum (upto 5cm from anal verge)
• Ultra low anterior resection (upto 2cm from anal verge)

Using these procedures, 90 per cent of rectal cancers can be treated and a colostomy is avoided. These procedures are facilitated by the use of staplers in some cases. Depending on the pathology report of the resected tumour, the exact stage and extent of the disease is known, and additional treatment in the form of radiotherapy and chemotherapy according to the stage is initiated.

How to prevent colorectal cancer?

Various studies now suggest The incidence of colorectal cancer can be significantly reduced by dietary and lifestyle changes. Screening leading to early detection of cancer will lead to higher cure rates and reduce mortality.

Following lifestyle changes can surely help to prevent Colorectal cancer :-

1. High fibre diet (WHO recommendation – at least 25gm/day)
2. Low fat diet
3. Avoidance of red meat, barbequed/ grilled meat.
4. Low alcohol intake
5. Avoidance of tobacco
6. Lifestyle changes – Increased aerobic exercises like running and jogging reduce obesity and the risk of colorectal cancers
7. Secondary screening – It involves identification of high-risk populations:

• Age group of below 45 years
• Inherited colorectal cancer families
• Inflammatory bowel diseases (Ulcerative colitis, Crohn’s disease)

Individuals above 45 years of age are recommended to undergo:

• Fecal occult blood testing yearly
• Colonoscopy once in three years
• Ultrasound abdomen once in three years

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