What is Colon Cancer and how to treat it before it's too late?

Author: Roy de Souza

In March 1997, Katie Couric was the famous anchor on the Today Show across the US, a mother of two daughters, and the wife of Jay Monahan. Jay was a 41-year-old health conscious lawyer. Jay suddenly received a diagnosis of colon cancer. He died nine months later at the age of 42, leaving his children fatherless and his wife alone. She became determined to help others.

Colon cancer, also called colorectal cancer, usually starts with polyps (small growths) in the colon or rectum. The term colorectal cancer is used to describe colon cancer and rectal cancer. It was sometimes called bowel cancer. The colon is part of the large intestine which is below the stomach.The rectum is further along and is the passageway that connects the colon to the anus or bowel.

The colon and rectum are inside our abdomen, so they are not visible. You can’t easily tell if you have colon cancer. Symptoms to watch out for include new pain below the stomach, change in bowel movements or occult blood (occult meaning you can’t see it) detected in a routine stool test. These symptoms don’t mean that you have colon cancer but suggest that you should be tested for it.

Colon cancer is treatable – especially if caught early enough. We need to catch it when it is only in the colon (before it has spread) to have the best chances to get rid of it. But to catch it early people need to do regular colonoscopies. A colonoscopy means inserting a tube with a camera from the bottom up into the intestine to have a look and see if any cancer is growing in the colon. It is not something that healthy people like to do! But it is painless and harmless.

Two years after her husband Jay died, Couric underwent a televised colonoscopy during her TV Show to show viewers that it was no big deal. So, thanks to the effort of Katie Couric and others many more people across the US now do regular colonoscopies to check whether they have early colon cancer. This saves many lives.

Risk factors that can cause colon cancer

Some things that cause colon cancer are in your control and some are not. To prevent getting colon cancer, focus on the things that you can control, for example, eat green vegetables and brown bread not white bread. According to the American Cancer Society 5 factors that you can control include:

1. Being overweight or obese

2. Physical inactivity

3. Eating red meat and processed meat

4. Smoking

5. Heavy alcohol use

However, there are some risks that you cannot control. So in that case the best thing is to be vigilant and do a colonoscopy or a FIT test. As you grow older, your risk of colorectal cancer goes up. Younger adults can get it, but it’s much more common after age 50.

Cancer.org lists the causes of colon cancer that are not in your control:

 A personal history of colorectal polyps or colorectal cancer

If you have a history of polyps in your colon, you are at increased risk of developing colorectal cancer.

 Inflammatory bowel disease

If you have inflammatory bowel disease (IBD), including either ulcerative colitis or Crohn’s disease, your risk of colorectal cancer is increased. IBD is a condition in which the colon is inflamed over a long period of time. Inflammatory bowel disease is different from irritable bowel syndrome (IBS), which does not increase your risk for colorectal cancer.

 Family history of colorectal cancer

Most colorectal cancers are found in people without a family history of colorectal cancer. Still, 1 in 3 people who develop colorectal cancer have other family members who have had it. So if your father, mother, brother, sister has had it you need to get colonoscopies regularly.

 Inherited form of colon cancer

About 5% of people who develop colorectal cancer have inherited gene changes (mutations) that cause family members to get colon cancer. The most common are Lynch syndrome and familial adenomatous polyposis (FAP). People who have Lynch syndrome have few polyps and develop cancer at a young age. People who have FAP, find hundreds or thousands of polyps in their colon and rectum, often starting at ages 10 to 12 years. Cancer usually develops in 1 or more of these polyps as early as age 20. By age 40, almost all people with FAP will have colon cancer.

What are the treatments?

Fortunately, if you have been diagnosed with this cancer, there are more treatment options now than were available for Jay Monahan twenty years ago. The two main types of treatments are surgery and chemotherapy. Immunotherapy is a new option and may really help. First, make sure if at all possible that you are getting treatment from a major cancer hospital, where they see many cases of colon cancer.

The place you choose should have experienced oncologists who specialise in colon cancer or gastrointestinal cancers. It should also have the latest technology and equipment.

Second, find a doctor you trust and who tells you as much as you want to know. The experience of cancer is psychological as well as physical, and support can help. Don’t overlook the fear, anger, and other emotional “side effects” of being a cancer patient.

Surgery

The surgeon removes the part of your colon that contains the cancer, along with a margin of normal tissue on either side of the cancer. The colon is like a very long flexible plastic pipe. The surgeon can cut out a bad section from the middle of it and rejoin the two ends. The colon becomes a little shorter but works fine. If the cancer has spread, surgery is not so effective.

Chemotherapy

Chemotherapy uses highly toxic drugs to stop the cancer cells growing and kill them. For colon cancer it is usually given after surgery to kill any remaining cells around the body. In some cases chemotherapy is used before surgery to reduce the size of the tumour to make it easier to remove with surgery. There are two main chemotherapies (FOLFOX and FOLFIRI) and two drugs are often added to help (Avastin and Erbitux).

Radiation

Radiation is used on rectal cancer which is right at the bottom and easier to access. It is not normally used on colon cancer which is higher up inside the abdomen.

Immunotherapy

This is a new way to fight cancer. The drugs don’t kill any cancer cells at all. Instead the drugs activate your own immune system to fight the cancer. This type of treatment may become more important in the future. One type of immunotherapy now being developed is called a Personalized Neoantigen Vaccine or Personalized Cancer Vaccine. It is called a vaccine, but it doesn’t prevent colon cancer, it aims to cure patients even when the cancer has spread.

Colon cancer is quite common and if it has spread, it is difficult to treat. It is the 2nd largest cause of cancer deaths after lung cancer. So, if you are worried about cancer and you are a non smoker, then you should watch out for colon cancer.

About the author

Roy de Souza is a tech entrepreneur. When a family member was diagnosed, he moved his focus to curing difficult metastatic cancers for the sake of patients and their families. He has a Masters from Oxford and an MBA from The Kellogg School.