FAMILY MEDICINE® COLUMN

By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

HEALTHY DIET, WATCHING WEIGHT AND SCREENING PREVENT COLON CANCER

Question: My father was just diagnosed with colon cancer. He had extensive surgery, and the doctors are pretty sure they got all of the cancer. Dad is only 65 and never really had any problems with his bowels. The doctors say my brothers, sisters and I should have some testing done because this runs in families. Besides testing, are there things we can do to prevent colon cancer?

Answer: Colon cancer is one of the most common types of cancer, accounting for about 8 percent of all forms of this disease. The probability of being diagnosed with colon cancer increases with age. Over 90 percent of colon cancer cases are in people over 50.

Before I answer your question directly, a brief anatomy lesson might be of help. The colon, or large intestine, forms the last five to six feet of your gastrointestinal tract. Before arriving in your colon, the food you eat must pass through your stomach and small intestines -- where the nutrients are absorbed into the bloodstream. Once in the colon, water is removed from the leftover products of digestion, and the stool is pushed further along. When it reaches the final six inches of the colon –- an area known as the rectum –- it is ready for elimination from the body through the anus. Since cancer can strike anywhere in the colon, including the rectum, I’ll use the broader term colorectal cancer in the rest of today’s column.

There can be many symptoms of colorectal cancer, but most are very non-specific. These include tiredness, weakness, change in bowel habits, weight loss, abdominal pain, cramping or bloating. Colon cancer can be present for many years before symptoms develop. The symptoms also depend on the location of the tumor. Tumors in the right side of the large intestine can become quite large before they are diagnosed, because the right side of the colon is very wide. Tumors in the left side of the colon have symptoms earlier, since this side of the colon is narrower than the right.

Many risk factors have been identified for colorectal cancer. One of these is having a close relative with the disease. A chronic bowel condition called ulcerative colitis can also increase your risk if you have it for more than 10 years. These factors cannot be changed.

Fortunately, there are some risk factors that you can control. These include smoking, obesity and diet. You can help prevent colorectal cancer by eating a diet high in fresh fruits and vegetables and keeping your weight down. There have been studies suggesting that having a diet high in calcium and taking aspirin can help reduce some types of colorectal cancer. On the down side, research has shown that people who eat a diet high in fat as well as those that eat a lot of red meat have an increased risk of getting colorectal cancer.

And yes, your doctors gave you good advice about the screening tests. Get all that they recommend. Most colorectal cancers start out as precancerous growths called polyps. Having regular colon screening tests so that these polyps are removed as soon as they are found can prevent colorectal cancer altogether. Colon cancer is highly preventable with proper screening.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org