Colorectal Cancer (CRC) is One of the Most Common Causes of Cancer-Related Deaths Worldwide
By: Helge V. Keitel
Who’s at risk?
- All people ages 50-75
- Anyone with a familial history of colon cancer (parents, siblings, aunts, uncles or cousins) should be screened at an earlier age
- People with a history of smoking
- Lifestyles that contribute to lack of physical activity and obesity
- Heavy alcohol consumption
- A person with a personal history of inflammatory bowel disease such as Crohn’s disease or ulcerative colitis, or a genetic disease such as familial adenomatous polyposis or Lynch Syndrome, which is a hereditary non-polyposis colon cancer.
What is a Colorectal Polyp?
Colorectal polyps are growths that appear on the surface of the colon. The types of colorectal polyps are:
- Hyperplastic polyps- which are polyps that are harmless and don’t develop into cancer
- Adenomatous polyps- these are the most common polyps and have the potential to develop into colon cancer
Please refer to the video for a greater detailed description of colorectal polyps.
This video explains the different types of polyps and what they look like:
- Tubular- has holes or tubes
- Villous- has tree like branches
- Tubular Villous- has tubes and tree like branches
- Pedunculate- has a stalk
- Sessile- is firmly and closely attached
Small Polyps-also known as Hyperplastic Polyps are rarely malignant
Large Polyps- often flat and sessile with a greater chance for malignancy
The video goes on to explain that with polyps there are usually no symptoms and they are found with a colonoscopy. A biopsy is done to find out the type of polyp and this is done by doing a polypectomy which is a medical term for polyp removal. This video gives a good overview for anyone who wants to have a greater understanding of the different kinds of polyps and what the risk factors are.
Colon Cancer is Highly Preventable Through Recommended Screening
Screening reduces the disease from colorectal cancer through early detection of cancerous lesions and removal of pre-cancerous polyps.
Types of Colon Cancer Screening Tests
- The number one test is the colonoscopy, which uses a tool to examine the full length of the colon and rectum.
- Flexible Sigmoidoscopy uses a tool to examine a portion of the colon, not the full length, and polyps may be missed.
- Stool-based tests-1.Guaiac-based fecal occult blood test 2.fecal immuno-chemical test (FIT) 3. multi-targeted stool DNA test. If any of these tests come back positive, you most likely will have to go for a colonoscopy for further evaluation.
- CT Colonography, which is a scanning technique that produces images of the colon that are examined by the doctor. This technique may miss small polyps, and if any are seen, they are unable to be removed unless followed by a colonoscopy.
Larry King interviews Dr. Merit Oz on his first colonoscopy experience. Watching the video you see Dr.Oz awake and watching the procedure as it is happening, this is a very unlikely situation. Undergoing a colonoscopy the patient is given either a light anesthesia or conscious sedation and have no recollection of the procedure and in fact usually feel like they have had a nice nap. Dr. Oz explains how he didn’t follow the instructions the day before and ate some solid food instead of just the clear liquids diet as instructed. If your colon is not properly cleaned out it makes it difficult for the physician to visualize your colon and polyps can be easily missed. Dr. Oz was fortunate that a small polyps was found and removed. When going for a colonoscopy give your physician the best opportunity to see what may be in your colon, so follow the prep instructions!
Recommendations
- Colorectal screening can find cancer early when it is most treatable, so its important to be proactive in your screening. Only half of eligible individuals actually undergo colon cancer screening. My question to you is, what is holding you back? The procedure itself is painless because you are given conscious sedation. The hardest part is the day before prep of clear liquids and whatever is prescribed to clean your colon out in order for the gastroenterologist to visualize your clean colon for the chance of polyps.
- Studies have shown that plant based foods are associated with a decrease of polyp prevalence. Plant foods provide the best poly-pharmacy to help protect against the development of malignancy. Remember to eat your green vegetables, fruits and whole grains for added protection. Vitamin D and calcium have also been shown to be beneficial in the prevention of polyps.
Katie Couric and her friend Kim make fun of what people think to be the worst part of a colonoscopy- the prep!
Katie Couric and her friend Kim (who had just turned 50) scheduled a colonoscopy for the same day. The video shows what the prep is like and jokes about what was found on Katie’s procedure. Yet, Kim admits to trying to cancel the colonoscopy due to fear, but reveals how in the end, she was thankful to having gone through with it because a large polyp was found. Kim’s physician explains to her that if the polyp was left growing it could have been a big problem later on. The bottom line- that colonoscopy probably saved her life!
References
- Boyle, M. (2017). Colorectal cancer: An overview.Journal of The Australian Traditional-Medicine Society, 23(3), 140-144.
- Ely, J., Levy, B., Daly, J., Xu, Y., Ely, J. W., & Levy, B. T. (2016). Patient beliefs about colon cancer screening. Journal of Cancer Education, 31(1), 39-46. doi:10.1007/s13187-015-0792-5
- Tantamango, Y. M., Knutsen, S. F., Beeson, W. L., Fraser, G., & Sabate, J. (2011). Foods and food groups associated with the incidence of colorectal polyps: The adventist health study. Nutrition & Cancer, 63(4), 565-572. doi:10.1080/01635581.2011.551988