March is National Colorectal Cancer Awareness Month! Colorectal cancer is a malignant tumour in the colon or rectum, parts of the digestive tract, specifically the large intestine. This condition is something worth talking about because many people will ignore the symptoms of colorectal cancer because of embarrassment or they may think that they have irritable bowel syndrome (IBS). Colorectal cancer is currently Canada’s second leading cause of cancer death. But it doesn’t have to be! Bringing awareness to this disease is important because colorectal cancer is preventable, treatable and beatable! Talking about colorectal cancer will save lives!

Signs and Symptoms

At its early stages, colorectal cancer can remain silent, not producing any symptoms. As it progresses and grows into the surrounding tissues and organs, symptoms will start to present. There are other health conditions such as irritable bowel syndrome (IBS) that can present with the same symptoms as colorectal cancer which may delay testing for some individuals. Please see your doctor if you have any of the following symptoms:

  • Diarrhea
  • Constipation
  • Narrow, pencil-like stool
  • Incomplete evacuation
  • Blood in the stool
  • Bleeding rectum
  • Gas, cramping, bloating
  • Pain/discomfort in the rectum
  • Lump in the abdomen/rectum
  • Fatigue and weakness
  • Anemia
  • Nausea and vomiting
  • Loss of appetite
  • Weight loss
  • Bowel obstruction/blockage
  • Tear/hole in the intestines (can lead to sepsis)
  • Frequent urinary tract infections
  • Swollen lymph nodes
  • Enlarged liver
  • Jaundice
  • Buildup of fluid in the abdomen
  • Pain in the abdomen, buttocks, or legs
  • Difficulty breathing

 Risk Factors

A risk factor is something that will increase the chance of developing a disease, in this case specifically colorectal cancer. Occasionally, however, people with no risk factors can still develop colorectal cancer and so it’s important to get screened if you suspect a problem.

Non-Modifiable Risk Factors

  •  Age: Most people diagnosed with colorectal cancer are over the age of 50 and the risk increases with each decade. However, colorectal cancer has been known to develop in younger people as well.
  • Gender: More men than women develop colorectal cancer.
  • Living in an Industrialized Nation: The number of cases of colorectal cancer are highest in North America, northwestern Europe and Australia. Less industalized countries in Asia, Africa and South America have lower rates.
  • Personal History of Colorectal Cancer: If you have a history of an adenoma (non-cancerous polyp) in your colon, this will increase your chances of later developing colorectal cancer as adenomas are considered precursors to colon and rectal cancer. A person who has a history of colorectal cancer can also develop it again for a second time in other areas of the colon or rectum. The chance is greater if your first bout with colorectal cancer was at a young age (younger than 50 years old).
  • Family History of Colorectal Cancer: the risk of developing colorectal cancer increases if one or more close blood relatives have had colorectal cancer. The risk is higher if it’s a first-degree relative (parent, sibling, or child) that developed colorectal cancer, if more than one first-degree relative developed it or if colorectal cancer was diagnosed in a family member under the age of 50 years old.
  • Inherited Syndromes: Genetic syndromes are diseases that are passed down through family lines. Two such syndromes are responsible for the development of 5% of colon cancer cases: Familial Adenomatous Polyposis (FAP) and Hereditary Non-Polyposis Colorectal Cancer (HNPCC) also known as Lynch Syndrome.
  • Racial and Ethnic Background: African Americans have the highest colorectal cancer incidence and mortality rates of all racial groups, especially those living in the United States. Jews of Eastern European descent (Ashkenazi Jews) have one of the highest colorectal cancer risks of any ethnic group in the world.
  • Personal Cancer History: Women who have had breast, ovarian, or uterine cancer have an increased chance of developing colorectal cancer.

 Modifiable Risk Factors

  • Sedentary Lifestyle/Inactivity: People who are not physically active are more at risk of developing colorectal cancer. You can decrease your risk by engaging in more activity on a regular basis.
  • Diet: There are numerous dietary factors that increase the risk of developing colorectal cancer such as a diet that is high in red meat (beef, pork, lamb, goat) or processed meats, and low in fiber, vegetables, and fruits. Further, a diet that is high in fat or calories can increase your risk. Cooking meat and fish at high temperatures (frying, broiling, or grilling) can create chemicals that can increase cancer risk.
  • Obesity/Overweight: colorectal cancer occurs more frequently in those who are overweight or obese compare to those who are a healthy weight.
  • Alcohol Consumption: Drinking 50 grams of alcohol (~3.5 drinks) per day increases the risk of developing colorectal cancer by about 150% compared with non-drinkers.
  • Smoking: Smoking tobacco increases the risk of developing colorectal cancer. The risk increases with the length of time a person has spent smoking as well as with the amount that is smoked.
  • Inflammatory Bowel Disease (IBD): People with Crohn’s disease and ulcerative colitis are at increased risk of developing colorectal cancer, although the risk seems to be higher with ulcerative colitis.
  • Diabetes: People with type II diabetes are at increased risk of developing colon cancer, perhaps because many of the risk factors overlap between the two diseases.
  • Previous Radiation Therapy: A history of radiation therapy directed at the abdomen to treat previous cancers can increase the risk of subsequently developing colorectal cancer.

 Diagnosis

Routine yearly screening starting at 50 years old is essential for early diagnosis as colorectal cancer doesn’t usually have symptoms in the early stages. Typically this involves testing the stool for blood that cannot be seen (termed occult blood). If this comes back positive for blood, the next step would be to get a scope done with a colonoscopy.

Some doctors will recommend colonoscopy screening to be done every 10 years. At risk patients may be required to undergo a colonoscopy more frequently. In this procedure, the entire large intestine is examined for growths. If a growth is found, it may be removed to check for cancer.

The good news is that colon cancer has an excellent prognosis if it is caught early on, before it has had a chance to spread. By sharing this information with others, you can help bring awareness to colorectal cancer and hopefully save a life!

Dr. Nicole Hartman

About Dr. Nicole Hartman

Dr. Nicole Hartman is a naturopathic physician, a world traveler, a hiker, and a blogger. She focuses her practice in fertility and women's health and takes an integrative, evidence-based approach to healthcare.