Colon and Colorectal Cancer

Colon cancer is the second leading cause of cancer death in the United States. In the U.S., cancers of the colon and rectum combined (colorectal) are the third most common site of new cases. It is estimated that 148,300 will be diagnosed this year and that approximately 56,600 Americans will die of the disease this year. It is estimated that eighty percent of colon cancers occur in people with average risk of the disease, and about 20 percent occur in those at high risk, including those with a personal history of ulcerative colitis or a family history of colon cancer in a mother, father, sister or brother who receives a diagnosis before age 50. Anyone can get colorectal cancer, but over 90% of the cases occur after age 50. The median age at which colorectal cancer occurs is 62 years, but the risk of developing colon cancer starts rising at age 40. In addition, many younger people have colon cancer risk factors.

Rectal cancers occur in the final six inches of the digestive tract. Tumors that arise in the bowel above the rectum are colon cancers.

According to the American Cancer Society, approximately 90% of all colorectal cancer cases and deaths are thought to be preventable. Risk factors for colorectal cancer include a personal or family history of colorectal cancer or polyps, and inflammatory bowel disease. Other risk factors include a sedentary life-style (not enough exercise) high fat/low fiber diet and inadequate ingestion of fruits and vegetables. (Note: Garlic and its cousins (onions, chives, scallions and leeks) appear to help prevent cancers of the digestive system, including the colon and rectum.) 

In addition, according to a study reported by Cancer Epidemiology Biomarkers and Prevention, 2002;11:227-234, people with a family history of colon cancer may be able to reduce their risk of developing the disease with a few simple dietary changes. The study was based on the Nurses' Health Study, an ongoing project that has tracked the health of more than 100,000 female registered nurses in the United States for more than 25 years. It appears a diet high in folic acid, high in methionine (an essential amino acid), and low in alcohol intake, when followed for at least five years, significantly reduced colon cancer risk in those with a family history of the disease. 

As with all cancer, early detection is important. This cancer may exhibit no signs in its early stages. Gradually, as it progresses, any of the following may be noted:  a change in bowel habits, diarrhea, constipation or a sense that the bowel is not empty, blood (either bright red, or dark) in the stool, abdominal discomfort, pelvic pain, weight loss for no apparent reason, constant tiredness and fatigue, anemia due to blood loss, and vomiting.

There are a few tests normally used to diagnose colon cancer. These include:

The fecal blood test. Note: This test can have some false positives, as there are some other reasons for blood in the stool, such as if a person has hemorrhoids.

A sigmoidoscopy presents a visual picture of the colon so a doctor can clearly see the polyps that might be cancerous, but the procedure only looks at the lower part of the colon, and there is some discomfort with the procedure.

A colonoscopy, which is what is often recommended as a follow-up to other procedures if there is evidence of possible cancer, offers the most thorough look at the whole colon and only needs to be done every 10 years if no cancer is found. However, it is more expensive than the other procedures and requires preparation a day ahead of time.

When any suspicious signs or symptoms are encountered, further testing might be done - often a double contrast barium enema (DCBE). If cancer is found, a biopsy is normally performed.

Additional tests that are available include:

Tests for Colon/Colorectal Cancer:

• Carcinoembryonic antigen (CEA) is a cancer marker. Go to our cancer tests page for more information.
  
• DR-70 is a simple blood test - Go to our cancer tests page for more information.
  
• Hemoccult Test for colorectal cancer tests for blood in the stool. A positive finding warrants having further tests, like a colonoscopy or sigmoidoscopy to detect polyps and tumors. This test can be performed by almost any doctor's office. Note: A hemoccult test can yield a false positive if the person has recently consumed fresh fruits and vegetables, red meat, iron tablets or vitamin C tablets. Aspirin and other nonsteroidal anti-inflammatory drugs may also cause false positives. Be sure to discuss this with your doctor.
  
• PreGen-26 - a new DNA Test for Colorectal Cancer is not a predictive test but a test to detect the presence of actual disease in people with hereditary non-polyposis colorectal cancer (HNPCC). People with HNPCC have an 80% lifetime risk of developing the disease. The test, a stool-sample test was developed by Exact Sciences Corp. and is being commercialized by Laboratory Corporation of America (LabCorp, Burlington, NC, USA). In active colorectal cancer, DNA from tumors is shed into the colon and carried out of the body in stool. Patients collect stool samples and send them to LabCorp, who will send the test results to the patient's doctor for use in determining future monitoring and treatment.
  
• CEA is a blood test which indicates the presence of the cancer. Go to our cancer tests page for more information.
  

Once cancer of the colon is diagnosed, more tests are done to find out if cancer cells have spread to other parts of the body (staging) - a surgical procedure is usually performed. Knowing the stage of the disease will assist the doctor in effectively planning further treatment. Often X-rays, CT scans, bone scans, MRIs, and PET scans may be used to determine how advanced the cancer is and if it has spread.

The following stages are used for cancer of the colon:

Stage 0 or carcinoma in situ is very early cancer - found only in the innermost lining of the colon.

Stage I - The cancer has spread beyond the innermost lining of the colon to the second and third layers and involves the inside wall of the colon, but has not spread to the outer wall of the colon or outside the colon. Sometimes called Dukes A colon cancer.

Stage II: Cancer has spread outside the colon to nearby tissue, but it has not gone into the lymph nodes.  Sometimes called Dukes B colon cancer.

Stage III: Cancer has spread to nearby lymph nodes, but it has not spread to other parts of the body. Sometimes called Dukes C colon cancer.

Stage IV: Cancer has spread to other parts of the body, such as the liver, bones, or lungs. Sometimes called Dukes D colon cancer.

Recurrent - The cancer has come back (recurred) after it has been treated. It may come back in the colon or in another part of the body. Recurrent cancer of the colon is often found in the liver and/or lungs.

Many believe many cases begin as polyps, small, precancerous growths on the inner wall of the colon or rectum. If not removed, some polyps can develop into cancer, but they are easily found with screening tests and are often removed during the same procedure.

Colon cancer, if not treated, tends to become advanced and may develop into any of the following complications: Spinal cord compression, brain metastasis, bone metastasis, high calcium levels, pain, high uric acid, pleural effusion, and fluid in the abdomen.  

The most common conventional treatment for colorectal cancer is surgery. Usually this involves the removal of the primary tumor, part of the healthy colon or rectum, and nearby lymph nodes. Sometimes a temporary or permanent colostomy is required. Chemotherapy may be used, especially in later stages of colorectal cancer. Radiation is often used, even in early stages of rectal cancer. Some of the alternative approaches are discussed below.

We don't have the most recent stats, but the American Cancer Society shows the one-year survival rate for colorectal cancer at about 81%. The five-year survival rate is 61%. The 10 year survival rate overall is 50%.

Some of the more alternative approaches to treating colon and colorectal cancer include: Low dose naltroxene - LDN is sometimes used for treating rectal cancer. Laetrile (Vitamin B17) is often used.

RFA - radiofrequency albation is used in cases where colon cancer has spread to the liver. Radio frequency ablation is a technique that employs high-energy radio frequency sound waves to destroy inoperable tumors.

Diet programs seem to help, such as Gerson or Hallelujah diet.  Juicing.

Photodynamic therapy might be used.

Various supplements and herbal products may be used to shrink the tumors. These include Ellagic acid, shark cartilage or shark liver oil, Haelan, BioBac, and more. Hi dose Vitamin C is often used.

For a list of doctors that are comfortable treating colon cancer using alternative or integrated approaches, go to our directory of clinics page. 

More Aggressive Colon Cancer Screening Urged - Reported July 15, 2002 - HealthScoutNews -- More evidence that early screening reduces death from colon cancer has prompted a government group to boost its recommendation that everyone over 50 be screened for the disease. According to The U.S. Preventive Services Task Force (USPSTF), studies show that a fecal occult blood test, a colonoscop, or a sigmoidoscopy are effective is reducing mortality from colon cancer. They feel people at a higher risk for the disease, like those with a family history, should be tested at younger ages, but that 90 percent of colon cancers appear in people over age 50, they feel that is a good age to start undergoing screenings. The American Cancer Society also feels that beginning at age 50, both men and women should have a fecal occult test every year or a sigmoidoscopy every five years, or both, or a barium enema every five to 10 years, or a colonoscopy every 10 years.

Although colon cancer is the second leading cause of cancer death in Western countries, prognosis for people with the disease has been improving in recent years. Better diagnostic tests can uncover the cancer in its early stages, making treatment more effective, and new medical therapies have improved survival rates after surgery.  LAC, which has been used for other types of gastrointestinal surgery, causes fewer complications because it is less invasive, but it has not been used on a regular basis for colon cancer due to the difficulty of performing the procedure. Even more important, LAC patients, particularly those with more advanced tumors, had a 60 percent reduced risk of suffering a relapse of their tumor than those in the conventional group.

Vitamin D May Be Crucial to Protect Against Colon Cancer

New studies by researchers at the Howard Hughes Medical Institute indicate that vitamin D protects against colon cancer by helping to detoxify cancer-triggering chemicals that are released during the digestion of high-fat foods. One should not overdue the amount of vitamin D they take as it can produce hypercalcemia, but if one gets adequate exposure to the sun, the body can manufacture Vitamin D. Go to Howard Hughes' website for more information.