Uneasy Stomachs
Colon cancer is a silent killer, but with regular screenings, proper diet, and the latest technologies, you can detect—and perhaps even prevent— this “equal opportunity” disease.

First, the good news: For the past 20 years, the number of people dying from colorectal cancer has been dropping. The bad: There were still 147,000 new cases diagnosed last year, keeping the disease on pace to remain the second-leading cause of cancer-related deaths (lung cancer is No. 1). Colorectal cancer strikes men and women in equal numbers and doesn’t discriminate based on race or ethnicity. In other words, no one is safe. But regular screenings and a colon-healthy diet combine to provide the best defense against what is otherwise an equal-opportunity killer.

Screen for Life

The best way to safeguard your health and maybe your life is to get screened. Colon cancer is often referred to as a “silent killer,” since it is typically symptom-free until it has progressed beyond a treatable stage. “Screening is so important because an absence of symptoms doesn’t automatically mean an absence of disease,” says Thomas Amrick, MD, a gastroenterologist at Overlook Hospital. And if you are diagnosed with colorectal cancer in its early stage, the five-year survival rate is better than 90 percent. In this case, what you don’t know can hurt you, which is why your best bet is to have a colonoscopy.

The American Cancer Society recommends colonoscopy screenings beginning at age 50 for men and women without any symptoms and no family or personal history of colorectal cancer or colon polyps. “Fifty has become the magic number, since research has shown a sharp rise in the incidence of colon cancer after this point,” says Amrick. “Before age 50, the colon cancer risk for a person with no history of the disease is 6 per 100,000. But after age 50 it’s almost 10 times higher, jumping to 65 for every 100,000.” Regardless of age, Amrick warns patients never to ignore symptoms that last longer than a week, including changes in bowel habits or pain or bleeding when you have a bowel movement. Anemia also can be a sign that something is wrong.

Explains Amrick, “The theory behind regular screenings for colon cancer is based on findings that the disease may actually have an evolutionary phase in which it transitions over a period of time from something like a non-malignant polyp to something more sinister.” In the 1940s—before definitive tests like the colonoscopy—doctors would measure the risk of malignancy by the size of a colon polyp; rather than removing it immediately, they would sit back, watch it grow, and operate only if it became problematic. “But now that we can remove polyps on the spot, we’ve not only decreased the mortality rates of cancer but the incidence of it as well. That’s what’s so exciting and significant about colon cancer screening, since it actually has the power to prevent you from developing the disease.” In fact, in just the past 30 years, the death rate from colorectal cancer has dropped an impressive 40 percent.

Before performing a colonoscopy, your gastroenterologist will assess your personal risk for colon cancer. This risk is significantly higher if you have a family history of the disease (meaning a parent or sibling who had colon cancer) or a personal history of colon polyps. Where you live also can affect your risk of developing the disease. The incidence of colon cancer tends to be higher in urban areas and in manufacturing regions, which is why screening in these areas is especially important. Consider this: Just 15 years ago, New Jersey had very high colon cancer rates, but with better and more frequent screenings (plus all we’ve learned about healthy eating), those rates have dropped to be more in line with the national average.

Colonoscopy and Beyond

A colonoscopy involves a gastroenterologist or colorectal surgeon using a lighted scope to view the inside of your colon. The test is performed under sedation and is fast and painless. Preparing for the test tends to get a bad rap, but it involves little more than following a clear-liquid diet one day prior to the test and using laxatives to empty your bowel. “Right now, colonoscopy is the best tool we have for preventing colon cancer and reducing the mortality rate of the disease, since it’s readily available, widely accepted, and has a high degree of sensitivity,” says Amrick. But there are other, less invasive tests available now and on the horizon.” One example is the use of virtual colonoscopy, which allows doctors to view the colon non-invasively, much in the same way they view the brain during a CT scan. Another test being studied is the fecal DNA test, which can pick up the small DNA particles thrown off by colon polyps. If a DNA polyp particle was found, a colonoscopy would then be used in follow-up. “In the future, this could be a good test for low-risk, symptomless patients,” says Amrick, “but right now it’s just not sensitive enough and misses almost half the polyps that would otherwise be found with a colonoscopy.”

Food for Thought

When it comes to a healthy colon, you really are what you eat; diet has been found to play a huge role in lowering your risk of colon cancer. Gale Reed, an outpatient dietician at Overlook Hospital, states that the two most important nutrients in keeping your colon healthy are fiber and phytochemicals.

“Studies show that the incidence of colon cancer is lower among populations with high-fiber diets,” she says. “This is due to the fact that fiber speeds up the transit time of solid waste, and decreases the contact time between cancer-causing toxins and the mucosal cells of the colon.” Experts recommend that women get 25 grams of fiber per day and that men get 30 grams, but the reality is that most Americans get only an average of 15 grams per day. So how can you put more fiber in your diet? The key is to start slow. “Don’t go from 15 grams a day right to 30,” says Reed, “and be sure to drink plenty of water to prevent constipation and blockages.”

Many plant-based foods contain phytochemicals, which are high in cancer-fighting antioxidants like vitamins C and E. And it’s these nutrients that protect cells from free radicals and prevent the damage caused by toxins, pollutants, pesticides, and radiation—all of which are processed through the colon. To incorporate more phytochemicals in your diet, fill your plate with foods like garlic, broccoli, Brussels sprouts, beans, onions, tomatoes, and cauliflower. “It’s also important to eat a variety of phytonutrients, rather than just one or two, since they all work differently and in tandem to keep you healthy,” Reed says.

It may not be easy to follow a sensible diet all the time—and few people look forward to a colonoscopy—but the benefits far outweigh the inconveniences. Remember, when it comes to preventing, detecting, and beating colorectal cancer, your life really is in your own hands.

For a referral to a gastroenterologist, call (866) 432-6743.