Colon Cancer Wrap Up and Prayer

We have learned a lot in our journey to discovery more about colon cancer and some of the ways we can prevent this disease. During our colon cancer series, we learned some interesting facts about colon cancer as well as risk factors for this disease. We also learned how to make changes to our diet and lifestyle in order to lower the risk of colon cancer. We discussed colon cancer symptoms and the importance of early screening and detection. We discussed several screening methods for colon cancer and treatment options based of the stage of this disease at the time of diagnosis. Finally, we took a closer look at stage 4 colon cancer and discovered this disease is curable. Let’s review each topic in detail. Afterwards, I would like to pray for you.

Colon cancer is the second most common cause of cancer related death in the United States. About 140 men and women are expected to die from colon cancer every day. (1) Colon cancer is 25% more common in men than women and African American men represent one of the highest risk groups for colon cancer. About 59% of Americans older than the age of 50 take part in colon cancer screening. Interestingly, up to 53% of men and women over the age of 50 will have a pre-cancerous growth found on colonoscopy. (2) What does this mean? About 40% of Americans are not being tested for colon cancer. In this untested group, half of the them will have the beginning of cancer. This means there is unnecessary death from a disease that is largely preventable. This should not happen.

Colon cancer develops when the chromosomes in the cells of our colon become unstable. About 85% of all colon cancers are due to an instability in the DNA that make up our colon lining. (1) Many genetic mutations need to occur over time for colon cancer to develop. When these mutations build up over time, parts of our normal colon lining turn into an adenoma. Once an adenoma develops, colon cancer is in its infancy. An adenoma can be thought of as the “middle-man” of colon cancer. Adenomas can turn into cancer within 7 – 10 years. (3)

When looking at risk factors, not only can excessive alcohol intake increase the risk of throat, breast, stomach, liver and kidney cancer; it has also been shown that alcohol intake can increased the risk of colon cancer. In those who are moderate or heavily drinkers, there is a 21 to 52% increase in the risk of colon cancer compared with those who are light drinkers of alcohol. (4) At times, we can be a poor judge of our own drinking habits. In general, if you are drinking more than 1-2 alcoholic beverages each day on most days of the week, this is too much. Similar to excessive alcohol use, smoking has been linked to many cancers, including colon cancer, and should be avoided.

Remember, our decisions can greatly affect our chances of getting colon cancer. Weight loss and diabetes control can go a long way to lower our risk of colon cancer. Decreasing, or eliminating, processed and red meat from our diet also has benefits as these kinds of foods seem to have cancer causing properties. (5) If you have any other diseases of your colon, such as ulcerative colitis or Crohn’s disease, it is important that you follow regularly with your gastroenterologist to make sure you are on the right medications to control these diseases as there is a higher risk of colon cancer with these conditions as well.

The symptoms of colon include changes in bowel habits, passing blood in the stool, abdominal pain, anemia or weight loss. One of the most common symptoms of colon cancer is a change in the way someone would normally have a bowel movement. This is called a change in bowel habits. The changes in our bowel habits include experiencing a bowel blockage, constipation, passing “pencil-like” stools or even having diarrhea. At other times, one may experience tiredness from anemia caused by a mass in the colon that bleeds very slowly over time. Furthermore, bleeding from colon cancer can be so small that it cannot be seen with the naked eye. Yet, any blood witnessed in the stool should also be taken seriously and you should see you doctor immediately. Despite knowing the symptoms of colon cancer, it is important to realize that it is our goal to detect colon cancer at an earlier treatable stage before symptoms develop.

One of the most common tests for colon cancer is called a FIT, which stands for Fecal Immunochemical Test. The FIT measures blood in the stool, with the understanding that colon cancer tends to bleed. This test does not detect cancer, only blood. A FIT card should be completed each year. The stool DNA test, also known by its trade name as Cologuard, is a newer test for colon cancer. Unlike the FIT, Cologuard detects cancer directly. The Cologuard test can be done every 3 years. Both the FIT and stool DNA tesy are not good at leading us to the “middle-man” of cancer, adenomas.  This is one of the reasons why a colonoscopy remains the gold standard for detecting colon cancer. Once a FIT or a stool DNA test are positive, a colonoscopy should be performed. Which begs the question: Should I just start with a colonoscopy?

A colonoscopy can not only pick up colon cancer, but also find the middleman of cancer – an adenoma. Even more importantly, adenomas can be removed and treated with colonoscopy. A colonoscopy needs to be done in a hospital or office setting and involves some inconvenience of holding medications, eating a clear liquid diet and “cleaning your colon” with a laxative based solution. With sedation or “twilight,” there is little to no pain or discomfort during a colonoscopy and the procedure is well tolerated. Bleeding following poly removal is one of the most common complications and occurs in about 1 – 2 % of the cases. (6) Before undergoing colonoscopy, speak with your doctor about other complications that may occur. There is an option to have a virtual colonoscopy, but this test is limited to the average risk individual without bowel complaints. Similar to the FIT and stool DNA test, if a virtual colonoscopy finds a polyp or other mass, an actual colonoscopy will be required.

Finally, when we look at the treatment for colon cancer, the decision for surgery or chemotherapy largely depends on the stage this disease. Stage 1 colon cancer requires only surgery and has the highest 5 years disease free survival rate at 90-95%. (2) Stage 2 colon cancer may require chemotherapy if the cancers cells are aggressive. Stage 3 and 4 colon cancer will inevitably require surgery and chemotherapy. With stage 4 colon cancer, the 5-year disease free survival rate is low. Yet, if only a few masses have spread to the liver, stage 4 colon cancer is considered curable in some cases from the perspective of your doctor. In all, at every stage, colon cancer is most treatable when discovered early. Do not be misguided, colon cancer can be deadly and aggressive, but this is one of the most preventable cancers in the United States. Speak with your doctor, remain on guard and do not turn you back on this caner even if you feel “normal.” In the fight against cancer, cancer itself gains the most ground when you have no symptoms at all. The best way to defeat colon cancer is to remove adenomas and pre-cancerous polyps before they grow up to stag 4 disease.

If have concerns about your health or you and loved one are dealing with cancer, I want to pray for you today:

“God You’re are Holy and we trust You. We believe everything you say. We give You ours troubles because we know you can do the impossible. Healing is in Your right hand and we know that you will give generously onto us because You love us. You love us so much that you sent your son Jesus to die for our sins. So, we thank you. We know there is no good thing you will withhold from us. Help us today. We need You. We need Your presence. We need Your strength. We need your direction. Help us to open our hearts and listen when we don’t want to listen. Let us put our guards down and be obedient to those you have sent to help lead us on a path to better health. Let us have a spirit of conviction when we have strayed off this path. Do not turn us over to a reprobate mind, but instead bring us back to You. Whatever diseases are in our body, bring it to our attention. Whatever cancers are growing, show us how to get help. Remove fear and untrust. When we have done all we can, carry us the rest of the way. When we have lost our hope, fill our hearts with joy and heal us. Even if we came to a place in our health due to our mistrust and disobedience, let Your mercy find us anyway. We know that wisdom, long life and healing are in Your hands, so we come to your first. And we thank you in advance for all that you will do in our lives. We thank you in advance for what You have done on the cross. In Jesus name. Amen.”

Remember, no battle is worth winning if you do not know Jesus. Accept Him into your heart, and He will change your life.

REFERENCES
1. Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer Statistics, 2021. CA Cancer J Clin. 2021 Jan;71(1):7-33
2. In Alguire, P. C., & American College of Physicians, (2018). MKSAP 18: Medical knowledge self-assessment program.
3. Heitman SJ, Ronksley PE, Hilsden RJ, Manns BJ, Rostom A, Hemmelgarn BR. Prevalence of adenomas and colorectal cancer in average risk individuals: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2009 Dec;7(12):1272-8.
4. Fedirko V, Tramacere I, Bagnardi V, Rota M, Scotti L, Islami F, Negri E, Straif K, Romieu I, La Vecchia C, Boffetta P, Jenab M. Alcohol drinking and colorectal cancer risk: an overall and dose-response meta-analysis of published studies. Ann Oncol. 2011 Sep;22(9):1958-1972.
5. World Cancer Report. Cancer research for cancer prevention. Available at: https://www.iccp-portal.org/sites/default/files/resources/IARC%20World%20Cancer%20Report%202020.pdf (Accessed on April 27, 2020)
6. Lee L &Saltzman JR. Overview of colonoscopy in adults. In: UpToDate, Howell AD & Grover S. (Eds), UpToDate, Waltham, MA. (Accessed on July 24, 2021.)