The Tribune

By ALESHA CADET

Tribune Features Reporter

acadet@tribunemedia.net

IN THE medical field, the month of March is dedicated to colorectal cancer awareness. Local doctors and health care providers are hoping Bahamians gain as much knowledge as they can on the disease, more commonly known as colon cancer.

Colon cancer refers to a malignant tumour arising from the inner wall of the large intestine. Nevein Girgis, medical oncologist at The Cancer Centre Bahamas, told Tribune Health, once a colorectal cancer forms, it begins to grow in two ways. First, the cancer can grow locally and extend through the wall of the intestine and invade adjacent structures. Second, as the cancer grows it begins the process of metastasis, shedding thousands of cells a day into the blood and lymphatic system that can cause cancers to form in distant locations. Colorectal cancer, she said, most commonly spread first to local lymph nodes before travelling to distant organs.

Dr Girgis said colorectal cancer in the Bahamas is found significantly in the younger age population, at more aggressive rates than in most other countries.

With the exception of breast and cervical cancer in women and prostate cancer in men, Dr Girgis said colon cancer is the most frequently occurring cancer in the Bahamas.

“It is number two in men after prostate cancer. And number three in women, after breast cancer and cervical cancer,” said Dr Girgis.

While the exact causes of colorectal cancer are not known, Dr Girgis said studies show that certain factors increase a person’s chance of developing colorectal cancer.

Dr Girgis said the factors that increase a person’s risk of colorectal cancer include: high fat intake, a family history of colorectal cancer, the presence of polyps in the large intestine, and inflammatory bowel diseases.

She said the most effective prevention for colorectal cancer is early detection by screening and removal of precancerous colorectal polyps. Even in cases where cancer has already developed, Dr Girgis said early detection still significantly improves the chances of a cure by surgically removing the cancer before the disease spreads to other organs.

She said there are multiple world health organisations that have suggested general screening guidelines at the age of 50.

“Some evidence suggests earlier screening in blacks, or people of African descent at the age of 45. Health care providers may suggest one or more tests for colorectal cancer screening, including a faecal occult blood test (FOBT); sigmoidoscopy; colonoscopy; virtual colonoscopy; or double contrast barium enema (DCBE). New methods, such as the genetic testing of stool samples, to screen for colorectal cancer are under study,” said Dr Girgis.

Colonoscopy, she said, is a procedure whereby a doctor inserts a long, flexible viewing tube into the rectum for the purpose of inspecting the inside of the entire colon. Dr Girgis said colonoscopy is the best procedure to use when cancer of the colon is suspected.

“Colonoscopy is generally considered more accurate than barium enema X-rays, especially in detecting small polyps. If colon polyps are found, they usually are removed through the colonoscope and sent to the pathologist,” said Dr Girgis.

When it comes to being aware of colorectal cancer symptoms, Dr Girgis said when it first develops, there may be no symptoms at all.

As the cancer grows, Dr Girgis said it can cause changes that people should watch for. She said the common signs and symptoms of colorectal cancer include: a change in the frequency of bowel movements; diarrhoea, constipation, or feeling that the bowels do not empty completely; either bright red or very dark blood in the stool; stools that are narrower than usual; general abdominal discomfort such as frequent gas pains, bloating, fullness, and/or cramps; weight loss with no known reason; constant tiredness and vomiting.

“These symptoms may be caused by colorectal cancer or by other conditions. It is important to check with a doctor if you have symptoms because only a doctor can make a diagnosis. Don’t wait to feel pain. Early cancer usually doesn’t cause pain,” said Dr Girgis.

She said persons can take steps to reduce their risk of colon cancer by making changes in their everyday life. “Take steps to eat a variety of fruits, vegetables and whole grains, drink alcohol in moderation, if at all, stop smoking, exercise most days of the week and maintain a healthy weight,” said Dr Girgis.