COLORECTAL CANCER

By Pharm Sejoro Tonuewa

What better way to honour the death of our beloved Chadwick Boseman, the man who played the character of Black panther, (which is arguably one of the most iconic characters in the history of cinemas based on its symbolism especially to negroes) than to enlighten others on the disease that took him, perhaps too early, and maybe save more lives.

Colorectal cancer (also known as colon cancer, bowel cancer or simply CRC) is like the name suggests, a cancer that originates from the colon (large intestines) or the rectum both part of (at the end of) the digestive tract.

Generally, cancers are abnormal growth of cells with a potential to spread to other parts of the body. Cancers are usually named based on the part of the body they originated from.

Colorectal cancer is the third leading cause of cancer in both men and women in the United States, especially affecting black people.

The colon is responsible for absorption of water and salt from the remaining food matter during digestion and the waste matter left is stored in the rectum before being passed out finally through the anus.

Colorectal cancers typically start as polyps in the colon or rectum. These polyps are growths on the inner linings of these organs. It is these polyps that go on to become cancers depending on the type they are. However, not all polyps become cancers.

There are;
Adenomatous polyps: These have a high rate of turning into cancers
Hyperplastic and Inflammatory polyps: More common. Do not readily turn into cancers however, hyperplastic polyps greater than 1cm may lead to cancer.
Sessile serrated and traditional serrated adenomas: High risk of becoming cancerous.

Once these polyps develop into cancers, they may then invade neighbouring cells and even spread to other part of the body.

There is no known cause for colorectal cancers however common risk factors include: Family history of colorectal cancer, African-American race, personal history of colorectal polyps, inflammatory intestinal diseases, lynch syndrome, high fat diet, sedentary life style, diabetes, obesity, smoking, heavy use of alcohol.

Although old age is also consider a factor, and it is advised that people over the age of 50 should regularly screen for colorectal cancer especially if black, colorectal cancer can occur at any age and screening should be considered at younger ages (less than 50) especially with a family history of the disease.

Due to the risk factors, preventive measures that can be advised include: high fibre diet, low fat intake, moderate alcohol intake, exercise regularly, try to maintain a healthy weight and quit smoking.

Symptoms of the disease include:
Blood in stool (hematochezia)
Persistent change in bowel habits
Unexplained weight loss
Persistent abdominal discomfort
Worsening constipation

The treatment of colorectal cancer could be curative or palliative (to relieve symptoms only) depending on the stage of detection.

At stage 1, the cancer is least advanced;

At stage 2, the cancer invades nearing structures.

At stage 3, the cancer spreads to lymph nodes and

At stage 4, it has metastasized (spread to distant organs).

At stage 1, there is higher (90%) chance for cure and lower risk of recurrence and this reduces drastically the later the stage. Therefore, regular screening is recommended for people with high risk.

Different methods exist for screening including: Colonsco0py, and some faecal and blood tests.

Treatments options include: chemotherapy, radiation therapy, surgery, and immunotherapy.