Dr. Kassam Your Guide To Colorectal Cancer

Your Guide To Colorectal Cancer

 
 

Facts About Colorectal Cancer

CRC is diagnosed in the colon (large intestine) and/or the rectum with rapidly dividing tumour cells. It is one of the most common types of cancers in humans and is the fourth leading cause of tumour related deaths worldwide. It affects more than 26,000 Canadians a year. 90% of people diagnosed with colorectal cancer are over the age of 50, however it can happen earlier in life, most notably when there is a family history. 
 
 

Risk Factors

There is no single cause of colorectal cancer but rather a combination of them, including: 
  • Being over the age of 50 
  • A diagnosis of inflammatory bowel disease (ex. Ulcerative Colitis or Crohn’s Disease)
  • Family History of colorectal cancer in first degree relatives
  • Personal history of other cancers
  • Sedentary lifestyle
  • Diets high in meat, processed foods and low in fiber
  • Smoking
  • Excessive amounts of alcohol
  • Obesity 
  • Diabetes
 

Signs & Symptoms 

Unfortunately, most people with colon cancer do not have symptoms in the early stages of the disease. But when you do see some signs popping up it is important to see your doctor right away as survival rates rise when colorectal cancer is found early and treated. In general, signs and symptoms of colorectal cancer can include the following: 
  • Changes in bowel movements
  • Pain with bowel movements
  • Changes in the quality of stool
  • Blood or mucus in stools
  • Abdominal pain
  • Unexplained weight loss
  • Fatigue
  • Problems related to blood loss (anemia, fatigue, shortness of breathing, chest pain) 
  • Not feeling completely empty after a bowel movement as a result of the tumor

 

Screening for Colorectal Cancer

Screening for Colorectal cancer in those over 50 years of age is the key to prevention. The Centers for Disease Control and Prevention (CDC) recommends for anyone over the age of 50 to do an fecal occult blood test (FOBT) every year, a sigmoidoscopy every 5 years and/or a colonoscopy every 10 years. 
 
Usually, if the FOBT is positive it is followed up with a colonoscopy or sigmoidoscopy. 
  • Sigmoidoscopy - Examines half of the colon
  • Colonoscopy - Examines the entire colon
High risk populations may require more frequent screening at an earlier age. High risk includes:
  • A 1st degree relative with colorectal cancer
  • A personal history of colorectal cancer
  • A personal history of benign polyps in the colon or rectum
  • Diagnosis of Inflammatory Bowel Disease

 

Naturopathic Recommendations For Prevention

Currently, clinical treatment of CRC involves surgery and chemotherapy. However, as we all know there are a plethora of side effects that come along with these treatment options. Natural products that are well tolerated and have less toxicity can help patients achieve better treatment outcomes and improve overall quality of life.
 
Prevention, especially in those who are at a higher risk of colorectal cancer is the first and most important step in the fight against cancer. While there are many risk factors that cannot be changed like, age and family history there are many risk factors that can be changed like, dietary choices, regular physical activity, smoking cessation and limiting alcohol consumption. 
 
Naturopathic medicine can reduce the risk of initially developing colorectal cancer and act as supportive treatment in combination to radiation and/or surgery.
 
 

Lifestyle Changes

  • Increase Exercise - There is lots of data showing an inverse relationship with physical exercise and colorectal cancer risk. Some studies have shown that regular exercise can cut the relative risk of colorectal cancer by about half! A study by the world cancer research fund found that physical activity was associated with a 15% reduction in colon polyp risk.
    • Even just walking for 30 mins a day has been shown to decrease all cause mortality. Being active on an everyday basis can include everyday activities like gardening, housework, dancing, walking to and from work and so forth. 
  • Don’t smoke - Smoking has been linked to many different types of cancers as well as other diseases. Keep in mind that it is never too late to benefit from quitting smoking. Read Allen Carr’s book,  ‘Easy Way To Smoke Smoking’ if you are looking for a resource to help you quit. 
  • Limit alcohol consumption - People who drink about 2 standard drinks of alcohol a day have about a 20% increased risk of developing colon cancer. In addition, people who drink regularly often do not have a healthy diet, so they will lack important nutrients like Vitamin D, calcium, and folate that are very important against the fight against colorectal cancer. 

Dietary Changes

  • Eat Foods High in Fiber -  A diet that is high in fiber has been shown to lower the risk of CRC. It helps by increasing the amount of time stool is spent in the colon and helps to eliminate it faster.
    • Fiber is found in whole grains, legumes (beans, peas, lentils) vegetables (specifically, cruciferous vegetables), seeds and some fruit.
    • Consumption of whole grains specifically has been associated with a decreased risk of developing colorectal cancer. 
  • Decrease inflammatory foods like red, processed, charred meats and fried foods - When meat is cooked at high temperatures (ex. Frying or barbequing), it creates cancer-causing chemicals.
  • Increase specific foods that have been shown to reduce the risk of colon cancer:

Nutrients in Preventing Colorectal Cancer

  • Calcium - Most people know calcium as it is related to healthy bones but calcium plays a very important role in the prevention of cancer. Calcium binds to carcinogenic bile acids and makes them inactive to reduce overall toxicity in the gut.
    • Foods high in calcium include: dairy products, beans, lentils, poppy, sesame, chia seeds, sardines and almonds
    • Supplement form: Dose: 1,200-2,000 mg/day of Calcium carbonate as it contains a higher amount of elemental calcium. 
  • Vitamin D - Vitamin D supplementation may be associated with up to a 50% reduction in colon cancer risk. Higher intake and higher circulating levels of Vitamin D are inversely associated with CRC risk.
    • The major source for Vitamin D is the sun. Optimal daily UV-B sunlight exposure translates to an oral dose of 20,000 IU.
    • Dietary sources include: Fish (salmon, mackerel, sardines)
    • Supplement form: Dose: 1,000 IU/day of Vitamin D
    • Always remember calcium and Vitamin D work better when taken together 
 

Nutritional Supplements in Preventing Colorectal Cancer

  • Omega-3 fatty acids - Studies have suggested that omega-3 fatty acids may reduce the risk of developing colon, breast and prostate cancer due to its anti-inflammatory effects. Fish oil may help reduce the growth rate of colon cancer cells.
    • Try adding more cold water fish to your diet, like salmon and halibut. 
    • Dose: 2-3 g a day of Omega -3 fatty acids 
  • Probiotic - Probiotics are a collection of “friendly” bacteria that help to maintain a balance between the “good” and “bad” bacteria in the gut.  A healthy microflora can influence the environment in the colon. 
 
 
 
All patients need to be screened for colorectal cancer at the age of 50 since symptoms at early stages are not always present. Earlier screening can be considered in patients who are of higher risk. Prevention, especially in those who are at a higher risk of colorectal cancer is the first and most important step in the fight against cancer. Making an effort to change the modifiable risk factors like, reducing smoking, alcohol intake and increasing exercise while changing one’s diet can go a long way in preventing colorectal cancer. 
 
 
 
 
 
References:
  1. Abeloff: Abeloff’s Clinical Oncology, 4th ed. Colon Cancer. Churchill Livingstone. 2008. Ch. 81
  2. Naturopathic Medicine Clinic of Excellence
  3. Kaczor. T. (2012). Colorectal Cancer in Primary care. Natural Medicine Journal
 
 
 
 
 
 
 
 
** Disclaimer: The advice in this article is for informational purposes only. It does not replace the care of a Naturopathic physician.