Written by Alexis Dobranowski, a Communications Advisor at Sunnybrook.
What's Your Poo Telling You?
How to S*** in the Woods.
All great books about bowel movements. (Or BMs, or number twos, or poop. Or stool.)
And all just merely a way to get us all in the headspace to talk about this month's health topic: colorectal cancer.
Colorectal cancer is when cancer cells begin to grow in the colon or rectum, parts of the digestive system. The colon takes in water and nutrients from the food we eat and then passes the waste to the rectum (and voila -- poop).
Because of its location in the body, colorectal cancer is an oft-shied away from topic. It's certainly not the first thing people want to talk about at a dinner party, but it should be, says Dr. Shady Ashamalla, surgical oncologist at Sunnybrook and head of the colorectal program.
"We know that early detection is key," Dr. Ashamalla says. "So, talking to your family and friends about this disease -- and the screening program that's in place for it -- could help save a life."
Who is at risk?
"Familial risk depends on what age the immediate family member was diagnosed," Dr. Ashamalla says. "The Ontario screening program starts at age 50. So if your immediate family member was diagnosed before age 60 it's important to tell your doctor."
If your immediate family member was diagnosed at age 54, for example, your screening should start when you are 10 years younger than that. You should start getting screened at age 44.
"We know there are genetic/hereditary disorders that put people at increased risk of colon cancer," Dr. Ashamalla says. "But the majority of cases are sporadic, meaning there's no specific genetic association."
What's the cause?
"It's important to remember there's no good evidence for cause," Dr. Ashamalla says. "There is evidence of association, but that's not the same as cause."
So, alcohol-use, obesity, red meat consumption, low fitness levels have all been found to be associated to an increase in risk. But that doesn't mean those things cause colon cancer.
You can make healthy lifestyle choices to help reduce your risk, he adds.
"Eat a healthy diet with lots of fruits and vegetables and not too much red meat, be physically active, don't drink too much -- they can make a difference in your risk," he says. "That said, you could check off all those lifestyle boxes and still get colon cancer."
Also important to remember, Dr. Ashamalla says, is that there's no scientific evidence that probiotics or colonic cleanses do anything to reduce your risk.
You can check your risk at mycanceriq.ca -- it's a site run by Cancer Care Ontario.
Cancer cells in the colon and rectum can be present long before you have any symptoms. The symptoms don't present themselves until the disease is advanced.
"That's why it's important to get screened starting at age 50 -- or earlier if you have immediate family history," Dr. Ashamalla says.
In Ontario, you can actually do a fecal occult blood test to screen for colorectal cancer from the comfort of your own bathroom. Talk to your family doctor or call TeleHealth at 1-866-828-9213.
Screening doesn't prevent colon cancer. But it catches it early, before you would notice any symptoms. And catching it early means better outcomes.
What to watch for?
There are some symptoms to watch out for:
- Changes in bowel habits, including changes in frequency or in the shape of the stool
- Black stool
- Blood in your stool
- Unexplained fatigue, or a feeling of unwellness that can't be explained
- Unexplained weight loss.
If you have any of those, go see your family doctor. Don't be shy or delay -- early diagnosis is key to better treatment outcomes.
Explore your options
Dr. Ashamalla says treatments for colorectal cancer have come a long way in the past few years, meaning less treatment side effects and better outcomes for patients.
"The treatments for colon cancer can have effects that last a whole lifetime, even if your disease is cured. But there are a lot of new minimally invasive techniques that really are better for patients. It's not a one-size-fits-all treatment approach anymore."
Be sure to talk to your specialist about all your options.
And talk to your family and friends about getting screened. (C'mon you can do it!)
Learn more about cancer prevention and treatment from Sunnybrook experts at health.sunnybrook.ca
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Researchers from Britain and the Netherlands found that the more total dietary fiber and cereal fiber people consumed, the lower their colorectal cancer risk. For example, people who consumed an extra 90 grams of whole grains a day also had a 20 percent lower risk of colorectal cancer, according to the British Medical Journal review. However, that same study didn't show a link between eating fiber from fruits and vegetables and a lowered colorectal cancer risk, meaning there may be something else in whole grains at work, too.
Researchers from the Leiden University Medical Center in the Netherlands found that people who take aspirin once a day have a 30 percent decreased risk of dying from colorectal cancer, if taken for at least a nine-month period. And, the benefit extended to after a person had been diagnosed with colorectal cancer. The researchers found that people who had already been diagnosed and who took aspirin had a 23 percent decreased risk of dying from the disease, compared with people who didn't take it at all.
The Daily Mail reported on a study in mice, published in the journal Molecular Nutrition and Food Research, showing that rats exposed to a carcinogen developed fewer colon cancer lesions than rats if they consumed high-cocoa diets. "Being exposed to different poisons in the diet like toxins, mutagens and procarcinogens, the intestinal mucus is very susceptible to pathologies," study researcher Maria Angeles Martin Arribas, a researcher at the Institute of Food Science and Technology and Nutrition, said in a statement. "Foods like cocoa, which is rich in polyphenols, seems to play an important role in protecting against disease." However, it's important to note that this effect was tested only on mice.
Research published in the journal Cancer Prevention Research showed that taking 2 grams of ginger root supplement every day might have colon cancer-preventing powers. The researchers from the University of Michigan Medical School found that taking ginger root supplements helped to minimize signs of inflammation of the colon, which has been connected to colon cancer.
A study from the University of Texas Health Science Center showed that doctors who conduct colonoscopies while listening to Mozart are more likely to find polyps, which can lead to colon cancer, ABC News reported. The study showed that polyp-detection increased to 36.7 percent from 27.16 percent when the doctors listened to Mozart.
A study in the journal Cancer Causes & Control showed that people who exercise or play sports five or more times a week can lower their risk of developing colorectal cancer, compared with those who don't exercise regularly (or at all), Johns Hopkins University reported. Why exercise might reduce colon cancer risk isn't well understood. It may be because exercise enhances the immune system or because it reduces levels of insulin and insulin-like growth factors, all of which have been associated with colon cancer risk.
A number of studies have linked the consumption of cruciferous vegetables with a decreased risk of colorectal cancer, Oregon State University reported, though the effect may depend on a person's genetic risk. In particular, a study published in 2000 in the American Journal of Epidemiology, showed that people who ate the most cruciferous veggies in a day (about 58 grams per day, on average) had a lower risk of colon cancer compared with people who ate the fewest cruciferous veggies in a day (about 11 grams per day, on average), Oregon State University reported.
A study in mice showed that compounds called anthocyanins, found in black raspberries, seem to have powers at anti-colorectal cancer powers, MyHealthNewsDaily reported. The berries may help to prevent cancer because of their "high antioxidant activity," study researcher Gary Stoner, of the College of Medicine at Ohio State University, told MyHealthNewsDaily; those antioxidants work to fight against DNA-damaging free radicals in the body.
The Doctors and USA Weekend share tips for reducing your risk of colorectal cancer.
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