HEALTH - COLON CANCER (COLORECTAL CANCER SYMPTOMS & TREATMENT)
What is Colon Cancer?
Colon cancer is cancer of the large intestine (colon), the lower part
of your digestive system. Rectal cancer is cancer of the last 6 inches
of the colon. Together, they're often referred to as colorectal
cancer. Colorectal cancer is a disease in which cancerous growths (tumors) are found in the tissues of the colon and/or rectum. The colon and rectum are part of the digestive system. Together they form a long, muscular tube called the large intestine. The colon is the upper five to six feet of the large intestine; the rectum is the last 15 inches of the colon.
The colon and rectum are made of many kinds of cells. Normally, cells divide in an orderly way to produce more cells only when the body needs them. If cells keep dividing when new cells are not needed, a mass of extra tissue (called a tumor) forms. The tumor can be either benign (non- cancerous) or malignant (cancerous). Colon cancer spreads directly from the lining of the colon and into adjacent tissues.
The tumor may spread (metastasize) to other parts of body, such as the lymph nodes, liver, lungs, bones, brain, kidneys and bladder. About 112,000 people are diagnosed with colon cancer annually, and about 41,000 new cases of rectal cancer are diagnosed each year, according to the American Cancer Society.
Most cases of colon cancer begin as small, noncancerous (benign) clumps of cells called adenomatous polyps. Over time some of these polyps become colon cancer.
Polyps may be small and produce few, if any, symptoms. Regular
screening tests can help prevent colon cancer by identifying polyps
before they become cancerous. If symptoms of colon cancer do
appear, they may include changes in bowel habits, blood in your stool,
persistent cramping, gas or abdominal pain.
Globally, cancer of the colon and rectum is the third leading cause of cancer in males and the fourth leading cause of cancer in females. The frequency of colorectal cancer varies around the world. It is common in the Western world and is rare in Asia and Africa. In countries where the people have adopted western diets, the incidence of colorectal cancer is increasing.
Health: Risk Factors of Colon Cancer (Colorectal)
Colon cancer is rare in young people. Fewer than 6 percent of cases occur before the age of 50 years old. Incidences increase markedly after the age of 50, continues to rise until the age of 75, and then tapers off. The average age at the time of diagnosis is 60 years old.
Factors that may increase your risk of colon cancer include:
- Age. About 90 percent of people diagnosed with colon cancer are older than 50. Colon cancer can occur in younger people, but it occurs much less frequently.
- A personal history of colorectal cancer or polyps. If you've already had colon cancer or adenomatous polyps, you have a greater risk of colon cancer in the future.
- Inflammatory intestinal conditions. Long-standing inflammatory diseases of the colon, such as ulcerative colitis and Crohn's disease, can increase your risk of colon cancer.
- Inherited disorders that affect the colon. Genetic syndromes passed through generations of your family can increase your risk of colon cancer. These syndromes cause only about 5 percent of all colon cancers. One genetic syndrome called familial adenomatous polyposis (FAP) is a rare disorder that causes you to develop thousands of polyps in the lining of your colon and rectum. People with untreated FAP have a greater than 90 percent chance of developing colon cancer by age 45. Another genetic syndrome, hereditary nonpolyposis colorectal cancer (HNPCC), also called Lynch syndrome, is more common than FAP. People with HNPCC have an increased risk of colon cancer and tend to develop colon cancer at an early age. Both FAP and HNPCC can be detected through genetic testing. Talk to your doctor about whether your family history suggests you have a risk of these conditions.
- Family history of colon cancer and colon polyps. You're more likely to develop colon cancer if you have a parent, sibling or child with the disease. If more than one family member has colon cancer or rectal cancer, your risk is even greater. In some cases, this connection may not be hereditary or genetic. Instead, cancers within the same family may result from shared exposure to an environmental carcinogen or from diet or lifestyle factors.
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Diet. Colon cancer and rectal cancer may be associated with a diet low in fiber and high in fat and calories. Research in this area has had mixed results. Some studies have found an increased risk of colon cancer in people who eat diets high in red meat and processed meats. People who eat a diet similar to that of Western countries, such as the United States and Europe, have a higher risk of developing colon cancer than do people who eat diets typically seen in developing countries. When people move from a developing country to a Western country and adapt to the Western diet, their risk of colon cancer increases. Although many studies have tried to identify what part of the Western diet may cause colon cancer, the answer remains unknown.
- A sedentary lifestyle. If you're inactive, you're more likely to develop colon cancer. This may be because when you're inactive, waste stays in your colon longer. Getting regular physical activity may reduce your risk.
- Diabetes. People with diabetes and insulin resistance may have an increased risk of colon cancer.
- Obesity. People who are obese have an increased risk of colon cancer and an increased risk of dying of colon cancer when compared with people considered normal weight.
- Smoking. People who smoke cigarettes may have an increased risk of colon cancer. They may also have an increased chance of dying of colon cancer.
- Alcohol. Heavy use of alcohol may increase your odds of colon cancer.
- Growth hormone disorder. Acromegaly, an uncommon disorder that causes an excess of growth hormone in your body, may increase your risk of colon polyps and colon cancer.
- Radiation therapy for cancer. Radiation therapy directed at the abdomen to treat previous cancers may increase the risk of colon cancer.
CANCER FREE
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Health: Causes of Colon Cancer (Colorectal)
Doctors are certain that colorectal cancer is not contagious (a person cannot catch the disease from a cancer patient). Some people are more likely to develop colorectal cancer than others. Factors that increase a person's risk of colorectal cancer include high fat intake, a family history of colorectal cancer and polyps, the presence of polyps in the large intestine, and chronic ulcerative colitis.
Diet and colon cancer
Diets high in fat are believed to predispose humans to colorectal cancer. In countries with high colorectal cancer rates, the fat intake by the population is much higher than in countries with low cancer rates. It is believed that the breakdown products of fat metabolism lead to the formation of cancer-causing chemicals (carcinogens). Diets high in vegetables and high-fiber foods such as whole-grain breads and cereals may rid the bowel of these carcinogens and help reduce the risk of cancer.
Colon polyps and colon cancer
Doctors believe that most colon cancers develop in colon polyps. Therefore, removing benign colon polyps can prevent colorectal cancer. Colon polyps develop when chromosome damage occurs in cells of the inner lining of the colon. Chromosomes contain genetic information inherited from each parent. Normally, healthy chromosomes control the growth of cells in an orderly manner. When chromosomes are damaged, cell growth becomes uncontrolled, resulting in masses of extra tissue (polyps). Colon polyps are initially benign. Over years, benign colon polyps can acquire additional chromosome damage to become cancerous.
Ulcerative colitis and colon cancer
Chronic ulcerative colitis causes inflammation of the inner lining of the colon. Colon cancer is a recognized complication of chronic ulcerative colitis. The risk for cancer begins to rise after eight to 10 years of colitis. The health risk of developing colon cancer in a patient with ulcerative colitis also is related to the location and the extent of his or her disease.
Genetics and colon cancer
A person's genetic background is an important factor in colon cancer risk. Among first-degree relatives of colon cancer patients, the lifetime risk of developing colon cancer is 18% (a threefold increase over the general population in the United States).
Even though family history of colon cancer is an important risk factor, majority (80%) of colon cancers occur sporadically in patients with no family history of colon cancer. Approximately 20% of cancers are associated with a family history of colon cancer. And 5 % of colon cancers are due to hereditary colon cancer syndromes. Hereditary colon caner syndromes are disorders where affected family members have inherited cancer-causing genetic defects from one or both of the parents.
Health: Symptoms of Colon Cancer (Colorectal)
Many people with colon cancer experience no symptoms in the early
stages of the disease. When symptoms appear, they'll likely vary,
depending on the cancer's size and location in your large intestine. Colon cancer can be present for several years before
symptoms develop. Symptoms vary according to where in the large
bowel the tumor is located. The right colon is spacious, and cancers
of the right colon can grow to large sizes before they cause any
abdominal symptoms.
Typically, right-sided cancers cause iron
deficiency anemia due to the slow loss of blood over a long period
of time. Iron deficiency anemia causes fatigue, weakness, and
shortness of breath. The left colon is narrower than the right
colon. Therefore, cancers of the left colon are more likely to
cause partial or complete bowel obstruction.
Cancers causing partial bowel obstruction can cause symptoms of constipation, narrowed stool, diarrhea, abdominal pains, cramps, and bloating. Bright red blood in the stool may also indicate a growth near the end of the left colon or rectum.
Symptoms of colon cancer include:
- A change in your bowel habits, including diarrhea or constipation or a change in the consistency of your stool for more than a couple of weeks
- Rectal bleeding or blood in your stool
- Persistent abdominal discomfort, such as cramps, gas or pain
- Abdominal pain with a bowel movement
- A feeling that your bowel doesn't empty completely
- Weakness or fatigue
- Unexplained weight loss
- Frequent gas pains
- Narrow stools
- Anemia
Health: Diagnosis of Colon Cancer (Colorectal)
In addition to a physical examination, the
following tests may be used to diagnose colon cancer. The doctor
will also ask about the person's medical and family history and will
likely order a full-bowel examination, such as a colonoscopy, described
in the Screening section. If colon cancer is present, a complete
diagnosis that accurately describes the location and spread of the
cancer may not be possible until the tumor is surgically removed.
Biopsy. A biopsy is the removal of a small amount of tissue for
examination under a microscope. Other tests can suggest that cancer is
present, but only a biopsy can make a definite diagnosis of colon
cancer. The sample removed from the biopsy is analyzed by a pathologist
(a doctor who specializes in interpreting laboratory tests and
evaluating cells, tissues, and organs to diagnose disease). A biopsy
may be performed during a colonoscopy, or it may be done on any tissue
that is removed during surgery. Sometimes, a CT scan or ultrasound is
used to perform a needle biopsy (removing tissue through the skin with
a needle that is guided into the tumor).
Blood tests. Because colon cancer often bleeds into the
large intestine or rectum, people with the disease may become anemic. A
test of the number of red cells in the blood, which is part of a
complete blood count (CBC), can indicate that bleeding may be occurring.
Another blood test detects the levels of a protein called
carcinoembryonic antigen (CEA). High levels of CEA may indicate that a
cancer has spread to other parts of the body. CEA is not an absolute
test for colon cancer because it is elevated in only about 60% of
people with colon cancer that has spread to other organs from the
colon. In addition, other conditions may cause a rise in CEA. CEA tests
are most often used to monitor patients already treated for colon
cancer.
Imaging tests
Imaging tests performed before treatment look for cancer that may have spread outside of the colon and rectum.
CT scan. A CT scan creates a three-dimensional picture of the inside of the body with an x-ray machine. A computer then combines these images into a detailed, cross-sectional view that shows any abnormalities or tumors. Sometimes, a contrast medium (a special dye) is injected into a patient’s vein to provide better detail. In a person with colon cancer, a CT scan can check for the spread of cancer in the lungs, liver, and other organs.
Ultrasound. Ultrasound is a procedure that uses sound waves to produce images of the body to tell if cancer has spread to the liver or other organs. Endorectal ultrasound is commonly used to determine the depth of penetration of rectal cancer, and can be used to help plan treatment; however, this test cannot accurately detect metastatic lymph nodes (cancer that has spread to nearby lymph nodes) or metastatic disease beyond the pelvis.
Chest x-ray. An x-ray is a picture of the inside of the body. For instance, a chest x-ray can help doctors determine if the cancer has spread to the lungs.
Positron emission tomography (PET) scan.A PET scan is a way to create pictures of organs and tissues inside the body. A small amount of a radioactive substance is injected into a patient’s body and absorbed by the organs or tissues being studied. This substance gives off energy that is detected by a scanner, which produces the images.
Health: Staging of Colon Cancer (Colorectal)
Staging is a way of describing a cancer, such as where it is located, if or where it has spread, and if it is affecting the functions of other organs in the body. Doctors use diagnostic tests to determine the cancer's stage, so staging may not be complete until all of the tests are finished. Knowing the stage helps the doctor to decide what kind of treatment is best and can help predict a patient's prognosis (chance of recovery). There are different stage descriptions for different types of cancer.Stage 0: Refers to cancer in situ. The cancer cells are only in the mucosa (the inner lining) of the colon or rectum. Most colon cancers at this stage can be treated by polypectomy (removal of the mass of tissue that develops on the inside wall).
Stage I: The cancer has grown through the mucosa and has invaded the muscular layer of the colon or rectum. It has not spread into nearby tissue or lymph nodes.
Stage IIa: The cancer has spread through the wall of the colon or rectum and may have spread to nearby tissue. It has not spread to the nearby lymph nodes.
Stage IIb: The cancer has spread through the colon or rectum to nearby organs. It has not spread to the nearby lymph nodes.
Stage IIIa: The cancer has grown through the inner lining or into the muscle layers of the intestine and to one to three lymph nodes, but has not spread to other parts of the body.
Stage IIIb: The cancer has grown through the bowel wall or to surrounding organs and into one to three lymph nodes, but has not spread to other parts of the body.
Stage IIIc: The cancer (any size) has spread to four or more lymph nodes, but not to other distant parts of the body.
Stage IV: The cancer has metastasized to distant parts of the body, such as the liver or lungs.
Recurrent: Recurrent cancer is cancer that has come back after treatment. The disease may be found in the colon, rectum, or in another part of the body.
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Natural Alternative Treatment: NATURAL CANCER TREATMENT
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Health: Conventional Treatment for Colon Cancer (Colorectal)
The usual treatment of stage 0 cancer in situ is a simple polypectomy during a colonoscopy. There is no additional surgery unless the polyp is unable to be fully removed by polypectomy.
If the cancer is stage I, surgical removal of the tumor and lymph nodes is usually the only treatment.
Patients with stage II colon cancer, which involves deeper penetration of the bowel lining without involving the regional lymph nodes, are advised to talk with their doctor, as some patients are treated with adjuvant chemotherapy. This is treatment after surgery with chemotherapy aimed at trying to destroy any remaining cancer cells. However, cure rates for surgery alone are quite good, and the benefits of additional treatment are still uncertain in this setting. A clinical trial is also an option after surgery. Additional drugsare being investigated in clinical trials in combination with chemotherapy.
If the cancer is stage III and has spread to nearby lymph nodes, the treatment usually involves surgical removal of the tumor followed by adjuvant chemotherapy. A clinical trial is also an option.
For patients with stage II or III rectal cancer, radiation therapy is usually offered in combination with chemotherapy, either before or after surgery.
At stage IV, patients may or may not have surgery to remove the tumor in the colon. Standard treatment includes chemotherapy along with a targeted treatment. If possible, additional surgery to remove metastases (areas where cancer has spread) may also be done. Generally, such surgery is possible if there are a limited number of spots where the tumor has spread that are identified.
Surgery
The most common treatment for colon cancer is surgery to remove
the tumor. Part of the healthy colon or rectum and nearby lymph nodes
will also be removed. While both general surgeons and specialists may
perform colon surgery, many people consult specialists who have
additional training and experience in colon surgery.
Some patients may be able to undergo laparoscopic colon cancer
surgery. With this technique, several viewing scopes are passed into
the abdomen while a patient is under anesthesia. The incisions are
smaller and the recovery time is often shorter than with standard colon
surgery. It appears that the laparoscopic surgery is as good as
conventional colon surgery in terms of its effectiveness in removing
the cancer. Surgeons who perform laparoscopic surgery have been
specially trained in that technique.
In a minority of cases, a person with rectal cancer may need to have a
colostomy, which is a surgical opening, or stoma, through which the
colon is connected to the abdominal surface to provide a pathway for
waste to exit the body; such waste is collected in a bag worn by the
patient. Sometimes, the colostomy is only temporary to allow the rectum
to heal, but it may be permanent. With modern surgical techniques and
the use of radiation therapy and chemotherapy in selected cases before
surgery, most people treated for rectal cancer do not require a
permanent colostomy.
The side effects of surgery include pain and tenderness in the area of
the operation. The operation may also cause constipation or diarrhea,
which usually goes away after a while. People who receive a colostomy
may have irritation around the stomach. The doctor, nurse, or a
specialist in colostomy management (called an enterostomal therapist)
can teach the patient how to clean the area and prevent infection.
Many people require retraining of the bowel after surgery; this may require some time and assistance. People should talk with their doctor if they do not regain good control of bowel function. This is one of the most common side effects of those who have had a large part of the colon removed.
Radiation therapy
Radiation therapy is the use of high-energy x-rays to kill cancer cells
and is commonly used in treating rectal cancer due to the tendency of
this tumor to recur locally. Radiation therapy may be used before
surgery (called neoadjuvant therapy) to shrink the tumor so that it is
easier to remove, or after surgery to destroy any remaining cancer
cells, as both have shown value in treating rectal cancer. One recent
study found that pre-operative radiation therapy in combination with
chemotherapy showed greater benefit compared with the same radiation
therapy and chemotherapy given after surgery. The main benefits
included a lower rate of the tumor coming back in the area where it
started, fewer patients that needed permanent colostomies, and fewer
problems with scarring of the bowel in the area where the radiation
therapy was administered. Chemotherapy is often given at the same time
as radiation therapy (called chemoradiation therapy) to increase the
effectiveness of the radiation therapy. Chemoradiation therapy is often
used in rectal cancer before surgery to avoid colostomy or reduce the
chance that the cancer will recur.
External-beam radiation therapy uses a machine to deliver x-rays to the
site of the body where the cancer is located. Radiation treatment is
given five days a week for several weeks and may be given in the
doctor's office or at the hospital.
In some cases, specialized radiation therapy techniques, such as
intraoperative radiation therapy (a high, single dose of radiation
therapy given during surgery) or brachytherapy (placing radioactive
"seeds" inside the body), may help eliminate small areas of tumor that
could not be removed during surgery.
Side effects from radiation therapy may include fatigue, mild skin
reactions, upset stomach, and loose bowel movements. It may also cause
bloody stools (bleeding through the rectum) or bowel obstruction. Most
side effects go away soon after treatment is finished.
Sexual problems, as well as infertility (the inability to have a baby) in both men and women, may occur after radiation therapy to the pelvis and need to be addressed. Talk with your doctor for more information.
Chemotherapy
Chemotherapy is the use of drugs to kill cancer cells. Systemic
chemotherapy is delivered through the bloodstream, targeting cancer
cells throughout the body.
Chemotherapy may be given after surgery to eliminate any remaining
cancer cells. In some situations, a doctor will give chemotherapy and
radiation therapy before surgery to reduce the size of a rectal tumor
and reduce the chance of cancer returning. Chemotherapy is usually
injected directly into a vein, although some chemotherapy can be given
as a pill.
The most common chemotherapy given for colon cancer may cause
vomiting, nausea, diarrhea, or mouth sores. However, medications to
prevent these side effects are available. Because of the way drugs are
administered, these side effects are less problematic than they have
been in the past for most patients. In addition, patients may be
unusually tired, and there is an increased risk of infection.
Neuropathy (tingling or numbness in feet or hands) may also occur. Hair
loss is an uncommon side effect with the drugs used to treat colon
cancer. There are medications to ease most side effects, including
nausea, neuropathy, and diarrhea. If side effects are particularly
difficult, the dose of drug may be lowered or a treatment session may
be postponed. Patients should talk with their health-care team to
understand when to call their doctor about side effects. These side effects usually go away once treatment is finished.
Targeted therapy is a treatment that targets faulty genes or proteins that contribute to cancer growth and development. These drugs are becoming more important in the treatment of colon cancer.
Anti-angiogenesis therapy. Some of the first targeted treatments focused on stopping angiogenesis, the process of making new blood vessels. Because a tumor needs the nutrients found in blood vessels to grow and spread, the goal of anti-angiogenesis therapies is to “starve” the tumor. One such therapy is bevacizumab. When given with chemotherapy, bevacizumab improves survival in people with advanced colorectal cancer. In 2004, the U.S. Food and Drug Administration (FDA) approved bevacizumab along with chemotherapy for the first-line treatment of patients with advanced colorectal cancer. Recent studies have shown it also to be effective as second-line therapy along with chemotherapy. Bevacizumab is a monoclonal antibody, a substance made in the laboratory that recognizes and attaches to specific proteins on the outside of cancer cells.
Epidermal growth factor receptor (EGFR) inhibitors. Researchers have found that the EGFR protein may contribute to the growth of colon cancer. Cetuximab and panitumumab are monoclonal antibodies that block the EGFR. Cetuximab is an antibody made from mouse cells that still has some of the mouse structure. Panitumumab is entirely made from human proteins and is less likely to cause an allergic reaction than cetuximab. Both drugs are approved to treat patients with metastatic colon cancer.
Recent studies show that cetuximab and panitumumab are not effective in patients with tumors that have specific mutations (changes) to a gene called KRAS. In January 2009, ASCO released a provisional clinical opinion recommending that all patients with metastatic colorectal cancer who may receive anti-EGFR therapy, such as cetuximab and panitumumab, have their tumors tested for KRAS gene mutations. If a patient’s tumor has a mutated form of the KRAS gene, ASCO recommends against the use of anti-EGFR antibody therapy.
Research is underway to determine what role cetuximab and panitumumab might play in patients with metastatic colorectal cancer who’ve had surgery and who have not previously been given chemotherapy.
Advanced or recurrent colon cancer
Colon cancer can spread to distant organs, such as the liver,
lungs, peritoneum (the tissue lining the abdomen), or a woman’s
ovaries. A combination of surgery, radiation therapy, and chemotherapy
can be used to slow the spread of the disease, and, in many cases, can
temporarily shrink a cancerous tumor.
At this stage, surgery to remove the portion of the colon where the
cancer started usually cannot cure the cancer, but it can help relieve
blockage of the colon or other complications. Surgery may also be used
to remove parts of other organs that contain cancer (called resection),
and can cure some people if a limited amount of cancer spreads to a
single organ, such as the liver or lung.
Chemotherapy and radiation therapy at this stage can rarely cure
cancer, but they may help to relieve pain and other symptoms and
prolong survival. Clinical trials that test new treatments may also be
an option.
In colon cancer, if spread is limited to the liver and if liver
resection is possible–either before or after chemotherapy–the patient
has a chance of complete cure. Even in cases where cure is not
possible, surgery may add months or even years to an individual’s life.
Determining who can benefit from surgery in this setting is often a
complicated process that involves collaboration between doctors of
multiple specialties.
Treatment of recurrent cancer depends on where the cancer is located
and the person’s health. Generally, the treatment options for recurrent
cancer are the same as those for metastatic cancer and include surgery,
radiation therapy, and chemotherapy. Clinical trials of experimental
treatments may also be an option.
Get screened for colon cancer:
Regular colon cancer screening should begin at age 50 for people at average risk of colon cancer. Several screening options exist — each with its own benefits and drawbacks. Talk about your options with your doctor, and together you can decide which tests are appropriate for you.
Guidelines issued in 2008 by the American Cancer Society, the U.S. Multi-Society Task Force on Colorectal Cancer and the American College of Radiology include several options for colon cancer screening:
- Annual fecal occult blood testing
- Stool DNA testing, though it's not clear how often this test should be repeated
- Flexible sigmoidoscopy every five years
- Double-contrast barium enema every five years
- Colonoscopy every 10 years
- Virtual colonoscopy (CT colonography) every five years
More frequent or earlier screening may be recommended if you're at high risk of colon cancer. Discuss the benefits and risks of each screening option with your doctor. You may decide one or more tests are appropriate for you. One factor to consider is whether your health insurance covers colon cancer screening.
Medicare covers colon cancer screening procedures. If you're older than 50 and have Medicare benefits, Medicare will cover annual fecal occult blood tests and sigmoidoscopy every four years. If you're at high risk of colorectal cancer, you'll be covered for colonoscopy every two years, or every 10 years if you're of average risk. Double contrast barium enema — which is sometimes supplemented with flexible sigmoidoscopy — can be used as an alternative, if your doctor thinks it's a better choice for you.
Make lifestyle changes to reduce your health risk:
You can take steps to reduce your risk of colon cancer by making changes in your everyday life. Take steps to:
- Eat plenty of fruits, vegetables and whole grains. Fruits, vegetables and whole grains contain vitamins, minerals, fiber and antioxidants, which may play a role in cancer prevention. Try to eat five or more servings of fruits and vegetables every day, and to include a variety of produce in your diet.
- Limit fat, especially saturated fat. Eat a low-fat diet. Avoid saturated fats from animal sources such as red meat. Other foods that contain saturated fat include milk, cheese, ice cream, and coconut and palm oils.
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Eat a varied diet to increase the vitamins and minerals you consume. A number of vitamins and minerals have been linked to a lower risk of colon cancer, though results have been mixed. Studies haven't proved certain vitamins and minerals will stop you from getting colon cancer, but it can't hurt to vary the fruits and vegetables in your diet to ensure you get a wide selection of nutrients. Vitamins and minerals linked to a lower incidence of colon cancer include vitamin B-6 (pyridoxine), calcium, folic acid and magnesium.
Food sources of calcium include skim or low-fat milk and other dairy products, shrimp, tofu and sardines with the bones. Magnesium is found in leafy greens, nuts, peas and beans. Food sources of vitamin B-6 include grains, legumes, peas, spinach, carrots, potatoes, dairy foods and meat. Folic acid is the synthetic form vitamin B-9, and it's used in fortified breads, cereals and supplements. Vitamin B-9 occurs naturally in dark leafy greens such as spinach and lettuce, and in legumes, melons, bananas, broccoli and orange juice.
- Limit alcohol consumption. Limit the amount of alcohol you drink to no more than one drink a day for women and two for men. A drink is a 4- to 5-ounce glass of wine, a 12-ounce can of beer, or a 1.5-ounce shot of 80-proof liquor.
- Stop smoking. Talk to your doctor about ways to quit that may work for you.
- Stay physically active and maintain a healthy body weight. Try to get at least 30 minutes of exercise on most days. If you've been inactive, start slowly and build up gradually to 30 minutes. Also, talk to your doctor before starting any exercise program.
Talk to your doctor about drugs that may reduce your health risk:
Some medications have been found to reduce the risk of precancerous polyps or colon cancer. However, not enough evidence exists to recommend these medications to people who have an average risk of colon cancer. If you have an increased risk of colon cancer, you might discuss the benefits and health risks of these medications with your doctor:
- Aspirin. Some evidence links a reduced risk of polyps and colon cancer to regular aspirin use. However, studies of low-dose aspirin or short-term use of aspirin haven't found this to be true. It's likely that you may be able to reduce your risk of colon cancer by taking large doses of aspirin over a long period of time. But using aspirin in this way is likely to cause side effects, such as gastrointestinal bleeding and ulcers.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) other than aspirin. This class of pain-relief medications includes drugs such as ibuprofen (Advil, Motrin, others) and naproxen (Aleve, others). Some studies have found NSAIDs may reduce the risk of precancerous polyps and colon cancer. But side effects include ulcers and gastrointestinal bleeding. Some NSAIDs have been linked to an increased risk of heart problems.
- Celecoxib (Celebrex). Celecoxib and other drugs known as COX-2 inhibitors work similarly to NSAIDs to provide pain relief. Some evidence suggests COX-2 drugs can reduce the risk of precancerous polyps in people who've been diagnosed with these polyps in the past. But COX-2 drugs carry a risk of heart problems, including heart attack. Two COX-2 inhibitor drugs were removed from the market because of these health risks.
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Sources: NIH News In Health/National Institutes of Health/National Library of Medicine/Dept of Health and Human Services_______________________________________________________________________________________________________
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