Everyone, well not everyone but most people are familiar with lung cancer, breast cancer and prostate cancer. For me, I understood smokers are at risk for lung cancer, females for breast cancers (it does affect males also) and after Steve Jobs, prostate cancer for men over forty. But until the beginning of this year, I never knew what colorectal cancer was.
Colorectal cancer, the name itself leaves no doubt that it portends something ominous. And like the majority of my fellow country folk, I was enjoying the bliss of ignorance about most forms of cancers until someone close to somebody close to me was diagnosed with colorectal cancer and it became a new addition to my list of medical terms.
Funny enough, that is, if there is anything funny about cancer, this form of cancer is the third most common type of cancer affecting men worldwide (more than a million cases) and the fourth most common cause of cancer deaths after lung, stomach and liver cancer. So with this type of serious track record, it is quite surprising that majority of Nigerians are totally in the dark about colorectal cancer.
So what is colorectal cancer?
The American Cancer Society defines colorectal cancer (CRC) as the unchecked division (growth) and survival of abnormal cells which occurs in the colon or rectum (the colon and rectum combined are referred to as the large intestine). It begins as a non-cancerous growth in the large intestine called an adenomatous Polyp which could become cancerous as it grows larger with time. Men and women are susceptible to colon cancer but men have more incidence rate for rectal cancer.
Who is at risk of colorectal cancer?
- People over 50 years old, although some cases develop in very much younger folks.
- People with ulcerative colitis and Crohn’s disease
- Heavy smokers and drinkers
- People with Lynch syndrome and Gardner syndrome
- Diabetic patients (Adult onset, Type 2)
- Overweight people and those who do not exercise sufficiently.
Um, although there are genetic factors involved in being diagnosed with colorectal cancer, majority of cases arise from non-genetic causes like old age, poor diets and unhealthy lifestyles. This means that the risk of having colorectal cancer increases with age. Also, excessive smoking and consumption of alcohol, red meat, processed meat and fatty foods puts one at risk of developing colorectal cancer, likewise, insufficient exercising.
What are the signs and symptoms of colorectal cancer?
A few of the symptoms are:
- Dark or black stool
- Blood in stool
- Constipation and diarrhea lasting more than a few days
- Frequent gas pains, bloating and cramps in the lower abdomen
- Unexplained weight loss
- Nausea, tiredness and vomiting
How is colorectal cancer screened and diagnosed?
The screening and diagnostic methods for colorectal cancer are Stool Tests comprising of Fecal immunochemical or guaiac Fecal Occult Blood Test (FIT, gFOBT), and the visual examinations such as colonoscopy, flexible sigmoidoscopy, Virtual colonoscopy/ Computed Tomographic Colonography (CTC) and Double contrast Barium Enema, which all help in confirming the presence or absence of precancerous/cancerous cells. Although colonoscopy is the best test method for diagnosis of colorectal cancer cases, the FOBT is a low cost, low sensitivity stool test effective for screening, which should be done every year. Detection of polyps/adenomas through screening tends to occur 2-3 years before diagnosis of cases with symptoms.
How can we prevent colorectal cancer?
There are four stages of colorectal cancer progression namely: Stage I (carcinoma in situ) whereby the growth is limited to the inner lining of the colorectum, Stage II (Localized stage) when the growth has penetrated the walls of the colon/rectum but has not invaded other tissues, Stage III (Regional Stage) where the lymph nodes and other tissues are affected and Stage IV (Distant/metastasis Stage) whereby other body organs in different parts become affected.
There are a few steps we can take to prevent colorectal cancer. Regular screening is very important especially for males over forty. This aids early detection and removal of precancerous polyps thus preventing the development of colorectal cancer. Early detection reduces deaths from colorectal cancer by 60%.
Indulging in healthy lifestyles (quit smoking and drinking alcohol), regular exercise (get physically active) and proper diets (Avoid junk and unwholesome food) help reduce the risk of having colorectal cancer.
Can colorectal cancer be cured?
Yes! Colorectal cancer can be cured. However, the stage of the cancer determines how effective the treatment is. Early stage (Stage I) colorectal cancer as well as some other cancers can be surgically treated effectively if detected very very early. Adjuvant Chemotherapy and Radiotherapy are additional treatment options for other stages of colorectal cancer. Early detection is key to successful treatment hence the emphasis on regular screening.
Whereby the cancer is at a very advanced stage (with visible symptoms), palliative care is recommended to improve the quality of life of the patient because the survival rate is not encouraging at this stage.
Follow-up surveillance for successfully treated patients in terms of more tests and medical checkups are done regularly to diagnose very early any tumors that may develop later.
What is being done?
Trying to get information about colorectal cancer in Nigeria is difficult. Statistics are quite scarce, probably due to our conventional mode of record keeping. One wonders why such a serious disease like cancer has very few online information resources based on Nigerian data as well as why there is little or no concerted effort at public enlightenment about cancer by our government. Fortunately, there are a few individuals and organizations who have taken up the challenge to create public awareness and advocacy about colorectal cancer.
Participating by chance in one of such colorectal cancer campaigns by Niola Cancer Care Foundation during their “Walk for Colorectal Cancer” on World Colorectal Cancer Day observed on March 3, 2017, I became more enriched by some explanations devoid of many of the confusing medical jargons. In addition to distributing pamphlets containing information on colorectal cancer, the founder of the Cancer Care Foundation, Mrs Eniola Akintunde-Salu spoke (In Yoruba, Pidgin and English) to the public on colorectal cancer during the public enlightenment walk. Her message was clear and simple:
“All cancers, colorectal cancer included are not automatic death sentences, however, early detection is key to effective treatment and survival.”
She enjoined the public, particularly adult males above forty years of age to go for regular screening. To encourage more participation, her foundation spearheaded a public screening exercise at the Mende Town Hall as well as partnered with Chion Family Medical Centre and some other medical facilities to perform in-clinic Fecal Occult Blood (FOB) screening at heavily discounted prices for residents within Mende, Maryland and Anthony in Kosofe Local Government Area of Lagos State.
Colorectal cancer is not caused by voodoo, juju or the devil. It is also not prevented through faith expressions like “it is not my portion,” “Back to sender” and other religious clichés. Regular screening to aid early detection is the best option against cancer and there is no jinx for actions to safeguard one’s health.
“Prevention is better than cure” holds true for cancer cases. The Fecal Occult Blood (FOB) Test cost less than what most adult men and women spend on frivolities.
Painfully, Nigeria is not at the forefront of core cancer research, yet this does not prevent concerted effort by the opportune few to carry out public enlightenment that dispel superstitions and general ignorance about cancer in all its forms as well as encourage proactive steps in the support of the fight against all cancer menace.
It is definitely encouraging to know that something is being done by some people about public awareness for colorectal cancer. It is with this in mind that I say kudos to Niola Cancer Care Foundation, Chion Family medical Centre and other personnel and facilities lending support to the fight against colorectal cancer and other cancer forms.
For further reading, check out the web resources below:
National Foundation for Cancer Research: 9 Must-Know Facts About Colorectal Cancer
American Cancer Society: colorectal cancer facts & figures 2017-2019
Stephanie Watson (WebMD): Top 5 Deadliest Cancers
Wikipedia: Colorectal cancer