Fight colorectal cancer

With Prevention and Timely Screening

Our colon: an extremely significant determinant of overall health, an area replete with nerve endings and chemical changes affecting every other body system and, unfortunately, an oft-ignored health subject. For many people, constipation or diarrhea call only short-term attention to its wellbeing. Even physicians often fail to recommend diet improvements and early disease screening. We take our colons for granted.

ILLUSTRATION

Recently, however, steady news of prominent colorectal cancer sufferers including Ronald Reagan, Vince Lombardi, Tip O'Neill, Steve Allen, Jackie Gleason and Senator John Tower -- some of whom caught the disease in the early, highly curable stages, some who did not -- has raised public awareness. In the past six months alone, actress Audrey Hepburn (age 63) and comedian Cleavon Little (53) succumbed to this "silent killer."

One of the most under-detected cancers, colorectal cancer (CRC) results in approximately 160,000 new cases and 60,000 deaths a year (for both sexes) -- making it the #2 lethal carcinoma right behind lung cancer. On the other hand, it is a cancer for which prevention and regular diagnostic screening can make a tremendous impact. CRC has an impressive 90% 5-year survival rate with early detection -- when symptoms have yet to appear, tumors are localized and lymph nodes are uninvolved. The key here is early detection.

RISK FACTORS
One in every 20 adults over age 40 will get CRC -- especially higher risk groups: those over 50 blacks those with a personal or family history of cancer, colon or rectal polyps, or chronic and inflammatory bowel disease (such as chronic ulcerative colitis and Crohn's disease) and those with poor dietary and elimination habits.

"For persons who have a first-degree relative (parent, sibling) with colorectal cancer, risk is increased two and a half times and the usual surveillance should begin ten years earlier," says Dr. Robert G. Norfleet, gastro-enterologist at the Marshfield Clinic, WI, and member of Smith-Kline Diagnostics (SKD) Colorectal Health Panel: "Normally, digital rectal examination should begin at age 40, stool testing (FOBT) and flexible sigmoidoscopy at age 50. However, those with risk factors other than age need earlier, more frequent, and perhaps more extensive screening"

CRC AND RACE
Thirty years ago, the overall death rate for cancer was similar for all races. But, today, general cancer mortality has risen 66% for black men and 10% for black women. For all people, lack of CRC awareness, aversion to colon discussions, exaggerated fear of tests and delay of diagnosis are maininly to blame.

Although the exact cause of colorectal cancer is not known, high-fat, high-protein, low fiber diets and over-processed, nutrient-poor foods are often cited. According to the Journal of The National Medical Association ("Colon Cancer in Blacks: A Disease With a Worsening Prognosis"): "Blacks of all socioeconomic classes have consumed this potentially carcinogenic diet quite out of proportion with the general population for most of their existence in America."

DIET FACTORS
A diet low in fat and high fiber could reduce the chance of getting CRC by more than 50%. Bulky, fiber-rich foods help gastrointestinal peristalsis and inhibit the production of cancer-causing agents. According to private gastroenterologist, SmithKline panelist, and cancer expert Dr. Arthur Hoffman. "Dietary exposure to animal fats --especially sausage, fatty beef, and organ meats such as kidney, liver, and brains -- is a definite problem. These fats are a particular danger because fat is where pesticides concentrate in animals. When eaten in combination with a low fiber diet the bowels slow down, causing these dangerous substances to stay in the vulnerable colon longer."

According to Harvard research, red meat tends to promote colorectal cancer. Even worse, it's not simply the fat in the meat is bad, but that the amount of meat considered safe in CRC is zero. A high amount of the antioxidant beta carotene (a preventive nutrient for heart disease and cancer) is present in dark orange and dark green vegetables such as carrots and spinach, and the good news is that "light cooking" (steaming, quick microwaving, short boiling and stir-frying) releases more beta carotene and boosts absorption, according to prominent University of Illinois researcher, John Erdman, Jr. An Italian study from the Catholic University of Rome cites exciting evidence that generous amounts of seafood (fish oil contains omega-3 fatty acids) squelch cell changes that lead to colon cancer, and may even prevent abnormal cell growth in the first place.

The American Cancer Society has found that high fiber diets (especially vegetable, fruit and grain ingestion) as well as alternate-day aspirin doses reduce the risk significantly. Specific food recommendations emphasize yellow-green vegetables including cabbage, cauliflower and especially broccoli (which John Hopkins researcher say contains a powerful anti-cancer agent), tomatoes, whole grain breads, bran cereal and foods rich in vitamin A (carrots, apricots, egg yolk, fish liver oils, low-fat dairy foods, etc., which protect the gastrointestinal, urinary and respiratory system linings).

The better the elimination is, the higher the potential for colon health. Sluggish elimination debilitates the entire body, pollutes blood, creates fatigue and lessens removal of cancer-causing wastes. Aloe vera, buckthorn, acido-philus, senna, cascara sagrada, apple pectin and foods such as papaya and fennel (which also aid digestion) are often recommended. When snacking, vegetables, fruit, granola and butter-free popcorn are good choices.

EARLY DETECTION
Because CRC is "silent" in the early stages, patients should be alert to maintaining regularity and colon health. If one waits for pain, bleeding, and changes in stool size or bowel habits, they risk progressed disease -- when cure rates drop to 30-40%.

Despite American Cancer Society (ACS) recommendations for annual stool testing, 60-70% of our population (especially seniors and lower socioeconomic groups) is not aware of the simple, efficient, low-cost take-home stool tests -- fecal occult (unseen) blood tests (FOBT) --that physicians can order. One common FOBT test is called Hemoccult, which must be dispensed by an MD and lab processed. It costs less than $25.00.

According to Certified Nurse Practitioner, Joyce Avel who is President of Colon Cancer Prevention, Inc., Minneapolis, MN (herself a CRC survivor): "Together, stools tests and sigmoidoscopy are a best-bet approach to CRC detection. The flexible sigmoidoscope (which is much more comfortable now than in the past ) provides a direct view of the lower 1/3 of the colon, while FOBT check for hidden bleeding throughout the colon."

MORE INFORMATION
Organizations presenting a lecture and/or organizing a screening may obtain pamphlets on this important subject. Write to: Colorectal Health Awareness, SmithKline Diagnostics, C/O JC&A, 310 University Avenue, #212, Palo Alto, CA, 94301. Health professionals and the public are welcome to inquire about additional materials.

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By Linda M. Jekel, M.S., RN.

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