Colon cancer: Surgery remains only curative treatment modality – Part 1

Dr. Femi Olaleye is an oncologist and medical director of Optimal Cancer Care Foundation. In this interview with GERALDINE AKUTU, he talks about colon cancer and how it can be managed.

COULD you explain what Colon cancer is?
Colon Cancer is cancer of the colon. It is also the most common type of gastro-intestinal cancer – basically the commonest cancer affecting the tissues and organs of the digestive tract. The colon is the large intestine and divided into three parts, the ascending (right) colon, the transverse colon and the descending (left) colon. It can also be referred to as colo-rectal cancer especially if the cancer involves the lowest part of the large intestine (rectum).

What are the signs and symptoms?
Due to lack of widespread screening programmes in most developing countries, we see patients with symptoms of advanced disease with common clinical presentations such as evidence of chronic blood loss, abdominal pains, change in bowel habits and at times, evidence of intestinal obstruction and perforation.

Right-sided cancers are likely to present with bleeding from the back passage and diarrhoea while left-sided tumours are detected much later and present as bowel obstruction with constipation and abdominal swelling and pain with tenderness. There could be associated liver swelling (hepatomegaly) and fluid in the abdomen (ascites).

Who is at risk of developing Colon cancer?
Worldwide, colorectal cancer is the second most common cancer in women and third most common in men. So it is fairly common. Reassuringly though, epidemiologists inform us that Australians/New Zealanders have the highest risks (per 100,000 population, 44.8 in men and 32.2 in women) while West Africans have the lowest risks (per 100,000 population, 4.5 in men and 3.8 in women). Sadly though, the same cannot be said for mortality rates as more cases result in death in developing countries due to late detection and lack of access to good care.

Epidemiologic studies have linked increased risk of colorectal cancer with diet high in red meat and animal fat, low-fibre diets and low overall intake of fruits and vegetables. In particular, cereal fibre, whole grains and yoghurt were found to be effective in reducing the risk of developing the disease.
Obesity, lifestyle choices such as cigarette smoking alcohol and lack of exercise are all associated with increased risk.