Dr. Sanjeewa Aryasingha will tell you that it pays to be on your guard against colon cancer. A Consultant Gastroenterologist and Hepatologist, he knows such a cancer often begins as a small, benign clump of cells known as a polyp in the large intestine or colon. Over time, this unassuming polyp can morph into a life threatening cancer, that can spread throughout the body.
Like other cancers, it too is the result of healthy cells beginning to function abnormally.

Where they would otherwise multiply in an orderly and controlled fashion, they start to divide even when new cells aren’t needed. The first hints come with the appearance of precancerous cells in the lining of the intestine. Over a period of years, it is these polyps that become cancerous. “The idea is that if we catch a polyp early and remove it, we remove the chance of a cancer occurring,” says Dr. Aryasingha, adding “the larger the polyp, the higher the risk of cancer.”

But a polyp can go unnoticed for a long time –it is small and accompanied by few or no symptoms. However, once a cancer has grown past its initial stage, many other symptoms appear, but can vary, depending on the cancer’s size and location in the large intestine. Weakness and unexplained weight loss should ring alarm bells. Get your doctor’s advice if you are experiencing a change in the consistency of your stool or in your bowel habits, including bouts of diarrhoea or constipation. Rectal bleeding is a cause for concern as is persistent abdominal discomfort, such as cramps, gas or pain.

If the cancer lies low in the intestine, patients may complain of a feeling of fullness, as if their bowel hasn’t emptied completely, says Dr. Aryasingha

Since early detection is key, regular screenings are recommended. Guidelines generally recommend colon cancer screenings begin between the ages of 45 and 50. Do you have a family history of colon cancer? The doctor is certain to recommend additional screenings if so, says Dr. Aryasingha. Certain inherited genetic syndromes – such as Familial adenomatous polyposis (FAP) and Lynch syndrome – account for a number of cases. Here are some of the other risk factors that might leave you more vulnerable:

• Being 45 years and over: A majority of colon cancer cases occur in older people.
• A previous diagnosis of colorectal cancer or polyps: You’re more at risk if you’ve already had a bout with colon cancer. Regular screening is advised in such cases.
• Inflammatory intestinal conditions: Chronic inflammatory diseases of the colon, such as ulcerative colitis and Crohn’s disease leave you more vulnerable to colon cancer.
• Sedentary lifestyle: If you’re inactive, you’re more at risk.
• Diabetes: People with diabetes and insulin resistance may have an increased risk of colon cancer.
• Obesity: If you’re overweight, you’re more likely to develop colon cancer and more likely to have trouble treating it.
• Smoking: The habit puts you at increased risk not just for colon cancer but many other health issues.
• Radiation therapy for cancer: Ironically, radiation therapy used to treat an abdominal cancer may increase vulnerability to colon cancer.

Your doctor can find out if you have colon cancer by ordering stool tests that examine the faeces for signs of bleeding and also by examining the large intestine itself directly by resorting to a colonoscopy. The latter also provides an opportunity for a doctor to take biopsies of any growth and remove polyps at the same time, says Dr. Aryasingha.

A barium enema followed by an X-ray could allow the doctor to study your rectum and colon as do CT scans, but these are not as good as a colonoscopy.

If the tests reveal colon cancer, a doctor must identify the extent to which it has progressed to determine the most suitable treatment approach. Options include surgery, chemotherapy and radiation therapy.  However, if the cancer has spread to the liver and lymph nodes, patients may find their condition complicated by other health issues, cautions Dr. Aryasingha, emphasising again that while colon cancer is imminently treatable, it is particularly so if caught early.

Lifestyle changes to  reduce your risk:

• Adopt a varied diet that includes fruits, vegetables and whole grains rich in vitamins, minerals, fibre and antioxidants.
• Quit smoking.
• Exercise every other day for at least 30 minutes.
• Maintain a healthy weight.

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