Colon cancer: a quick guideline

Few things are as scary as learning you have cancer—a challenge that more than 18,000 Canadians with colon cancer will face in this year alone. Today, more and more people are surviving the disease, many with complete recovery and cure.

• Colon cancer occurs when abnormal cells grow out of control and form a mass, or tumour, in your large intestine. Doctors often refer to it as "colo­rectal cancer" because a malignancy can arise in either the colon or the rectum. Cancer of the colon and rectum is the third leading cause of cancer deaths in Canada, after lung and breast cancer.
• Usually slow growing, colorectal cancers often originate in a cell with genetic mutations. Some of the genes that allow for cancer cells are inherited, causing colon cancer to run in families. More often, the abnormalities arise spontaneously, although diet appears to play an important role. Many colo­rectal cancers begin in a polyp that eventually forms a tumour.
• Left untreated, the tumour can bleed, obstruct your intestines or break through your bowel wall. Eventually cancer cells may also spread to lymph nodes or penetrate other organs.

• At diagnosis, colon cancers are graded to indicate how aggressive they are, and tests are done to determine whether the cancer has spread (metastasized) into lymph nodes or other tissues.
• Each cancer is ranked according to a four-stage scale, often expressed as I through IV, to determine therapy and prognosis. People with stage I cancer, confined to the lining of the colon, have the best outlook.

More than nine out of 10 patients with early-stage tumours will be alive five years after their diagnosis. If cancer has not reappeared during this time, you're considered cured. Those with higher-stage tumours generally do not do as well, though most with stage II or III cancers can be effectively treated.

• Testing: Colonoscopy, blood tests and radiological scans to help determine if your cancer has spread and what the best treatment options are.
• Surgery: to remove the tumour and surrounding tissue.
• Drugs: In certain cases, cancer drugs (chemo­therapy) may be given after surgery.
• Radiation: In certain cases, radiation treatments may be needed before or after surgery.

• To prevent colon cancer, reduce your dietary fat: A number of studies have shown that people who eat a lot of animal fats have an increased risk of colon cancer.
• Stay positive: A diagnosis of cancer is often overwhelming. Marshal your energies to gather information and resources.
• De-stress before surgery, if possible: Meditation, exercise, yoga, biofeedback, massage and breathing exercises may be useful.
• Try ginger if nausea is a problem because of chemo­therapy: A cup of ginger tea or the powdered herb (100 to 200 milligrams) every four hours may quell symptoms; take it with food to avoid stomach irritation. But do let your doctor know if you are trying ginger or other remedies.
• Get regular follow-up tests: Blood and stool should be tested on a regular schedule to prevent colon cancer and to help detect any recurrence. The Canadian Cancer Society recommends anyone age 50 and over have a fecal occult blood test at least every two years. After surgery and every few years, a colonoscopy will be necessary. During this procedure, the doctor can remove pre-­cancerous growths called polyps and very early-stage cancers.

• The Colorectal Cancer Asso­ciation of Canada (CCAC) maintains a comprehensive website with links to active clinical trials, news articles, pharmaceutical sites and support groups (1-888-318-9442 or www.colorectal-cancer.ca/).
• The Canadian Cancer Society (1-888-939-3333 or www.cancer.ca) has in-depth research, statistics and tips on reducing your risk of colon cancer.